Pediatricians have new guidelines for depression screening in teens.

Family, health tips, parenting, pediatrics, teens, Uncategorized

It has been over ten years since the initial publication of the American Academy of Pediatrics (AAP) endorsement of guidelines for Adolescent Depression in Primary care (GLAD-PC).  The newest endorsement was released weeks after the most recent horrific school shooting trauma in Parkland, FL.

In our current society teens are at risk for depression and other mood disturbances like anxiety when exposed to traumas such as school shootings, cyber bullying, teen dating violence and even social media influences.  Those are all in addition to just normal puberty hormonal changes that can also affect mood.  Depression can look different in teens and can often present in the doctor’s office as somatic complaints like, “He’s been really tired.” or “She can’t remember things I tell her. It’s hard for her to concentrate.” Very seldom will an adolescent report having a problem with their mood.  It is estimated that 1 in 5 adolescents will suffer from depression prior to their adult years.  Although depression is treatable more than 50% of cases of adolescent depression does not get identified.

Depression is more than an occasional sad mood or defiance to the family rules.

Here are a few ways depression may present in your teen:

  1.  Poor performances in schoolwork when previously doing well.
  2.  No longer showing an interest in former social activities or hobbies.
  3.  Decreased energy.
  4.  Sleeping more or sleeping less.
  5.  Substance use.
  6.  Low self-esteem. Poor body image. Feelings of unworthiness.
  7.  Isolating themselves. Withdrawing from friends and family.
  8.  Lack of motivation.
  9.  Irritability, aggressiveness, outbursts, agitation.
  10.  Changes in eating habits.
  11.  Poor concentration.
  12.  Suicidal thoughts.  Self-harming behaviors.

One of the major updates in the new guidelines includes universal yearly screenings for all children ages 12 years and older.  The AAP also endorses the use of a formal depression self-reporting tool.  The prior guidelines only supported systematically identifying risk factors without any universal screening.

These screenings should be implemented during:  1. well child exams,  2. for adolescents who present with chronic somatic complaints  or 3.  if there are risk factors for depression like a family history of depression, trauma, substance use or psychosocial stressors. There should also be a time during your teens visit that they will be interviewed alone by their pediatrician. This helps to establish a rapport and to allow your teen to freely discuss what is on their mind. However, it is also important to have the guardians insight and even more important to include the physician, teen and guardian(s) all together when establishing a safety plan.

The safety plan needs to restrict any means an adolescent might have to committing suicide, removing firearms from the home, designating a trusted adult they can speak to during a crisis.  According to the CDC, depression can lead to suicide. Suicide is the second leading cause of death in children ages 10-24. The National Suicide Prevention Line is  available 24/7.  They provide free and confidential support and crisis resources for people and their loved ones during times of distress.

The new depression screening guidelines were updated to help primary care physicians screen for depression in adolescents in the primary care settings.  It is imperative to start the screening early during this era of shortage of behavioral health resources.  If your teen meets the criteria for mild depression this can be managed by your pediatrician.  For moderate to severe depression, starting an anti-depressant may be required. This therapy should be managed by your pediatrician in adjunct with a mental health professional who can provide psychotherapy simultaneously.

In summary, our children deserve the best and it is important to identify signs of depression early on for the best possible outcomes.

 

 

 

 

 

 

 

P.S. Remember you can book an appointment with me for any pediatric non-emergent illnesses like ear aches, rashes, vomiting, pink-eye etc. or for any parenting questions about pediatric illnesses, behavior, mood or development.

All posts containing medical information are for informative purposes only and is not direct medical advice nor establishes a patient-physician relationship. 

Photo by G. Madeline on Unsplash.

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Baby’s First Flight

Family, Toddler Life, travel, Uncategorized

Sweet Sage’s  first flight of 2018 is actually her 24th flight of her life.  Wait! Maybe it’s number 26, I have lost count.  Where is she going so often, you ask? I’m pretty sure she has more airline miles than I do and any day now American Airlines should be sending her an enrollment form for their “elite gold members club”.  But I digress, today’s flight had me sitting in the window seat (as usual) feeling cramped like a dried out sardine thinking, “Never again”. Traveling with a toddler, alone, is NO JOKE!

