Dr. Jeremy F. Shapiro
Pediatrician
Dr Shapiro completed his undergraduate education at UC San Diego earning a B S in Biochemistry and Cell Biology and a B A in Political Science He furthered his education at UCLA where he earned a Masters Degree in Public…
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LOCATION: Los Angeles, CA, USA
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  • Attending Physician, Providence Tarzana Regional Medical Center
YEARS IN PRACTICE: 6
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Screening for Adolescent Depression
11
Posted in ADHD / ADD by Dr. Jeremy F. Shapiro on Apr 11, 2009
  

A great balance to the many visits I have with younger-aged children are my routine, and hopefully yearly, adolescent physical exams.  It's an opportunity to catch up on the past year's events and often take some personal satisfaction in witnessing the maturation process of children I have cared for over the years.  But is also the one opportunity for me to determine whether any medical concerns are appearing...whether they be physical and/or mental. 

 

And although some issues are more readily identifiable, a once-a-year 20 minute exam (if that), may not always allow for the recognition of what could be some very significant issues...particularly as it relates to some of the mental health conditions that affect so many of us.  But when current numbers find 6% of U.S. teenagers living in a state of clinical depression, it is vital that pediatricians, family physicians, and other medical caregivers of teenagers not overlook this component of the exam as of those affected by this condition, many often go undiagnosed, and therefore, not treated.

 

And as I've just read through the most recent recommendations regarding screening and treatment for childhood and adolescent depression from the U.S. Preventive Services Task Force, it serves as a reminder that the medical community needs to do more to identify our youths at risk.  We in the community need to further investigate children who are experiencing anxiety, substance use/abuse, changes in appetite, friends, sleep, and even vague pain symptoms as they may be calls for help.  Something many of my pediatric colleagues already do is complete a HEADSS interview with our ‘tween and teenager patients (please see my earlier blog on this topic...http://www.dailystrength.org/blog/277-headss-up).  It is during this time of the exam where the adolescent has an opportunity to speak freely without the presence of a parent or caregiver.  And while I think this experience is helpful, I certainly agree with the recent recommendations that a screening test/questionnaire that the adolescent would fill out prior to the actual exam would be all the more helpful to the medical caregiver in hope of identifying potential red flags that would warrant further evaluation and care.

 

So I end my thoughts here and turn this over to all the wonderful members we have here at DS...as I would thoroughly enjoy hearing from both our teenagers and adults who have battled depression at some point during their life as to any suggestions/recommendations for the medical community on how better to diagnose and reach out to someone who may not be so willing to share information regarding his/her daily struggles.

 

 

Dr. Jeremy


CATEGORIES: News
CONDITIONS AND COMMUNITIES: ADHD / ADD  •  Adoption  •  Anger Management  •  Anxiety  •  Anxiety Disorders in Children  •  Asperger Syndrome  •  Autism / Autism Spectrum  •  Bipolar Disorder  •  Bipolar Disorder - Teen  •  Caregivers  •  Child Support & Custody  •  Children Of Divorced Parents  •  College Stress  •  Coming Out  •  Depression  •  Depression - Teen  •  Depression in Children  •  Depression Supporters  •  Diets & Weight Maintenance  •  Eating Disorders  •  Families & Friends Affected By Suicide  •  Family & Friends of Bipolar  •  Family Issues  •  Foster Care  •  Gay Parenting  •  Grandparents Raising Children  •  Homeschooling  •  Military Families  •  Motherless Children  •  Panic Attacks  •  Parenting 'Tweens (9-12)  •  Parenting Big Kids (5-8)  •  Parenting Newborns & Infants (0-1)  •  Parenting Preschoolers (3-5)  •  Parenting Teenagers (12-18)  •  Parenting Toddlers (1-3)  •  Parents of Children with ADHD  •  Post Partum Depression  •  Pregnancy  •  Pregnancy - Teens  •  Pregnancy After Loss/Infertility  •  Premature Birth  •  Single Dads  •  Single Parenting  •  Step Families  •  Teen Anxiety  •  Teen Sexuality  •  Twins, Triplets & More
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Displaying comments 11-1 of 11
11
I had adolecent depression from PBD, a lot of young people suffer from this horrible disorder, i thought this site would help me but instead it caused me SI after 15 years of not doing it.........There are people here who are sociopaths and WANT to inflict emotional pain on others on PURPOSE....here's a sample...

BPDs BE CAREFUL.. Stop Watching this Topic

davenger
View More Posts To my felloe BPDs i know i do not have to tell you how painful this disorder is and how MISUNDERSTOOD it is, i know a lot of us SI and are at the brink of suicide...

