Pro/Con: Should all teens be screened for depression?

Pro/Con: Should all teens be screened for depression?

Sandra Sunio and Chloe Johnson

Sandra Sunio: Pro
It has become common for many teens to express that they are feeling “depressed” when they are struggling with a difficult issue or just feeling sad, not knowing the seriousness behind the mood disorder. Teens often confuse feelings of sadness with depression.
According to the American College Health Association Spring 2015 assessment, two-thirds of students struggling with depression and other mental illnesses do not seek treatment.
“People don’t have the choice of obtaining a mental illness, but people do have the choice to perpetuate the stigma,” University of Missouri student Alex Lindley said in his documentary “Project Wake Up: End the Stigma.”
Oftentimes, teens cannot distinguish their feelings as normal sadness or signs of depression. In UCLA’s 2014 study, approximately one in 10 students report frequent feelings of depression. Recognizing this reality at the high school level is imperative to assure no one’s mental health is ignored. It is critical that clinicians help them make that distinction and mandatory screening would help ensure teens get the treatment they need.
Depression is one of many serious mood disorders that often go unnoticed and ignored. The National Institute of Mental Health conducted a study in 2014 about depression among adolescents between the ages of 12 and 17. Through their study, they estimate that 11.4 percent of adolescents are diagnosed with depression.
“My friend is suffering from depression, and it has greatly changed him,” sophomore Jasmine Tom said.
Long term depression is not only debilitating, it can also be life-threatening. Several forms of depression such as dysthymia, perinatal depression, psychotic depression, seasonal affective disorder, and bipolar disorder all affect the mind differently. Common symptoms of depression include, but are not limited to, persistent sad moods, pessimism, loss of interest in hobbies, thoughts of death and suicide, and decreased energy or fatigue.
If students experience symptoms for at least two weeks, they should seek help before their health, academics and social life are impacted.
“Staying focused in school was so hard for me; all I could think about was my depression and how sad I was,” senior Eurasia Williams said. “I was never happy anymore, so it also affected my social life. I went MIA, I couldn’t go out in big crowds, I couldn’t talk to people, and I wasn’t as open as I was before. I was just not me anymore.”
Many adolescents have trouble expressing their struggles with depression and bottle up their feelings and emotions. Therefore, it is up to the clinician to help them and ask the appropriate questions. Routine screening would encourage these interactions between the clinician and adolescent.
The U.S. Preventative Services Task Force and the American Academy of Pediatrics recommend screening for depression in adolescents as a routine practice in primary care. Early screening and diagnosis for depression lead to early help and support. Before the depression worsens, preventative measures could be implemented such as therapy.
However, some may argue that screening tools may not be so accurate and may falsely diagnose the patient.
The U.S. Preventative Services Task Force suggests the Patient Health Questionnaire for Adolescents and the Beck Depression Inventory as suitable screening tools; they both pose a good balance between any risks concerned with these screening processes such as false or missed diagnoses.
“It’s important to note: screening tools do not diagnose but simply draw attention to symptoms,” adolescent-medicine specialist Richard J. Chung said in “Should All Teens Be Screened for Depression?”
Once diagnosed, treatment such as psychosocial support, psychotherapy, and medication can be prescribed.
Many concerns with the process include overdiagnosis, misdiagnosis, and overtreatment, but improving communication among adolescents and clinicians is essential to ensure an accurate diagnosis.
Numerous patients suffering from mental illness lack necessary care. It is the disappointing truth which stems from the lack of resources in the healthcare system. Carefully screening all teens for depression is the first step toward better mental health.

Chloe Johnson: Con
In the most perfect of worlds, depression screening would be as effectively undeniable as a blood test. However, mental illnesses are not at all easy to diagnose — and depression is one of the hardest.
While 11.4 percent of Americans age 12-17 suffer from depression, only 6.7 percent of Americans over age 18 are affected. There is no doubt that this debilitating mental illness is a problem, but screening all teens is a practice that is both impractical and dangerous.
The common misconceptions of the true meaning of depression can affect the way people think about the disorder.
According to researchers at the Mayo Clinic, a nonprofit medical practice and research group based in Minnesota, the clinical definition of depression is “a mood disorder that causes a persistent feeling of sadness and loss or interest.” Those who suffer from depression can have trouble performing regular daily tasks. Simply making a personal effort to better your life doesn’t usually cure clinical depression, leading to the push for treatment.
Unfortunately, diagnosis must precede treatment. In mental illnesses such as depression, dignosis can be the most difficult part of the entire process. There is no solid questionnaire that you can fill out — there are some widely used online tests, but none of them are 100 percent accurate — and an extensive interview process is wildly impractical if it is being done on every teenager in America.
On the other hand, mislabeling a teenager can be almost as bad as the disorder itself.
“[Being diagnosed with depression] changes the way he sees himself and how others see him,” professor and chairman emeritus of Psychiatry and Behavioral Sciences at Duke School of Medicine Dr. Allen Frances said in an opinion piece for “The Wall Street Journal.” In the eyes of most teenagers, image is everything.
Misdiagnosis and lack of treatment for depression is already all-too-common with the current diagnosing practices. However, treatment is crucial with this disorder — without it, many people’s quality of life is driven into the ground.
“[Someone I know] had it so bad that they locked themselves up in a room and just wouldn’t communicate with anyone, and didn’t really ever want to go out or talk to anyone,” sophomore Cade Campigli said. “It got to a point where they had to go get counseling and take medication for it, and now they’re fine because it got rid of their depression…it took five years.”
It’s important to understand that these patients need to be taken seriously, or else suffer an adverse effect on their treatment and healing process. If every teenager in America is being screened for depression, chances are the screenings will be quick and impersonal. It is likely that either patients will hide information because they feel uncomfortable, or conclusions will be jumped to in order to speed up the process, which could lead to misdiagnosis.
“Screening for depression is one of those ideas that is terrific in theory but terrible in practice,” Frances said.
And he’s right. Depression is an illness that is rampantly plaguing the minds of American teenagers and must be stopped, but treating it like a black-and-white issue is not the right way to do it.