In some patients the distress of acne may result in depression. This must be recognised and managed.
Signs of depression include:
-loss of appetite
-lethargy
-mood disturbance
-behavioral problems
-wakefulness
-spontaneous crying
-feelings of unworthiness.
In teenagers depression may manifest as social withdrawal (retreat to the bedroom or avoidance of peers) or impaired school performance (lower grades or missed assignments). Worse still, severe depression from acne has resulted in attempted suicide and, unfortunately, successful suicide. Worrying statements include I don't want to wake up in the morning; I'd be better off dead; I'm worthless; You'd be better off without me. Parents, friends and school counsellors need to take heed when they start to hear these types of comments.
Rarely, depression can be associated with acne treatment, particularly isotretinoin. There is considerable doubt that the drug has caused the problem and it seems much more likely that it results from the acne and psychological disturbances described above.
Regardless of the cause, depression must be recognised and managed early. If you think you may be depressed, contact your dermatologist or family doctor urgently for advice.