BE CAREFUL on this site there are true PSYCHOPATHS here that would enjoy causing a BPD to SI or commit suicide.I'm signing off i as i find this site very DANGEROUS for a BPD or OCD, i have both..



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Sunday, June 28, 2009 | A Sad story THANK YOU for your comments, i have not commited suicide yet.



I am in the darkest place i think i've been in my life.I posted on the bipolar forum and i also said some mean thing ONLY aftet i would asked people to stop posting those that know me long know i do have OCD, BPD, BP, PTSD, major depression, i was diagnosed with it from Dr Gene Altman in Honolulu and Dr Alvin Murphy......I'm NOT currently being treated, and i CAN NOT control me BPD and OCD.........I kept asking people to stop posting, i cried and wanted to SELF-INJURED BAD, for the first time in 15 years, after i kept asking people to STOP posting because i could not...........These are some of the hugs they were giving each other, they were enjoying causing someone at the brink of suicide ALL these pain i cried and sat on my computer NOT able to stop for 10 hours.And they kept at it ON PURPOSE.



jaybear (12:11 am)

LOL, I know, that was the wildest thing, wasn't it? Not many of us DID know what the hell to really think of all that, did we? I lean a lot towards the idea of troll, but I could be wrong. I suppose a troll would have come back as another incarnation within half an hour or so, LOL. Do trolls get tired? But yeah, I couldn't buy the poor victim crap we were getting from, "her", because of the vicious things she was sending to everyone's inboxes, ESPECIALLY all the nicest people that were trying to be helpful---at least at first before they had enough! LOL. The thing is, all she ever said was about how cruel we were! What? Are we like supposed to be the pdocs around here? A lot of us have our own reasons we can't help being wiggy, so maybe it was cruel to get US all riled up, ya know? LOL. I'm so glad you had fun, twosides! I was afraid after a while that maybe you felt uncomfortable about it because it was too much arguing. Because of the health issues I've been having for the past several days, I was kinda out there, anyway, so it actually helped me a lot, having an outlet for psychotic moment! LOL. ;D Glad to see you are doing okay tonight. (((hugs)))
JAYBEAR
jaybear (11:55 pm)

Yeah, I know. Kinda sad, isn't it? LOL. No more insane pig piles! LOL. [wipes laugh tears from eyes] It was sheer bloodlust.
Yeah, I changed from the machine gun kitty b/c some people are really triggered by automatic weapons, and such, but yeah, that's part of why I chose the boxing kitty, because for anyone that still read the closed thread early this morning, it still would have almost made sense, LOL. Glad to see you're on too, sunshine
TwoSidesOfMe (6:10 pm)

It sure as hell was fun! I havent had that much fun on here in god knows how long. Loved how many directions the discussion took. It was unpredictable lol. Obsessive compulsive my ass. People make excuses for being jerks
ParagonOpus1 (4:52 am)

TOO FUNNY
Ray of Sunshine
From DontStealMySunshine Yesterday

I think you could've used the punching kitty avatar last night, too! Although, he is kinda cute and not as psycho as the other one, LOL. Glad to see you're online tonight, although I doubt we'll have nearly as much fun or "drama" hah!

I’m With You
From TwoSidesOfMe Yesterday

It sure as hell was fun! I havent had that much fun on here in god knows how long. Loved how many directions the discussion took. It was unpredictable lol. Obsessive compulsive my ass. People make excuses for being jerks

.
THis site has some very good people in it but it can also be DANGEROUS, a lot of people give advice using pop psychology, when they really do not understand a particuar problem..
Others like the ones above do it on purpose and enjoy inflicting emotional pain on others..
.
Pragonopus tried edging me on to commit suicide, even sending a hug asking how was he going to know if i did it or not..
.
To the new comers BE CAREFUL, i am signing off i find this site can be extremelly DANGEROUS
By davenger  Jun 28, 2009
10
You are one very good doctor! For you to ask how to better diagnose by asking people who've "been there" is so smart. Learning through books is one thing but to learn from your "patients" is knowledge you couldn't get from any book.

My son is in addiction recovery and now he has a psych doctor. This doctor, who comes recommended, spent 15 minutes with my son - no paperwork, and only one question for me "What is your family history?" I told him my mom had two sibs with bipolar, next thing I know my son has it. I KNOW bipolar, I was surrounded by it. My son has ADD (no H) and hasn't had any symptoms of bipolar but the impulsitivity but ADD kids have that.

