1. Depression in teenagers

2. Distress/depression Clinical depression is an extreme form of distressed mood. Differs mainly in seriousness. Distress : few hours to a few days Depression : affected for weeks or months

3. Signs and symptoms Less able to study (concentration) Do not want to see their friends Family and social lives impaired Much more likely to harm themselves Blame themselves for what they have done in the past See no hope for the future

4. Signs and symptoms Think people regard them as useless, unattractive,unlovable

5. Who ? About one in twenty adolescents (5 %) Frequency continues to go up into adulthood especially in women. Genetic predisposition More likely Hx of past physical or sexual abuse or neglect

6. Risk groups : Asperger’s Asperger’s syndrome : primary school somewhat eccentric but as teenager may become aware of their social isolation. Attempts to join in are met with ridicule May retreat into their own world,losing interest in social interaction and personal hygiene

7. Risk groups : ADHD

8. Risk groups : Tourette’s Many reasons The tics NOSI Bullying Long term condition

9. Why now? No indication hormones play a role More aware of disempowerment, frustration and a sense of impotence The family is often not set up to give their teenagers the autonomy to which their competence should entitle them Can feel trapped in school (bullying) without legitimate escape

10. Suicidal attempts England : every year 7-8/1000 girls between 15 and 19 and 2-3 boys this age make suicidal attempts. Mainly OD Peak age in girls 17, then very slow decline

11. Suicide Same pattern as attempts Extremely unusual under 14 yrs Rate stabilises by the end of teens until elderly when slight increase.