Depression Is Poorly Diagnosed and Often Goes Untreated

CreditStuart Bradford 

Using data from a survey that screened more than 46,000 Americans for depression, researchers found evidence that the condition is not properly diagnosed in many people. And even when diagnosed correctly, depression often goes untreated.

The nationwide survey was undertaken in 2012 and 2013 by the Agency for Healthcare Research and Quality. It used a well-validated scale to determine depressed mood, and the researchers defined treatment as having visited a psychotherapist or other mental health professional or taken a psychiatric drug. The study is in JAMA Internal Medicine.

About 8.4 percent of the people interviewed had depression. But of those, only 28.7 percent had received any treatment.

At the same time, of those who were treated for depression, only 29.9 percent had screened positive for the disorder. Many people with less serious psychological problems were being treated with antidepressants and other psychiatric medicines.

“There are challenges in aligning depression care with patient needs,” said the lead author, Dr. Mark Olfson, a professor of psychiatry at Columbia University Medical Center. “Extending the use of simple screening tools in primary care is a good first step. Most adults who screen positive for depression don’t receive any treatment."

By NICHOLAS BAKALAR

For Gay and Transgender Teens, Will It Get Better?

Animation by Jessica Tang. Emoji: Apple.

It’s easy to assume that now must be a better time than ever to be a lesbian, gay or bisexual teenager. We recently celebrated the one-year anniversary of the Supreme Court’s ruling in favor of same-sex marriage. Our culture has grown more accepting, too; one of the most anticipated albums of the year, Frank Ocean’s, embraces his desire for men. These factors work together to create the illusion that as a society we are barreling toward a world of complete liberation, where everyone is truly free to be whoever they are.

More Child Suicides Are Linked to A.D.D. Than Depression, Study Suggests

“Maybe in young children, we need to look at behavioral markers,” said Jeffrey Bridge, the senior author of the new research. CreditMaddie McGarvey for The New York Times 

Attention deficit disorder is the most common mental health diagnosis among children under 12 who die by suicide, a new study has found.

From He to She in First Grade

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By  LAURIE FRANKEl

When our son turned 6, my husband and I bought him a puppet theater and a chest of dress-up clothes because he liked to put on plays. We filled the chest with 20 items from Goodwill, mostly grown-man attire: ties, button-down shirts, a gray pageboy cap and a suit vest.

But we didn’t want his or his castmates’ creative output to be curtailed by a lack of costume choices, so we also included high heels, a pink straw hat, a dazzling fairy skirt and a sparkly green halter dress.

He was thrilled with these presents. He put on the sparkly green dress right away. In a sense, he never really took it off.

For a while, he wore the dress only when we were at home, and only when we were alone. He would change back into shorts and a T-shirt if we were running errands or had people coming over.

Then we would come home or our guests would leave, and he would change back to the sparkly green dress, asking me to tie the halter behind his neck and the sash around his waist.

If you know someone who might be suicidal, here are 12 helpful suggestions.

A lot of people in the United States live with suicidal thoughts.

One study suggested that about 15% of Americans will have suicidal thoughts in their lifetime. About 40,000 Americans die by suicide each year.

I could tell you more statistics too, like how more than half of those are by firearm or how men are three and a half times more likely to die by suicide than women. I can tell you a lot of statistics. And those statistics are important. But for most of us, they're just numbers.
But when it's not just numbers — when it's your dad, spouse, or someone you love who you think is in danger — what the heck are you supposed to do?

This is a situation that, unfortunately, some of us might have to deal with one day. And it can be incredibly scary.

11 Ways to Calm a Child’s Repetitive Anxious Thoughts

“What if I have no friends to sit with at lunch?”

“What if I have no friends to sit with at lunch?”

“What if I have no friends to sit with at lunch?”

“What if I have no friends to sit with at lunch?”

One anxious thought can repeat in the mind like a vicious broken record. Are you familiar with this phenomenon?

If you’re a parent of an anxious child, you might even hear this thought repeated out loud. What can you do to help? When nothing in your verbal toolbox seems to break the cycle of repetitive anxious thoughts, try the power of physical touch. A hug can actually activate the parasympathetic nervous system and soothe a child’s chattering mind.

