April 17, 2007 — -- Carla and Kelly are nonidentical twin sisters, age 15, coping with the recent divorce of their parents.
They are more tearful than usual. They spend more time in their rooms and seem more resentful when told by either parent what to do. But that is where the sisters' similarities end.
Carla's school grades have plummeted. She has all but stopped calling or joining friends on weekends. She is up most nights, and she is rarely smiling. All are stark behavioral changes, none of which have happened to Kelly.
Carla has developed depression. Kelly is sad, but OK.
Depression, when it occurs, is potentially lethal. Suicide is the third-leading cause of death in adolescents and is most often preceded by a major depressive episode.
Adolescents are particularly vulnerable to developing suicidal thinking in the context of depression, in part because adolescence is a time of identity formation during the human lifespan.
It is normal and typical for an adolescent to question his or her identity, to wonder what the meaning of his or her life is, to strive to define a useful role outside of the immediate family -- a way of fitting into the larger "whole" of the surrounding village, society, and universe.
It is particularly devastating then for an adolescent to be additionally bombarded with depressive symptoms, whether triggered by traumatic (or perceived traumatic) life events or not.
Warning signs of major depressive disorder in adolescents include: