How to Spot Depression in an Adolescent with Scoliosis

While idiopathic scoliosis itself does not typically cause physical pain in adolescence, it can lead to other forms of pain, discomfort, and obstacles:

• Emotional pain. Many adolescents struggle with the idea of looking different from their peers. Some of the feelings a teen with scoliosis might report include fear, shame, denial, anger, or sadness. If the young person is also being teased or bullied, it could make the situation even worse.
• Uncomfortable bracing treatment. The most-commonly prescribed nonsurgical treatment for scoliosis is to wear a rigid brace that squeezes much of the body’s torso. This bracing treatment can be uncomfortable, especially when the adolescent’s body is first getting used to wearing it. The brace could also add frustration by being too warm in hot weather, making some tasks take longer, limiting activity participation, and potentially becoming a source of teasing.
• Major surgery. If nonsurgical treatment does not work for the adolescent, a spinal fusion surgery will likely be recommended. While scoliosis surgery is a relatively safe procedure with a good track record of achieving satisfactory results, it is still major surgery. The recovery process—which takes 6 to 12 months—is both mentally and physically demanding.

Due to the many challenges that can accompany scoliosis, studies have found that adolescents with this condition are at an increased risk for depression. ¹ Payne WK 3rd, Ogilvie JW, Resnick MD, Kane RL, Transfeldt EE, Blum RW. Does scoliosis have a psychological impact and does gender make a difference? Spine (Phila Pa 1976). 1997; 22(12):1380-4. ^{, 2} Chang WP, Lin Y, Huang HL, et al. Scoliosis and the subsequent risk of depression: a nationwide population-based cohort study in Taiwan. Spine (Phila Pa 1976). Feb; 41(3):253-8. If an adolescent does develop depression, identifying it early and getting help right away can make a big difference in achieving a successful outcome.

Signs of Depression in Adolescents

While the signs of depression in adolescents can be similar to those in adults, adolescents are much more dependent on parents, family members, or teachers to recognize the problem and get them help. Also, some signs of depression can easily be mistaken for moody behavior or other normal changes typical in growing teens.

If an adolescent is dealing with scoliosis, some possible signs of depression to watch out for include one or more of the following:

• Sustained irritability or anger. While it is normal for teens to have more mood swings and the occasional outburst, signs of anger or irritability should not occur frequently.
• Loss of interest. A depressed adolescent is less likely to hang out with friends. He or she might also lose interest in activities that were previously enjoyable.
• Lower energy levels. The adolescent might appear tired or sad most of the time.
• Change in routine or habits. There could be a change in eating habits, such as eating much more or much less. Another example could be a change in sleep patterns, such as sleeping more often or having trouble sleeping.
• Reduced performance. Teachers might report that the adolescent is not doing schoolwork as well as before or showing up late.
• Reckless behavior. Examples could include drinking excessive amounts of alcohol, using drugs, or getting speeding tickets, among others.
• Talking about suicide. In severe depression, a teen may start to consider taking his or her own life. Hints might be dropped during conversations or in other communications, such as school writing assignments. Even if an adolescent mentions suicide in seemingly joking terms, it could be a plea for help.

See 4 Tips to Help Cope With Chronic Pain and Depression

It should be emphasized that someone with depression may not outwardly appear sad or down. For instance, some depressed teens might instead show it by being angry and exhibiting reckless behavior. Furthermore, these behaviors do not necessarily mean a teen is depressed, so a medical professional’s evaluation is needed for an accurate diagnosis.

How to Get Help for Depression

If an adolescent is exhibiting any potential signs of depression, it is important to not ignore them. Here are some tips that can help:

• Try to start a conversation. If someone asks the adolescent what might be wrong, it is possible that he or she will open up. When an adolescent opens up to a parent, teacher, or other trusted adult, the important thing is to focus on listening to the adolescent’s concerns rather than trying to lecture them.
• Seek professional help. The only way for depression to be officially diagnosed is if a medical professional has the opportunity to examine the adolescent. A detailed questionnaire will be given, and a blood test may be taken to rule out the possibility of another medical condition causing the symptoms.

Depression is a serious condition that can affect every aspect a person’s life, including his or her scoliosis treatment. Seeking help sooner rather than later is the best first step for better managing the condition.