Depression is often a chronic illness. New Duke study shows half of depressed teens relapse, girls are twice as likely to relapse

by Kristen McCLure

A new study at Duke studied 196 adolescents with major depression. All of the teens whether they received Prozac, Prozac and therapy or just therapy got better. The fourth group, which received a placebo, also got better. The symptoms resolved within two years. This is consistent with what we know that most depression abates on its own, eventually.

Unfortunately, after five years at least half of these teens had experienced a recurrence. The kind of treatment they received did not have any bearing on this. However, girls were more likely to relapse than boys, and those with anxiety were also more likely to have a recurrence. This and other research is leading professionals to view depression in teens as chronic condition which waxes and wanes.

In therapy it’s important to have a final phase of treatment which consists of teaching teens and families how to identify their symptoms if they should return, how to utilize the coping skills learned in therapy, and when there is a need to attend booster therapy sessions.

I teach my teenagers, and adults, when they come to therapy for the first time about relapse. It is important in treatment for adults to think back to when their first episode was, and how many they have had! Early onset is an important predictor of recurrence.

Treatment of depression is the same as that for a chronic physical illness. You need to permanently change your life. Adults and teens suffering from depression need to constantly monitor their stress level, the health of their social relationships and the state of their thinking patterns. Depression is a chronic illness that can be managed with lifestyle changes, the acquisition of new skills and a careful approach of being aware of the choices you are making in your life.

Although this research may seem discouraging, it also speaks to the ability to recover. All of the participants got better within two years. From previous research we also know that therapy does help. Teens who are resistant to the first antidepressants tried are more likely to get better with a switch to a different medication, and the addition of therapy, then just a switch in medications. Teens that have a positive response to medication and then receive psychotherapy are more likely to resist relapse than those who don’t receive any psychotherapy
This study helps clarify that their needs to be a psycho educational component in therapy addressing the likelihood of re occurrence as well as a cautiously optimistic outlook on the future for these teens, should they continue to monitor their symptoms and utilize the skills which they have learned in therapy.

Curry J, et al "Recovery and recurrence following treatment for adolescent major depression" Arch Gen Psych 2010; DOI: 10.1001/archgenpsychiatry.2010.150.

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