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What's a parent to do? The warning signs of teenage depression sound like the hallmarks of just being a teenager: irritability, changes in sleep, problems concentrating, sadness and crying.
But spotting depression in a teenager -- and then taking the right steps to relieve it -- can make the difference between life and death.
Nobody said parenting was easy, and parents today get conflicting information.
For example, some experts offer hope in the newer antidepressant medications. But the manufacturers of Paxil and Effexor have written "Dear Doctor" letters advising against the use of those drugs by teenagers. Studies suggest the drugs actually can increase suicidal thoughts in kids.
The parents of Sean Fitzpatrick, the 16-year-old who brought a gun to Lewis and Clark High School on Monday, did not recognize his state of mind, according to a statement released Tuesday by the boy's attorney.
"He was apparently suffering from severe mental problems which had not been recognized by his family, friends, or teachers," the statement read in part.
The following tips for parents were gathered Tuesday from three experts: Lee Judy of the American Association of Suicidology in Washington, D.C.; Dr. Jeff Lindenbaum, medical director of teen health for Group Health Cooperative in Seattle; and Dr. Michael Manz, a psychiatrist and chief of youth psychiatric services at Sacred Heart Medical Center in Spokane.
•Encourage kids to exercise, which releases the body's natural opiates -- endorphins.
•Watch for changes in behavior that last about two weeks. Changes could include aggression or withdrawal, sleeplessness or sleeping a lot. It's the change that's important.
•Approach without judgment. "You seem to be different. You used to hang out with your friends, and now you're in your room all the time. What's going on?"
•Approach with love. "I'm your parent, and I love you."
•Pay attention to your gut feelings as a parent. If you think something's wrong, it probably is.
•Take seriously any talk about suicide from a teenager, such as, "I might as well kill myself."
•Talking to a mental health counselor can help an adolescent get back on track. But don't rely on school counselors; they have too many students in their caseload.
•If considering medication, talk to a psychiatrist, rather than another type of doctor. Be willing to closely monitor for side effects. More research is needed on antidepressants and the developing brain.
•Worried parents can get information from a national suicide help line with an easy-to-remember number: (800) SUICIDE. That's (800) 784-2433.
The shred of good news is that youth suicide rates fell between 1990 and 2000, possibly because of better screening and public awareness -- although those reasons are guesses, said Judy of the American Association of Suicidology.
The national suicide rate for 15- to 24-year-olds was 13.2 per 100,000 in 1990. It was 10.4 per 100,000 in 2000.
Overall suicide rates also fell during that time period.
•Carla K. Johnson can be reached at (509) 459-5148, or by e-mail at carlaj@spokesman.com.
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