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While getting out of bed really late may be common among teens (afterall, you were up until 2am last night chatting with friends, right?), for some it's because they haven't got the energy or willpower to do anything.

And it's not because of simply being tired. In fact, a whopping one out of eight teens suffer from depression — a chronic and recurring medical condition.

Depression is a condition that should never be ignored, and it's not something a person can just 'snap out of'. Often there is an inherited genetic component, so it can run in families. People prone to depression have differences in how their brain works and responds to stress —it's a physiological thing. As a chronic disease, depression can resurface later on.

Levels of certain brain chemicals are out of kilter in someone who has clinical depression, and medications are designed to help restore the balance. The condition is not anyone's fault.

"Depression is a real illness, like asthma, or even cancer," said Dr. Amy Cheung, youth psychiatrist at Sunnybrook Health Sciences Centre in Toronto.

But untreated, it can lead to more severe consequences. In fact, studies show that bouts of depression tend to get worse over time, especially if left untreated. It's as though the brain adapts to the depressed state, and gets 'better' at being depressed with subsequent bouts. Some neuroscientists believe this has to do with a feature of the brain called plasticity — its ability to adapt and change. Unfortunately, its adaptation to depression is not a good thing.

Depression can lead to serious consequences such as suicide. In fact, suicide is the third leading cause of death in youth aged 15 to 24, and the sixth leading cause of death for kids aged 5 to 14, according to the US based Mental Health American. A recent study by Dr. Cheung and her colleagues show that Canadian teens suffer from similar rates.

Did you know? Suicide is the third leading cause of death in youth aged 15 to 24, and the sixth leading cause of death for kids aged 5 to 14.

"Suicide is the second leading cause of death in Canadian teens, second only to accidents. This is probably a low estimate given that many accidental deaths might be masked suicides," she said.

If you feel so down nothing peaks your interests, you're forever tired, and the feelings settle in for more than a few weeks (even if life around you is good), think depression. Look for help.

Your experiences can also contribute to depression. The death of someone close, violence, sexual abuse, neglect, bullying, or having a chronic disease such as diabetes all increase the risk of developing depression, according to the National Institute of Mental Health (NIMH).

Depression is not anyone's fault, and can be treated. Studies show that between 70% to 80% of teens respond to treatment.

There are two key types of therapy: medication and talk therapy. Several types of anti-depressant medications are available, but it's impossible to say which one will work best for a person. Individuals respond differently to different medications. You may have to try different treatments, one after another, until you find the right one.

Talk therapy consists of one-on-one sessions with a trained therapist such as a psychologist, psychiatrist or psychiatric nurse. Group sessions moderated by a therapist is another option. Talk-therapy helps you learn new ways to think through problems, and literally exercises certain parts of the brain that can improve mood.

"Research shows that a combination of both talk therapy and medication is ideal for most youth with depression," Dr. Cheung said.

It takes time for the coping strategies being taught to sink in. Sometimes people need to try different therapists until they get the right fit. Many people get the most benefit from a combination of medications and talk-therapy, though some improve with just one approach.

Research published in the Archives of General Psychiatry by Dr. Helen Mayberg at Toronto's Rotman Research Institute shows, through a series of brain imaging studies, that both talk therapy and antidepressant therapy lead to changes in the brain patterns of depressed patients. The study also showed that, individually, the different therapies lead to different sorts of changes in the brain.

"Our imaging study shows that you can correct the depression network along a variety of pathways. Anti-depressant drugs change the chemical balance in the brain through effects at very specific target sites. Cognitive behavioural therapy also changes brain activity, it's just tapping into a different component of the same depression circuit board," Dr. Mayberg said.

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Pippa Wysong

Pippa Wysong is a freelance medical, science and children’s writer. She writes for a variety of publications ranging The Medical Post to The Toronto Star and Canadian Living Magazine. She writes for various websites, and has written hundreds of answers to science questions for kids in her Ask Pippa column. To see samples of Ask Pippa check out: www.AskPippa.ca.

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