oil, mood swings, gloomy thoughts, and heightened sensitivity. It is a time of rebellion and experimentation. Blackman (1996) observed that the "challenge is to identify depressive symptomatology which may be superimposed on the backdrop of a more transient, but expected, developmental storm." Therefore, diagnosis should not lie only in the physician's hands but be associated with parents, teachers and anyone who interacts with the patient on a daily basis. Unlike adult depression, symptoms of youth depression are often masked. Instead of expressing sadness, teenagers may express boredom and irritability, or may choose to engage in risky behaviors. Mood disorders are often accompanied by other psychological problems such as anxiety, eating disorders, hyperactivity, substance abuse and suicide (Blackman, 1995; Brown, 1996; Lasko et al., 1996; Oster & Montgomery, 1996) all of which can hide depressive symptoms. The signs of clinical depression include marked changes in mood and associated behaviors that range from sadness, withdrawal, and decreased energy to intense feelings of hopelessness and suicidal thoughts. Depression is often described as an exaggeration of the duration and intensity of "normal" mood changes (Brown 1996). Key indicators of adolescent depression include a drastic change in eating and sleeping patterns, significant loss of interest in activities that were once found fun or interesting, constant boredom, disruptive behavior, peer problems, increased irritability and aggression (Blackman, 1995; Oster & Montgomery, 1996; Brown, 1996). Blackman (1995) proposed "formal psychological testing may be helpful in complicated presentations that do not lend themselves easily to diagnosis." For many teens, symptoms of depression are directly related to low self-esteem stemming from increased emphasis on peer popularity. For other teens, depression arises from poor family relations that could include decreased family support and ...
