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Depression:
Youth, Counselling and Antidepressants
The
advent of modern antidepressant medication has been a lifesaver to many.
Recent research demonstrates that a combination of counselling and
medication can provide the most effective treatment for youth suffering
from depression. However, there is evidence to suggest that in the early
stages of medication treatment, there is an elevated risk of suicidal
thought, which for some persons may lead to suicidal behaviour. This is
causing a great many people to reconsider their use of medication, even
when indicated.
This
issue is determining which youth will benefit from one or the other or
both treatments. To this end a good assessment will look for exogenous
factors and endogenous factors.
Exogenous factors are those things outside of the individual that may
contribute to depression. These include; family dysfunction, abuse or
neglect, parental separation, school related problems and relationship
problems. If it can be determined that one or more of these kinds of
factors are at play, then counselling alone may be sufficient to treat
depression. Such counselling includes family therapy, or in the case of
separated and fighting parents, mediation to help them resolve their
conflict, so that the youth is no longer subject to their turmoil. If the
youth is in a difficult interpersonal relationship, then counselling for
the youth to address the difficulty may be in order. If the youth is
abused or neglected, these issues must be addressed and the youth’s
safety must be attained.
Endogenous factors generally relate to biological or neurobiochemical
factors. If there is a history of depression in the family and there are
no known exogenous factors, then medication alone may be the treatment of
choice. Often though, with endogenous depression, the sufferer has
difficulty controlling depressive thoughts and as such, in this situation
a very specific form of counselling, CBT or Cognitive Behavioural Therapy,
is also indicated.
There are times of course when both endogenous and exogenous factors are
at play. In these circumstances a combination of counselling and
medication could be in order and should seriously be considered.
Parents and youth are cautioned against making their decision solely on
the basis of newspaper articles proclaiming the good or the bad about any
treatment. Depression is a serious disorder, which left untreated can lead
to suicidal thoughts, action, injury and death. If you or your child is
depressed, obtain a good assessment by qualified professionals that will
look at both endogenous and exogenous factors and devise a treatment plan
accordingly. Further, the counsellor and the prescribing physician should
be working hand-in-glove following the individual to manage safety issues
and communicating regularly about progress.
It
is important to know that with antidepressant medication, it can take a
good thirty days before the therapeutic effect is achieved. During this
time, counselling may be of benefit to resolve other issues as listed
above or to simply provide support until the medication reaches
effectiveness.
If
you or your child is depressed, get help. It is often advisable to start
with your family doctor or community clinic. A physician can make the
diagnosis and direct you to treatment.
-----------------
Listen
to a 20 minute discussion on Teen
Depression
Interviewer:
Aurelia Williams of www.parentingmyteen.com
Gary
Direnfeld, MSW, RSW
(905) 628-4847
gary@yoursocialworker.com
www.yoursocialworker.com
Gary Direnfeld is a social worker. Courts in Ontario, Canada, consider him
an expert on child development, parent-child relations, marital and family
therapy, custody and access recommendations, social work and an expert for
the purpose of giving a critique on a Section 112 (social work) report.
Search Gary’s name on GOOGLE.COM to view his many articles or visit his
website. Call him for your next conference and for expert opinion on
family matters. His services include counseling, mediation, assessment and
assessment critiques.
Buy
the book:
For
information on Direnfeld's book, Raising Kids Without Raising Cane,
click
here.
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