Every year in America 2 million teenagers become seriously depressed. Teen depression affects school life, home life and life itself since these teens face an increased risk for suicide. Teens who become severely depressed also face a higher chance of needing to combat depression all through life. Recent research suggests that interventions based on cognitive behavioral therapy (CBT) could be used with young people considered high risk or double risk for depression to prevent the disorder. CBT is based on the premise that how a person thinks (cognition) drives how that person feels and acts (behavior). Most people’s thinking and emotions drive their behavior with very little evaluation in between. It’s empowering to learn that a person can take control of their thoughts and thereby redirect their own emotions and behavior. In life, difficult situations rarely change, but CBT teaches teens that how you think about the situation and how you react to it can be changed. Things commonly explored during CBT therapy are questions like:
- What is it that I think versus what is it that I feel?
- How do negative thoughts drive negative feelings?
- Some thoughts come unbidden like a well-rehearsed script. Are those thoughts accurate?
- How can I become more aware of my thoughts and how can I redirect them? How can I re-write the script that I hear in my mind?
The randomized study of over 300 teens was headed up by a researcher from Vanderbilt University. Each teen in the study had a personal history of depression, or at least had experienced symptoms of depression. Each teen also had at least one parent with either presently occurring or past depression. Having a parent with depression is also a risk factor for depression, hence the double risk for the teen – personal and parental history of depression. The full study appeared in the Journal of the American Medical Association Psychiatry. The participants were divided in half, with 50 percent receiving standard care and the others receiving a CBT-based prevention program. The teens were treated at multiple sites. Those teens receiving CBT treatment met for group sessions one time per week for eight weeks and each session lasted an hour and a half. During the program teens were taught how to problem solve and given opportunities to put those skills into practice. Homework is also part of CBT therapy. With teens the ideal situation is for the therapist to begin the skill training but to hand off homework and skill teaching to the parent at some point. Brief intervention is a hallmark of CBT therapy with treatment rarely lasting beyond 20 sessions in total. The prevention program that was being studied met just eight times. Nevertheless, during the nearly three years of follow-up, teens who had participated in CBT prevention experienced notably fewer episodes of depression compared to the teens who had been given standard care. The intervention was most effective if mom or dad was not depressed when the CBT treatment was given. Researchers could note little benefit if one of the teen’s parents was depressed at the time of treatment. This fact underlines the tremendous impact of a depressed parent upon the teen. A Harvard Medical School psychiatrist commenting on the study said the study highlights the wisdom of prevention even to subjects currently being treated for depression. The relatively short treatment (33 months in this study) could be seen to have extensive benefits, he said. Finally, the psychiatrist, referring to the double risk concept, said therapists should ask about parental depression when treating teens, and even said parents being treated for depression should be asked if their teens are depressed.