Asked by Vanessa, San Bernardino, California
What can cause depression when you're 12 years old?
Mental Health Expert
Dr. Charles Raison
Emory University Medical School
Something about your question filled me with sadness. All I know about you is your one-sentence question, so I don't know whether you are 12 years old and feeling depressed or are the mother of a 12-year-old who has depression. In either case, your question is an example of how something that seems simple can be very complicated.
The truest answer to your question is that there are as many reasons for a 12-year-old to be depressed as there are 12-year-olds, but that doesn't do you much good, so let me try to give you a little sense of what science has taught us in general about depression in kids.
Let's start by thinking about depression as a seesaw. On one side of the seesaw, let's put everything that is going on in your life, good and bad. On the other side let's put your emotional makeup. When I say emotional makeup, I am referring to the fact that all of us are born into the world with different personalities and different strengths and weaknesses. Some people are by nature very outgoing and optimistic. Others tend to be more shy and cautious. One makeup is not usually better than another; evolution has selected so many different types of people because each type does better in different situations.
Back to the seesaw. Imagine that what we want to do in life is keep it balanced. When it becomes unbalanced and one side tips to the ground, that's equivalent to getting depressed. You can see that it can become unbalanced from either the side of what's going on in a person's life (i.e. the environment) or from the way a person was born in terms of personality (or more technically in terms of "temperament"). A bad environment is like a heavy load on the seesaw. The worse the environment, the more likely the seesaw is to become unbalanced, no matter what kind of temperament a person has. Said another way, there are things that can happen that are so bad that almost anyone would become depressed.
Now imagine people who are very sensitive and easily depressed by nature. Like a bad environment, this type of temperamental makeup is also like a heavy load on its side of the seesaw. The more vulnerable a person is by nature to depression, the more likely the seesaw is to become unbalanced, even when troubles in the environment are relatively small. Said another way, there are some people who are so vulnerable to depression that they are very likely to become depressed no matter what happens in their lives.
Most of us live somewhere in the middle.
But the story is a little more complicated than I've made it, because science has shown us that bad environments can affect a person so strongly that it changes the personal makeup in ways that will make the person more vulnerable to depression in the future. In the same way, there are some studies showing that the genes that increase the risk of depression may also make people a little more likely to put themselves in stressful and painful environments. So you can see that it is really very hard to separate a person's genetic makeup from what happens in life.
I have come to feel quite strongly as a result of my research work that when it comes to the seesaw of depression in kids, it is extremely important that we look at the environment side of the balance first and try to fix it if we can. Many, many children who are depressed will become significantly better if the troubles in their lives are addressed and corrected. An amazing recent example of this comes from a study that found that when a depressed mother takes an antidepressant medication and responds, the effect on depressive symptoms is bigger in her kids than it is in her. She takes the pill, but they get the biggest benefit.
On the other hand, I don't want to leave you with the impression that there's anything wrong with taking an antidepressant if you are a kid and feel really depressed. I've seen so many great kids who were struggling with depression bloom after getting an antidepressant. And recent studies show that children with serious depression often receive significant long-term benefits in their lives from being treated with medicines.
I hope this little column at least begins to help answer your question.
How can I make the voice in my head stop?
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