Treating Depression in Children and Adolescents

Karen Schaefer- In many ways, Kati Goetz is a typical 19-year old. She favors fashionable clothes, flaunts her bright red hair, and enjoys hanging out with friends. But a few years ago, Kati wasn't sure that she would live to see the onset of adulthood.

Kati Goetz- In my mind, I wasn't going to make it past 18. I was either going to die or I was going to kill myself...There was a part of me inside that was dying. I was literally dying. I was killing myself inside, because of how much pain I was in.

KS- Shortly after she entered high school, Kati was diagnosed with clinical depression, in her case the result of both biochemical and environmental factors. But Kati knew something was wrong long before that.

KG- I had always known there was some sort of first real incident was when I was 13 and I went through a little bout of anorexia...I guess halfway through my freshman year was when I started getting depressed. I started cutting myself a lot...About a month or two after I first started doing that was my first suicide attempt.

KS- Kati's mother, Pat Goetz, is a Stark County psychiatrist specializing in children and adolescents. Despite her professional training, Pat says she didn't recognize the red flags in her daughter's behavior.

Pat Goetz- ...she's the last child in the world that I thought would have a problem like this...I kept saying no. Not my family. This isn't happening to us...It was a very, very, very frightening experience.

KS- Pat says involving her daughter in positive peer group experiences was a key element in her recovery. But while Kati got the help she needed, it's estimated that only one in 35 children suffering from depression are receiving the proper treatment. Goetz maintains that one of the biggest barriers is recognizing the symptoms. Those can range from sadness to passiveness, be signaled by eating or sleeping disorders or simply by sudden changes in behavior. Teenagers, especially boys, may be prone to fits of anger. Even very young children can suffer from depression. Dr. Sylvia Rimm, director of the Cleveland Clinic's Family Achievement Center, says that's why it's important to seek professional help in making a diagnosis.

Dr. Sylvia Rimm- Children don't really have a lot of insights about what's really happening, but they can give you a lot of hints and clues when you ask them what's wrong or what's right with their life...The underlying cause could be biochemical or situational...The most important way to deal with depression with children initially is through psychotherapy.

KS- Dr. Rimm says treatment for depression in young children typically includes several sessions with a psychologist or psychiatrist. For older children, medications such as Prozac may also help children conquer their feelings of helplessness and despair. But while depression can be treated successfully, Pat Goetz says there's still a significant social stigma attached to mental illness.

PG- I have to tell you that as a professional in the field, when my daughter developed depression, I was very surprised how people pulled away, colleagues. I really had a sense of being blamed...Even today I find people start feeling uncomfortable when I start telling them about the fact that I had a daughter that was depressed.

KS- Amy Levin is director of the Lorain County Board of Mental Health. She says the high cost of psychiatric care may also play a role in limiting treatment.

Amy Levin- Through many or most insurances, someone with a chronic mental illness may have a cap on their insurance or five hundred or a thousand...That is a terrible deterrent.

KS- To supplement that need, Levin says some Ohio counties have a mental health tax levy that, among other things, provides financial support for low-income families. In Lorain County, voters have supported the mental health levy for more than two decades. In Cuyahoga County, funds have been provided for nearly thirty years by a levy shared with Health and Human Services, but the pool of money is small. Mental health experts hope that educating more people about childhood depression will help parents seek out diagnoses and treatment for their depressed children. In Cleveland, I'm Karen Schaefer for 90.3 WCPN, 90.3 FM.

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