DEPRESSION: Out of the Shadows
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DEPRESSION: Out of the Shadows + TAKE ONE STEP: Caring for Depression, with Jane Pauley  

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Chapter 8: Treatment in Teens [4:59]

Hart, Emma, and their families talk about medications and therapy. New methods aim to find faster-acting treatments.

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Transcript: Chapter 8 - Treatment in Teens

NARRATION: (SEPTEMBER SCHOOL, HART LIPTON IN CLASSROOM) In the case of Hart Lipton, he switched to an alternative school where he now gets intense personalized attention.

His irritability and rapid cycling moods led his parents and psychiatrist to recognize that he has a form of bipolar illness, called bipolar 2 disorder. It is characterized by intense irritability and severe depressive episodes.

NARRATION: (HART LIPTON PLAYING WITH BAND) His treatment includes an antidepressant and a mood stabilizing medication that is commonly prescribed for bipolar illness.

HART LIPTON: (VO, (HART LIPTON PLAYING WITH BAND) In the long run, the medicine

HART LIPTON: (OC) has probably saved my life, straight up.

NARRATION: (EMMA TAKING MEDICATION) After spending fifteen months in a treatment facility out of state, Emma returned home and is doing much better. Her treatment for depression includes weekly talk therapy and a single anti-depressant. She tried seven different medications before finding one that worked.

EMMA: (VO, EMMA TAKING MEDICATION) I am glad that I stuck with it though because the med I'm on now (muffled)

EMMA: (OC) certainly is not a miracle pill but it does take the edge off, ahh, enough so the down days aren't quite as down. mood doesn't fluctuate as much and I don't feel as anxious.'s easier to stay positive and work in therapy, when just, ahh, the edge is off of it. But I certainly wouldn't call it a miracle pill.

NARRATION: (EMMA ROCK CLIMBING) The use of medications in adolescents is not as well researched as in adults and should be cautiously prescribed and continuously monitored. There is also debate in some circles as to whether antidepressants increase the risk of suicide in some patients. This controversy prompted the food and drug administration to take action.

DR. CHARLES NEMEROFF: (VO, EMMA ROCK CLIMBING) the FDA put a black box warning, um,

DR. CHARLES NEMEROFF: (OC) first for children and adolescents, and now for all antidepressants, not just SSRIs, for all age groups. And I believe that this was a mistake, because in hastening our awareness, what we've shown is that there's been a marked drop in prescribing of antidepressants, particularly in children and adolescents.

DR. CHARLES NEMEROFF: (VO, NEWSWEEK ARTICLE) And this was highlighted in a Newsweek article recently, with the decrease in prescribing, a clear increase in suicide rates and suicide attempt rates.

DR. THOMAS INSEL: (VO, NEWSWEEK ARTICLE) In aggregate, I think there's no question that

DR. THOMAS INSEL: (OC) the value of treating, the benefits of treating with medication, and particularly with medication and cognitive behavior therapy far outweigh these small risks. And those risks can be mitigated if you carefully monitor kids who are on these medications.

NARRATION: (EMMA AND JULIE AT TABLE) Cognitive behavior therapy is a practical, short-term form of talk therapy that provides tools for correcting distorted patterns of thinking.

for most people, medications are also helpful, but waiting for them to work can be agonizingly slow.

SCIENTIST: : (VO, MEETING AT NIMH) we saw a reduction in...

NARRATION: (MEETING AT NIMH) Here at the national institute of mental health, scientists are working hard to identify faster acting treatments.

DR. THOMAS INSEL: (VO, MEETING AT NIMH) I worry that we've set our sights too low for the treatment of depression,

DR. THOMAS INSEL: (OC) it's hard to find another syndrome in medicine that's characterized by anguish or pain for which you'd say, "Whoa, six weeks improvement, that's pretty good." Most of the time, you want to know about what's gonna help you in two to four to six hours.

NARRATION: (DR. ZARATE WALKING, DR. ZARATE WITH CARL) Recently, in a ground breaking clinical trial, Dr. Carlos Zarate intravenously administered an experimental drug called ketamine to patients like Carl Gruber who has suffered from major depression since he was 16 years old.

(Carl: It's like after a rain storm when the sun breaks out and all the clouds go away...)

The results were dramatic.

CARL GRUBER: (OC, WITH DR. ZARATE) When I came out of the infusion, within minutes, I felt my depression lift completely, and the most interesting thing was, uh, not only did I no longer feel depressed, I felt as though I had never been depressed.

DR. CARLOS ZARATE: (OC, WITH CARL GRUBER) We didn't have only one or a few symptoms get better in terms of energy, "I feel a little bit better." We had complete resolution of symptoms in many patients. And not only that, that the sense of self-esteem and that, "I am a human being," is really restored very rapidly. So the whole essence of the individual is really returned rapidly in a short period of time.

NARRATION: (DR. ZARATE WITH CARL) most patients experienced a rapid response because ketamine targets glutamate, a chemical found throughout the brain that interacts with all the mood influencing chemicals involved in depression.

CARL GRUBER: (VO, WITH DR. ZARATE) I felt a very marked lifting of the depression.

NARRATION: (DR. ZARATE WITH CARL) More work needs to be done to determine if ketamine can be used in a safe and effective manner. At a minimum, the findings suggest that targeting the glutamate system may lead to more effective, rapidly acting drugs.

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