Susan E. Dubuque has a personal horror story to tell. She is the proud, doting mother of what she now describes as "a normal, obnoxious 16-year-old." But five years ago, she would not have used "normal" to describe her son. At age 11, after an eight-year battle with depression, her son threatened to kill himself.

Whenever she speaks publicly about her son’s ordeal, often to psychiatrists and mental health professionals, she says she likes to clarify her credentials up front. "I am not an M.D., nor a Ph.D.; my degree is an M.O.M."

Last month the Mental Health America (NMHA) presented Dubuque its Green Ribbon Founder’s Day Award for her efforts in establishing National Childhood Depression Awareness Day.

Dubuque strongly believes that it’s about time parents, educators, and, indeed, medical and mental health professionals understand that childhood depression is not a behavioral or discipline problem. "This is a real illness," she told Psychiatric News, "and the parents of these kids need to feel just as comfortable seeking help for their children as they would for any other medical problem."

Dubuque never had the luxury of that comfort. In relating her son’s struggles, she describes feelings of helplessness and hopelessness, anger and frustration, embarrassment and guilt.

"I thought," she said, "what am I, the toxic mother? What did I do to cause his problems?"

Her son’s first encounter with psychological evaluation came at the age of 3 after having significant problems in preschool. His teachers noted he was having difficulty getting along with other kids, was not following instructions, and was very difficult to manage. Dubuque was told that her son was too young to determine whether anything was "wrong" with him.

By the age of 5, his behavioral problems not only had failed to improve but also perhaps were even worsening. This time, a psychologist told Dubuque that her son just needed better discipline. "It’s the obvious, easy excuse: blame the parents," she said.

Dubuque had her son evaluated again at age 7, this time not only by a psychologist, but also a child psychiatrist. He was diagnosed with attention deficit/hyperactivity disorder (ADHD). Looking back, she said, this was an accurate, although incomplete, diagnosis. He was started on methylphenidate (Ritalin), which she said made a remarkable difference. Her son was more controlled, more disciplined, more sociable.

When he was 11, the family went through a series of significant stresses that put her son on a "roller coaster." Dubuque remembers, "We talk about kids being either turtles or dragons. He was definitely a dragon; he was angry, noncompliant, agitated, and irritable. He was completely demoralized and out of control."

Dubuque took him to see the psychologist and psychiatrist again. It was while they were waiting for the results of that evaluation that the boy threatened to commit suicide. The day after the threat, the psychologist simply said, "I’m not at all surprised." This time, the evaluation was clearly indicative of major depression. Fluoxetine (Prozac) was added to his methylphenidate regimen.

Within weeks, Dubuque saw a "total brightening." She knew things were turning around when he asked to bring a friend home from school, something he hadn’t done in years.

After eight years of interaction with psychiatrists and mental health professionals, Dubuque’s son finally had two diagnoses that went a long way to explaining his problems Today, at 16, he still takes medication for his ADHD, although he has been off antidepressants for more than a year.

Smiling in a way that only mothers seem to do, Dubuque said, "He’s doing great, just fine in school; he just got his driver’s license and is just like any other obnoxious 16-year-old."

Dubuque doesn’t want others to have to wage an eight-year war for accurate and appropriate diagnosis of their child’s psychiatric disorder. She has spent the last several years on a campaign to raise awareness and educate parents, teachers, mental health professionals, and the public that disorders like depression can and do occur in children and that they are highly treatable.

It was Dubuque who approached the NMHA with the idea of a public awareness campaign about childhood depression. A hospital-marketing professional, she and many of her friends and colleagues had been informally educating hospital personnel on the topic for quite some time. The NMHA was happy to promote the idea.

Dubuque has published two books, one cowritten with her son. The Parent’s Survival Guide to Childhood Depression summarizes research and diagnostic and treatment strategies and explains them in lay language, while Kid Power Tactics for Dealing With Depression is written in language common to kids and teens.

Although her son used to be very active publicly, he now chooses to simply be a "normal" teenager. He even turned down an invitation to be on "Oprah" because he was too worried about studying for a Spanish test.

Psychiatric News agreed to Dubuque’s request not to use her son’s name in an effort to help protect his "normalcy."