Successful treatment of pediatric depression

Ah! TOO (much too!) long ago, I posted about the importance of intervention. I raised the question “What types of intervention are most successful?” I found a study by several professors of psychiatry that seeks to answer this question, specifically focusing on pediatric depression (youths 11-18).  The highlights of the study are below:

  • Continuation-phase CBT combined with continuation pharmacotherapy reduced the risk of relapse 8-fold compared with continuation of medication alone.
  • The continuation of medication treatment for 6 months after acute treatment (initial 12 weeks of treatment) reduced the relapse rate by 27% (42% vs 69%).
  • 6 months of continuation-phase CBT (after acute-phase CBT) lowered the relapse rate by 46% (6% vs 50%).

Now to avoid “quote dropping” (a writing flaw my AP English teacher scared out of me), here’s the lessons I draw from these findings.

First, the most successful treatment is a combination of therapy and medication. While this is a “duh” statement to some, I think it is an important reminder. To those who are resistant to medication (Like me!), it is the reminder that to “retrain” your brain through CBT you might need the help of medication. For those resistant to therapy—well that’s a whole another blog.

Second, do NOT discontinue treatment too soon. While “too soon” is hard to identify, it appears treatment should last at least SIX months after the depression/anxiety goes into remission.

Recovery is hard!  So often I wish it was as easy as managing my allergies. The doctors gave me a nasal spray—and life has never been the same! But unfortunately, it’s hard work.  After graduating from my master’s program, my mom and I were going through old t-shirts from my childhood through college. You know all the swim team shirts or ones marking plays I was in (I know, me being dramatic is shocking!). 

I didn’t collect any in graduate school (and not just because I was older—you never outgrow those shirts. I just washed one for my husband the other day—it was from a bar), but because I was busy learning to take care of myself I didn’t commit myself to as many things. My mom jokingly suggested she could print me a “Proud Survivor–Therapy—2009-2011” t-shirt. While sometimes I did feel like I was missing out, I know dedicating two years of my life to continued treatment has helped me build the skills that keep me healthy and allowed me to re-engage on all those activities now. Score myself some free bar tshirts!

Rick recently reminded me, “I hope that I’ve mentioned to you that you are not going to have to be in therapy for the rest of your life (or even indefinitely). However it does seem to me that for the present it would be quite useful for you to maintain a relationship with a person that you have confidence in.”  He always joked his goal was to “work himself out of a job”. And trust me, there have been times (especially in the beginning when I hated therapy!) that I wished he was out of a job. : )

So when you start helping someone with a mental illness, here are the two clear steps to take. I suspect starting treatment will not be the problem, it will be convinceing them to continue treatment once they feel better. I had a friend the other day tell me he was likely going to go off his medication because he was feeling better. And it had only been three months!! Fortunately, I was able to whip out this study and convince him to stay with it. (Or at least lie and tell me he would!)

But what about those of us with “chronic and persistent mental illness”? I think this applies to us too. Keep on your medication, and realize that you are going to need to have some maintenance or “tune-up” therapy now and then as well. 

I write that very simply—like it’s oh so easy. And everyone reading this post knows how important these steps are. So why mention it? Because it’s not easy–even re-reading that gets me all wound up. So I give you this article so you can return to the statistics when you decide you no longer need treatment. I often use these short, clear facts to combat the dysfunctional thoughts in my head.

Thoughts?

http://www.psychiatrictimes.com/mdd/content/article/10168/1473061?pageNumber=1 

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4 thoughts on “Successful treatment of pediatric depression

  1. This is really useful, thanks for sharing this! I’m resistant to medication too… have tried 5 different antidepressants at different dosages and they don’t seem to have an effect. I’m coming off the current one, but about to start CBT, and hopefully see a psychiatrist to sort out my medication! xx

    • Nicole says:

      Im so sorry you’re having such a hard time finding a medication combination that works for you. Its so frustrating. Good for you for not giving up. Keep us posted on how CBT works for you. Id be interested in reading about your experience on your blog.

  2. sakuraandme says:

    My hands are up dear, Nicole!! Lol I am one of those people you think is cute!!!! Lol
    Seriously, I’m always wanting to stop taking my Seroquel. But, I know I need at least 1 med to keep me balanced. 🙂 I feel amazing right now and would flush the lot, if I didn’t know better! Super hugs to you. 🙂 ……Paula xxxx

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