History
Although antidepressants were used by child and adolescent psychiatrists to treat major depressive disorder, they were not always used in young people with a comorbid conduct disorder because of the risks of overdose in such a population. Tricyclic antidepressant were the predominant antidepressants used at that time in this population. With the advent of selective serotonin re-uptake inhibitors (SSRIs), child and adolescent psychiatrists probably began prescribing more anti-depressants in the comorbid conduct disorder/major depressive group because of the lower risk of serious harm in overdose. This raises the possibility that more effective treatment of these young people might also improve their outcomes in adult life. Although treatment rates are becoming more stable, there is a trend that suggests that little progress has been made in narrowing the mental health treatment gap for adolescent depression. The FDA has also placed a black box warning on using antidepressants, leading doctors to be hesitant on prescribing them to adolescents. Controversies
Throughout the development and research of this disorder, controversies have emerged over the legitimacy of depression in childhood and adolescence as a diagnosis, the proper measurement and validity of scales to diagnose, and the safety of particular treatments. Legitimacy as a diagnosis
In early research of depression in children, there was debate as to whether or not children could clinically fit the criteria for major depressive disorder. However, since the 1970s, it has been accepted among the psychological community that depression in children can be clinically significant.
Ebullism is the formation of gas bubbles in bodily fluids due to reduced environmental pressure, for example at high altitude. It occurs because a system of liquid and gas at equilibrium will see a net conversion of liquid to gas as pressure lowers; for example, liquids reach their boiling point at lower temperatures when the pressure on them is lowered. Symptoms
Symptoms of ebullism include bubbles in the membranes of the mouth and eyes, swelling of the skin, and bubbles in the blood. Blood circulation and breathing may be impaired or stopped. The brain tissue may be starved of oxygen because of blockage of arteries, and the lungs may swell and hemorrhage. Death results unless recompression is rapid enough to reduce the bubbles before tissue damage occurs. In 1960, Joseph Kittinger experienced localised ebullism during a 31 kilometres (19 mi) ascent in a helium-driven gondola. His right-hand glove failed to pressurise and his hand expanded to roughly twice its normal volume  accompanied by disabling pain. His hand took about three hours to recover after his return to the ground. Tissue samples from the remains of the crew of Space Shuttle STS-107 Columbia revealed evidence of ebullism. Given the level of tissue damage, the crew could not have regained consciousness even with re-pressurization. Mechanism
In the atmospheric pressure present at sea level, water boils at 100 °C (212 °F). At an altitude of 63,000 feet (19,000 m), it boils at only 37 °C (99 °F), the normal body temperature of humans.