Thank you for being so proactive and thorough. Your patients are fortunate.
By mom of 3  Apr 20, 2009
9
Thank you to everyone for their input...very insightful.
By DrJeremy  Apr 18, 2009
8
The questionnaire would have helped me as a teen. I would have had issues in each group of questions. My depression start, stayed oued at 17. I was a good student, didn't get in trouble, didn't worry my parents. But I had so many of the issues you list. Change in friends, sexual overtures including touching from a teacher, weight changes, serious sleep problems. I needed someone I could have talked to in confidence.
By rllong  Apr 17, 2009
7
I like the idea of a questionnaire, it certainly would have helped me. I have one suggestion for the medical community; be more sympathetic, I have dealt with far too many doctors who can't seem to be bothered to help anyone or if they do they make it blatantly obvious that they do not care. So have a little empathy and if that isn't possible, some genuine sympathy goes a long way.
By S73V3  Apr 17, 2009
6
Efficiency has many meanings it could be a sort of convenience or a way of reducing the cost. Perhaps most of us are familiar with cost cutting it is the frequently used word since recession arises. Yes recession is not yet over, it continue to threaten the world economy thus in response to this some other sector of the economy also got affected the even the defense budget had to be cut. Defense Secretary Robert Gates unveiled an idea to replace defense contractors entirely, with the budget providing for hiring 13,000 civil servants to start with. Granted, part of the cash advance loans of the stimulus was to create jobs, but this creates and takes away simultaneously. Part of the budget is an additional $5 billion for jets, and more funding for the withdrawal from Iraq and increasing activity in Afghanistan. After we heard so many promises to cut government spending, we now are on the hook for more cash advance loans in the defense budget.
By SamuelX  Apr 14, 2009
5
My son is 18 and 2 months ago was diagnosed with severe depression. He had been acting out for a few years and had been in counseling with a psychologist who send him to a neurospychtrist for testing. The test results showed that he had ADD (which we already knew) and learning disabilities. He was put on a different stimulant for the ADD. But he was still acting out. About 2 months ago he was found intoxicated and with a controlled substance (pain pills but he thought they were sleeping pills) and taken to the hospital for detox. We have since put him on wellbutrin and he is a completely different person!

The "new" psychologist told us that severe depression can manifest itself and risky behavior. Since the depression also shows as "teenageness" it's hard to identify. Thank God he seems to be back on track though he will not be graduating with his class this year.
By DonnaB23  Apr 13, 2009
4
Personally, I am 20 and suffering from depression. I don't really feel like I am have anyone I can talk to and I don't feel comfortable talking to anyone about personal issues. I have gone to counseling mainly for anxiety and I am currently on prozac but I am still depressed. When I go to counseling I always keep things to myself and pretend like things are fine for me because I don't feel comfortable being open, especially to a stranger. My main issue is that my parents seem to be uncaring and unaccepting of me; particularly my aspergers. I am currently trying open up to my mom and get her to be more understanding and accepting which I feel would minimize my depression greatly. As for my dad, I feel that he is a lost cause and I am not even going to try anything with him.

The main reason that I feel I am depressed is because my parents have ever increasing, impossible to reach expectations and they seem uncaring. All they seem to care about is that I make them happy, they don't seem to care if I am happy and satisfied with life. I have been feeling depressed for years now and have felt like killing myself that majority of that time also. I just hope that my mom will finally change for the better and that my life will improve.
By tshudyb  Apr 13, 2009
3
I distinctly remember my visit to my dr. when I was 14, and struggling with depression to the degree that every day was a battle to live. I knew that I needed help, but my main concern was that I did not want my parents involved. I did not want them to know why I was depressed, or what the extent of that depression was. I mentioned it briefly to my dr, and she told my parents I should see a therapist. That therapy ended quickly because I did not trust the limits of confidentiality. I was unsure as to whether SI behavior (non life threatening) would be shared with my parents.

I do think a questionnaire is a great idea, but you may also want to incorporate some short discussion outlining what a teenager can trust. I need not tell you how important it is for them to trust someone. Knowing before-hand how you are going to respond to certain types of information may make them more willing to open up; it would have for me.
By LostNights  Apr 13, 2009
2
Superdad, I am sorry to hear of your sister's circumstances. What else do you think could have been done to recognize the symptoms? Do you like the idea of a screening questionnaire?
By DrJeremy  Apr 12, 2009
1
I have two teenagers and a younger sister who suffered for years because their doctors thought they were "acting this way for attention". Too many doctors don't want to take the time to find out what is wrong and just put a cap over it until, as my younger sister did, hurt themself or hurt others. Since we have changed doctors but there is still no excuse.
By superdadRKJ  Apr 12, 2009
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