Do you want to know why?

From slamming window shields up and down repetitively, similar to how she performs her favorite song “Open shut them”, or as she calls it “sha shutt”! To walking down the plane aisle during boarding testing out every seat like she’s Goldilocks. She doesn’t understand yet that although they all feel hard as crap some are more pricier than others despite being in the back of the plane.

Oh, how could I forget about the middle of the airport meltdown as I’m packing up bags and breaking down strollers- that just about broke my shoulder. There we were, middle of the busy turnpike. Passengers and workers walking in all crazy directions and the 2.5 ft toddler running aimlessly in the OPPOSITE direction of our gate.  The gate agent is on the mic in the background announcing for group eight to board.  They only have nine board groups.  Our board group is number SIX!!!  I’m down on my knees, in the middle of the busy turnpike of people,  with a food bag in one hand, stroller clutched by my pinkie finger, backpack strapped on and trying to clutch the pinky of the toddler with my free finger on the opposite hand.

Oh no! Not the grab and hold move.  Every mom of a toddler knows that’s a fight waiting to happen. To the ground she melts like lava. SCREAMING!!! MELTING!!!! My “Mommy MacGyver” system is now falling apart. In the middle of the freaking turnpike while the agent is calling the LAST BOARDING group. We’re two gates away! Remember, I chased her in the opposite direction!!!!

We finally get BACK to our gate. I sit her down. Regroup. Search for my inhaler. Wait, I’m not an asthmatic but I felt like one in that moment. My cup spills all over the stroller spilling ice everywhere. Everywhere right where I am preparing to have my ticket scanned by the agent.

ICE!!!  Ahhh, her favorite non- nutritious thing to demand whenever it is in sigh. This toddler loves ice so much I have to hide my cups at restaurant’s under the table or on the seat.  Honest truth. Back to that fallen ice.  Welp, you can guess what happened next. Toddler win. Down the jetway we go. She runs. I waddle, holding on to wet items and open cups. On the plane we go. Second plane of the day. I let her lead and off she takes. Shout out to passenger in seat 29E who pointed his finger over his seat to let me know where she was “hiding”. Of course I knew where she was. No sense in chasing her with bags and open cups.

Speaking of bags and open cups, I sit the cup down in the middle seat. I retrieve the toddler who is NOW eight rows further back and return to our seat. Shimmy my way in to the window seat and, bam!  The open cup spills all over the middle seat and inside the bag of fresh food.  Food that was intended to be my breakfast, lunch, dinner and SANITY during this eight-plus hour travel day. Does toddler care? Nope she’s climbing seats. I’m hot. I’m sticky and I’m starving!!!

Anyone ever been so happy to have that middle seat open when traveling? I know right! Well having TWO empty seats open is like the lotto for this tired traveling mama. I think the guy in the aisle seat didn’t want to take any chances after that cup incident so he graciously moved to the row behind us.  Good looking out sir!

Welp, here I am now 34k feet in the air. Writing, eating cold soggy fries. They were at the bottom of the bag. The bag that the open cup spilled into, remember? Where’s the toddler you ask? Asleep. On those two empty chairs, resting peacefully as she once did when she was an itty bitty baby way back in the days of her former travels? Ha! No she’s lying right on top of me making my right arm go numb. So blame any and all of  my typos on that!

Happy Travels!

Sweet Sage’s Mom

Welcome

Family, Uncategorized

Hello,

We are glad you found our blog.  Who are we? Mommy and Sage. Well mainly mommy since all Sage likes to do at this point is slam down the laptop or bang on the keys like it’s her piano.  Wait, she doesn’t even own a piano so maybe I am not exactly sure what she is doing.  For me, mommy or “Dr. Mom”, I will be doing most of the writing here.  Hoping to share my parenting experiences thus far (new mom), funny toddler stories (plus the ones that are going to turn my sandy -brown hair to grey any day now) and pediatric health tips and current guidelines from my website: https://www.facebook.com/CTilfordMD/ (not meant to serve as a replacement of continuity of care with your medical provider).

Thank you for joining us!

Blessings,

Dr. Mom and Sweet Sage.