Thomas S. May, M.A.

Medical Writer

Scared Teens Often Become Depressed Grown-ups, Studies Show

Thomas S. May, Medical Writer

Introduction

Teens who haven't outgrown their childhood fear of the dark are more likely to face the darkness of depression as adults than others, a new study concludes. The finding is one of a number from recent studies that look at the relationship between teenage emotions and adult personalities.

For instance, a recent study done by researchers at the National Institute of Mental Health (NIMH) has found that fearful teens are more likely than others to develop a major depressive disorder when they grow up.

Fear of the dark was one strong predictor of subsequent depression.

The study, which is scheduled to be published in an upcoming issue of the journal Biological Psychiatry, looked at over 700 young people for about 10 years. Those to be studied were first interviewed as teens. Then they were interviewed again years later when they were young adults.

The researchers found that teenagers with generalized anxiety disorder--teens who worry about a lot of different things--"tended to develop depression later on as adults," says Daniel S. Pine, MD, chief of the development and affective neuroscience section at NIMH, the study's lead author. Fear of the dark was also a strong predictor of subsequent depression, according to Pine.

Overanxious Teens Underdiagnosed

Roughly 5-10% of teens suffer from some kind of anxiety disorder, and they are two to four times more likely to become depressed adults compared to teens who don't have any psychiatric problems, Pine says.

Common signs of anxiety disorders in young people include worrying a lot about ordinary activities like going to school or summer camp or taking a test or performing in sports. At times, there may also be physical symptoms, like sweating, trembling, stomachache, or headache.

Anxiety disorders are often not recognized and go untreated.

When these symptoms cause extreme distress and get in the way of normal day-to-day functioning, the child or teen may be diagnosed as having an anxiety disorder.

Although anxiety disorders cause suffering and affect many children and teens, these disorders are often not recognized and go untreated, Pine claims.

SAD Story

SAD can be thought of as an extreme form of shyness that leads to avoiding interacting with others--especially strangers.

One of the more controversial findings of the study done by Pine and his co-workers was that children and teens who had been diagnosed with social anxiety disorder (SAD) did not appear to be at increased risk for major depression as adults. This is in stark contrast to the findings of some other studies that looked at the relationship between SAD and later depression.

SAD can be thought of as an extreme form of shyness that leads to avoiding interacting with others--especially strangers. It has been linked to depression by several studies.

In one of these studies, researchers gave psychiatric evaluations to 2,548 adolescents and young adults (14-24 years of age) living in Munich, Germany. The same individuals were also interviewed 34-50 months later.

The investigators found that those who were diagnosed with SAD at the beginning of the study were 3.5 times more likely to develop depression during the follow-up period than those who had no psychiatric disorders at the time of the first evaluation. Therefore, the researchers concluded, "social anxiety disorder during adolescence or young adulthood is an important predictor of subsequent depressive disorders."

These findings appear to be in line with the results of another long-term study, which was presented in July 2001 at the World Congress of Behavioral and Cognitive Therapy in Vancouver, Canada. This study followed a group of about 400 individuals beginning in 1977, when they were only 5 years old.

Repeated psychiatric evaluations conducted over the past 24 years have revealed a "strong association between having anxiety at age 15 and major depression at age 26," according to the study's lead author, Helen Reinherz, ScD, a professor of social work at Simmons College. Most of the subjects who were suffering from anxiety disorders during their teens had social anxiety disorder, Reinherz says.

How Parents Can Help

There are two things that parents of teens should think about when they try to decide if their child needs any help dealing with anxiety, according to Pine, of the NIMH.

"The first thing to consider is the level of stress that a child has. Any time a parent feels that their child is suffering from the amount of stress they experience, they should consider having the child evaluated by a healthcare professional," Pine says. They should also do so "if there are specific things that the child cannot do, such as going to school or making new friends, because of their nervousness."

The best thing to do in these kinds of situations is to request an evaluation by a trained professional.

The best thing to do in these kinds of situations is to request an evaluation by a trained professional, according to Pine. "This doesn't have to be a psychiatrist or a psychologist. A good place to start with is the child's pediatrician."

Reinherz agrees that a young person who is very timid should be evaluated by a competent professional like a medical doctor or social worker. "Children who can't go to certain places because of their fear, or who worry needlessly about their performance or about interacting with others, require attention," she says.

"Unfortunately, these children are easily overlooked when there are more aggressive children out there who are creating problems. But even with the current scarcity of resources, they should still be considered and offered some help," Reinherz says.

"There are a lot of treatments available to these children, either in groups or individually. And hopefully, these interventions can help prevent the development of major depression, which is a very serious and severely debilitating illness."

Thomas S. May is a medical journalist based in Toronto, Ontario, Canada. He has a master's degree in psychology from Simon Fraser University in Burnaby, British Columbia.

Reviewer: Beth Israel Deaconess Medical Center. Reviewed for medical accuracy by physicians at Beth Israel Deaconess Medical Center (BIDMC), Harvard Medical School. BIDMC does not endorse any products or services advertised on this Web site.

Reprinted from Medscape Health for Consumers.

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