Wracked with inexplicable feelings she was too young to know weren't normal, a then 14-year-old Courtney Jones struggled to understand what was happening to her as an eighth-grader four years ago.
"I consciously knew that I was unhappy, but I didn't think that it was depression. I clearly wasn't happy like I used to be, I wasn't going out with my friends as often. I wasn't doing things that used to be fun for me," Jones, now 18, said. "[I] would just sit in my room and not do anything."
So when her school offered a free mental health screening, Courtney's parents told her to fill out the questionnaire. The result: Her answers raised serious red flags and a therapist later diagnosed the girl with depression.
The recent high school graduate, who said she had attempted suicide several times, credits the screening for saving her.
"[I] feel that TeenScreen saved my life," said Courtney, who resides in Portland, Ore. "I had to fully feel all of the emotions that were within me, hit rock bottom and then climb back up. I had a great support system that TeenScreen helped to build."
Should Teens Be Screened for Depression?
TeenScreen is the program Courtney credits with bringing her depression to light.
It is a national program active in 500 communities and its goal is to spot mental health problems early by offering questionnaires to all teens with their parents' consent during the students' annual physical or in school.
The National Center for Mental Health Checkups at Columbia University conducts TeenScreen.
"The sooner we find youngsters who may have early signs of depression, the sooner and the better we can get them the help they need," said TeenScreen national executive director Laurie Flynn.
Depression is a problem facing lots of families with an estimated 2 million teens in the United States suffering from depression, but less than half receive treatment, according to the Substance Abuse and Mental Health Services Administration.
For that reason, some believe programs like TeenScreen could be helpful.
"I think it's a first step. It can increase awareness for the pediatrician or the school. It can make the parent aware. It can make the child aware and start to dialogue," said Moira Rynn, of the New York State Psychiatric Institute. "And then there needs to be a more detailed evaluation."
The federal group, which makes public health recommendations, concluded that the current evidence is insufficient to assess the balance of benefits and harms of screening of children between ages 7 and 11.
"GMA" medical editor Dr. Marie Savard said the screenings are for kids who may not be showing symptoms.
Depression Screenings Worry Some Critics
But detractors worry that aggressive screening will lead to over-medicating children.
"It's a questionnaire and the questionnaire is with leading questions, which, if you had a child answer, you would find that most children are going to fall into a category of having something wrong with them," said Alliance for Human Research Protection president and founder Vera Sharav.
Parents like Mathy Downing believe screening isn't necessary to spot potential problems.
"I think if the issues are there, they are going to be picked up in school and they're going to be picked up by the parent," she said.
Five years ago the Laytonsville, Md., mother's 12-year-old daughter, Candace, was having problems in school and she took her to a therapist. Candace was diagnosed with anxiety-related issues.
Later, Candace committed suicide; when Mathy Downing's oldest daughter, Caroline, began having falling grades following Candace's death, Mathy Downing took it as a sign.
Mathy Downing, who said she believes her daughter's prescription medication helped contribute to Candace's death, took the now 20-year-old Caroline for an extensive psychological evaluation.
Despite their differences, both sides seem to agree more needs to be done to help teens deal with their emotional well-being.
"The thing I like to focus on is that I got through it and I was able to say I still want to be here," said Courtney, who is nearly done with her associate degree due to taking college level courses in high school, and plans to go into nursing. "I still want to live life. I want to do something good with this life that I've been given and I was able to pull through it."
Depression Warning Signs
Some of the symptoms are sadness, irritability, isolation, loss of interest in activities, and a big sleep and appetite change. While any teen can experience one of these symptoms, parents should look for a cluster of them for two weeks or more, Savard said. Of course, teens can get sad or irritable for a few days, but if it goes on for an extended time, that's a red flag.
Savard said one in five children may get depression at some point between 12 and 18, and teens that have a parent with a history of depression also may be at risk.
Teenagers who have experienced a major loss, such as the death of a parent, or kids with chronic illnesses from autism to childhood diabetes or asthma may be at risk for depression.
Savard said girls are more likely than boys to be depressed.
If you see these symptoms in your child, you want to take a more immediate step and talk to a primary care physician, or family doctor, and get a referral to a specialist, Savard said. The first resort is individual or group therapy -- group therapy has shown really encouraging results in recent studies.
Savard added that medication should not be the first resort and also medication should not be used alone. It should be used in conjunction with talk therapy.