Half of teens outgrow depression and anxiety

Teen mental health problems are not a ‘life sentence’. Image from shutterstock.com

Around half of teens who experience a brief episode of depression or anxiety do not go on to have a mental illness in adulthood, according to a study from the Murdoch Children’s Research Institute.

Half of girls and almost one-third of boys have an episode of depression or anxiety in their teens but rates drop sharply when young people reach their 20s.

The study is published today in The Lancet medical journal.

The researchers followed more than 1,900 adolescents from 1992 to 2008, assessing them for mental disorders at five points during adolescence and three in young adulthood.

The study defined depression and anxiety as a “level at which a family doctor would be concerned”.

“The good news is teen problems are not a life sentence,” said lead author Professor George Patton. “Many of these problems, particularly if they’re brief and last for six months or less, or in boys, tend to get better.”

This might be the result of adolescent development, including maturation of the brain systems involved in social and emotional processing, and learning new cognitive and emotional skills.

Or it could be that young people are successfully transitioning into young adulthood: completing education, leaving home, and developing relationships. “These things might be kicking in and making a positive difference in their lives,” Professor Patton said.

Yet, reaching your 20s without problems is not a guarantee against mental health problems. Almost one in five participants had their first episodes in their 20s, suggesting the risk period for onset of depression and anxiety problems extends into young adulthood.

Professor Louise Newman, Director of the Centre for Developmental Psychiatry and Psychology at Monash University, said the study was well conducted and gave an accurate picture of the prevalence of mental illness among young Australians.

“Because it’s an epidemiological study, it raises some tantalising questions about how we can better understand the risk factors for mental illness,” said Professor Newman.

Professor Newman pointed out however that the study didn’t distinguish between different types of depression and issues related to personality development, which “in the real world, overlap”.

She said it was interesting the researchers found an association with parental separation and divorce, and episodes of mental illness among adolescents, which suggests social contexts impact vulnerability.

Treatment

The study authors suggest that early interventions which shorten the duration of episodes of depression and anxiety could help prevent much mental illness later in life.

“If things are not getting better and have been continuing for months, that is the kind of situation where seeking help from a GP, a trained counsellor or psychologist, or an organisation like Headspace would make sense,” said Professor Patton.

“But for many of these kids, they will get over these problems. In this instance, the intervention we’re talking about is not an intervention with medication or even formal psychotherapy, it’s about allowing the young person to talk about the problems in their life and come to solutions that work for them”, he said.

University of Adelaide professor of psychiatry Jon Jureidini warned that benefits of medical therapies for depression were often over-stated.

“It’s always assumed that treating depression will improve those outcomes in the long term but there’s no evidence to support that,” Professor Jureidini said.

“The most often-given treatment would be antidepressants and not much else. And that’s not the right treatment for depressed adolescents.

"The right treatment for depressed adolescents is to try to understand what’s going on for the person. Depression is not a description, not an explanation.

"We should never ignore young people’s distress but taking it seriously doesn’t mean we need to treat it – there might be other responses to it.”

Child and adolescent psychiatrist Dr Peter Parry agreed, saying it was important to be wary of biological explanations for adolescent emotions.

“It reads as a very good epidemiological study but with nearly half of males and two-thirds of females having at least one episode of clinical anxiety or depressive disorder, we are almost talking about universal human experience,” he said.

“Another aspect is that anxiety and grief are normal mammalian responses to loss and stress. Not all suffering is abnormal – the context always matters – though help in normal suffering is still often needed and can lead to increased insight, maturer coping strategies and resilience.”