Depression & Anti Social Behavior

DEAR JEAN,
     In response to your inquiry, I would advise you to seek a professional mental health evaluation of your son.  Concerns about depression can be very serious, but know that there is also a wide spectrum of mild to severe.  Adolescence is a difficult period anyway.  It is a time of enormous change and challenge. I think your son is telling you he needs some help.  And from what you have described about his peer relationships, I would also counsel you to seek help as well.
     With regard to the question of medication, it is would be inappropriate and premature of me to make any recommendation here.  I can only say that for some patients, medication can make an enormous difference - but medication is not meant for everyone. And any medication needs to be monitored closely - with ongoing counseling. For some, counseling alone is appropriate.  But again, I cannot make that determination for you.
     I would encourage you to make an appointment for your son - and commend you for listening to him.
                                  Sincerely, HVM M.D.---EV
  My 16 year old son tells me that he has clinical depression.  He has told me that from the ages of 11 to 14 he had thoughts of suicide, but that he doesn't feel that way now.  At the age of 4 he was sexually abused by a male babysitter.  It was at the age of 11 that he told us of this incident.  We sought help and had one family session with a therapist and she felt that this incident had no major effect on his well being.  It has since been put in the back of our minds and never discussed.
  His social behavior has been the following: unable to make close friends, quiet, irritable, associates better with younger children than his peers, has difficulty speaking out to teachers and people of authority, and basically is a loner of sorts.  He was in special education classes all through elementary school and most of junior high.  However, we finally saw that this was holding him back and he has been mainstreamed and is now making the "B" honor rolls.  His teachers say that he is a good student, but that he doesn't talk. He was evaluated in school and we found that his high level of anxiety had been holding back his learning abilities.
  How should I follow up on his claim of clinical depression? He doesn't appear to be depressed all of the time.  Would antidepressant drugs be helpful?

[HVM M.D. - EV]

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