The hardest questions pediatricians must routinely ask teenagers at checkups are those about depression and suicide. But your child’s pediatrician should be asking those questions at every visit.

The Stats

From 2005 to 2014, the prevalence of depression, that is, the chance of having a major depressive episode over the course of a year — increased significantly among 12- to 17-year-olds in the United States. These data come from an annual survey, the National Surveys on Drug Use and Health, in which the same structured questions are asked every year.

The trend toward more depression was steeper in girls than it was in boys. Furthermore, when 18 to 25 year-olds were surveyed, there was again a significant increase in the prevalence of depression, but only among those 18 to 20. So the incidence of depression in girls seems to be increasing from 12 to 20.

Dr. Ramin Mojtabai, a psychiatrist and professor at Johns Hopkins, points out this increase in depression is recent. There was no real increase from 2005 to 2011, but then the rise began, and got more pronounced in 2012 and 2013.

Why was the prevalence of depression increasing, and why was it more intense among girls? Were adolescents actually suffering more from depression? They adjusted for the prevalence of substance abuse, and still the trend was there; it wasn’t explained away by drug use or drinking. Neither could it be accounted for by looking at household composition, two parents versus one parent versus no parents.

The Centers for Disease Control and Prevention announced last November that the suicide rate for younger children from 10 to 14 had increased to the point where the risk of dying by suicide was as high as the risk of dying in a traffic accident.

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Your Child

Dr. Benjamin Shain, the head of the division of child and adolescent psychology at NorthShore University Health System, said “When it comes to your child, in a sense statistics don’t matter, what matters is your particular child. Pay attention to worry signs.”

Too often, he said, the parental impulse is to give advice or even step in and try to fix the problem. “What parents should do is mostly listen, that should be 90% of the conversation,” he said. The other 10% of the time, parents should not attempt to offer a solution, “but help the child problem solve.” He raised concerns, in particular, about the impact of electronic media on adolescents.

“There’s certainly evidence that cyberbullying may be connected to an increase in depression particularly among girls, maybe an increase in suicide,” Dr. Shain said. And this is an area, he said, where many parents feel at a loss about how to guide their children; the parental impulse may be to take away the cellphone, which may make things worse for some adolescents.

“That’s how they connect to their peer group, that’s how they get their support, that’s how they have a conversation with their group; you take this away and then you have a very isolated child.”

Over all, Dr. Mojtabai said, we need more information about whether there really is a trend here, and much more information about the teenagers’ lives. Still, it’s important for parents to be aware of the risks, both for children who are already struggling with mental health issues, and for those who may not yet have given their feelings a name.

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