HOW TO BE DIVORCED: A STEPDAUGHTER’S WISH LIST

When asked, “How many brothers and sisters do you have?” I might give any of the following answers: only child, oldest of 3, or oldest of 5. All true. This is what it means to be a stepdaughter.

1,300 new stepfamilies are created every day. I am a statistic, a stepdaughter three times over, starting at ages 2, 9, and 15, with two half-brothers, a stepbrother and a stepsister. Everyone offers advice. Over the years I’ve heard dozens of opinions from the well-intentioned about how divorced parents and new stepparents should and should not behave. Most get it wrong.

The Best Way to Fight With a Teenager

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When raising teenagers, conflict usually comes with the territory. A growing body of research suggests that this can actually be a good thing. How disagreements are handled at home shapes both adolescent mental health and the overall quality of the parent-teenager relationship. Not only that, the nature of family quarrels can also drive how adolescents manage their relationships with people beyond the home.

Why Do Girls Tend to Have More Anxiety Than Boys?

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The laid-back, underachieving boy; the hyperachieving, anxious girl. Over the three decades since I graduated from medical school, and especially over the past 10 years, this pattern has become increasingly common in my practice.

In one case, which is pretty typical, my patient’s parents are concerned about their son. He’s not working hard at school and his grades are sliding. At 16, he spends most of his free time playing video games like Grand Theft Auto or Call of Duty, or surfing the Web for pictures of girls. He’s happy as a clam.

Turn the Volume Down on Drug Ads

Watching television these days means sitting through ads for drugs to ease pain, induce sleep, overcome sexual dysfunction, alleviate depression, ease urinary tract symptoms and more. Some patients say the ads are helpful, but many doctors warn that they are often misleading.

Programs Expand Schizophrenic Patients’ Role in Their Own Care

Frank was suicidal at 17. Two years later he attends college and makes his own treatment decisions.CreditElizabeth D. Herman for The New York Times 

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SAN FRANCISCO — The idea was to go out in an emotional swan dive, a lunge for the afterlife that would stretch his 17-year-old imagination. He settled on a plan and shared the details with a Facebook friend: He would drop DMT, a powerful psychedelic, and then cut his throat.

“Everyone was telling me what I could and couldn’t do — doctors, my parents,” said Frank, now a 19-year-old college student. “I was going to hurt myself, to show people, ‘Look, I am still in control of my life.’”

And so, in time, he was. Frank, who eight months earlier had received a diagnosis of psychosis, the signature symptom of schizophrenia, and had been in and out of the hospital, gradually learned to take charge of his own recovery, in a new approach to treatment for people experiencing a first psychotic “break” with reality.

At a time when lawmakers in Washington are debating large-scale reforms to the mental health care system, analysts are carefully watching a handful of new first-break programs like the one that treated Frank in New York as a way to potentially ease the cycle of hospitalization and lifetime disability that afflict so many mentally ill people.

Is the Drive for Success Making Our Children Sick?

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STUART SLAVIN, a pediatrician and professor at the Saint Louis University School of Medicine, knows something about the impact of stress. After uncovering alarming rates of anxiety and depression among his medical students, Dr. Slavin and his colleagues remade the program: implementing pass/fail grading in introductory classes, instituting a half-day off every other week, and creating small learning groups to strengthen connections among students. Over the course of six years, the students’ rates of depression and anxiety dropped considerably.
But even Dr. Slavin seemed unprepared for the results of testing he did in cooperation with Irvington High School in Fremont, Calif., a once-working-class city that is increasingly in Silicon Valley’s orbit. He had anonymously surveyed two-thirds of Irvington’s 2,100 students last spring, using two standard measures, the Center for Epidemiologic Studies Depression Scale and the State-Trait Anxiety Inventory. The results were stunning: 54 percent of students showed moderate to severe symptoms of depression. More alarming, 80 percent suffered moderate to severe symptoms of anxiety.
“This is so far beyond what you would typically see in an adolescent population,” he told the school’s faculty at a meeting just before the fall semester began. “It’s unprecedented.” Worse, those alarming figures were probably an underestimation; some students had missed the survey while taking Advanced Placement exams.