Adolescent Depression 2 Essay, Research Paper
Depression is a disease that afflicts the human psyche in such
a way that the afflicted tends to act and react abnormally toward
others and themselves. Therefore it comes to no surprise to discover
that adolescent depression is strongly linked to teen suicide.
Adolescent suicide is now responsible for more deaths in youths aged
15 to 19 than cardiovascular disease or cancer (Blackman, 1995).
Despite this increased suicide rate, depression in this age group is
greatly underdiagnosed and leads to serious difficulties in school,
work and personal adjustment which may often continue into adulthood.
How prevalent are mood disorders in children and when should an
adolescent with changes in mood be considered clinically depressed?
Brown (1996) has said the reason why depression is often over
looked in children and adolescents is because “children are not
always able to express how they feel.” Sometimes the symptoms of mood
disorders take on different forms in children than in adults.
Adolescence is a time of emotional turmoil, 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 lay 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 (Oster & Montgomery, 1996). Mood disorders are often
accompanied by other psychological problems such as anxiety (Oster &
Montgomery, 1996), eating disorders (Lasko et al., 1996),
hyperactivity (Blackman, 1995), substance abuse (Blackman, 1995;
Brown, 1996; Lasko et al., 1996) 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 previous
activity interests (Blackman, 1995; Oster & Montgomery, 1996),
constant boredom (Blackman, 1995), disruptive behavior, peer problems,
increased irritability and aggression (Brown, 1996). Blackman (1995)
proposed that “formal psychologic 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 which could include decreased family support and perceived
rejection by parents (Lasko et al., 1996). Oster & Montgomery (1996)
stated that “when parents are struggling over marital or career
problems, or are ill themselves, teens may feel the tension and try to
distract their parents.” This “distraction” could include increased
disruptive behavior, self-inflicted isolation and even verbal threats
of suicide. So how can the physician determine when a patient should
be diagnosed as depressed or suicidal? Brown (1996) suggested the best
way to diagnose is to “screen out the vulnerable groups of children
and adolescents for the risk factors of suicide and then refer them
for treatment.” Some of these “risk factors” include verbal signs of
suicide within the last three months, prior attempts at suicide,
indication of severe mood problems, or excessive alcohol and substance
abuse. Many physicians tend to think of depression as an illness of
adulthood. In fact, Brown (1996) stated that “it was only in the
1980’s that mood disorders in children were included in the category
of diagnosed psychiatric illnesses.” In actuality, 7-14% of children
will experience an episode of major depression before the age of 15.
An average of 20-30% of adult bipolar patients report having their
first episode before the age of 20. In a sampling of 100,000
adolescents, two to three thousand will have mood disorders out of
which 8-10 will commit suicide (Brown, 1996). Blackman (1995) remarked
that the suicide rate for adolescents has increased more than 200%
over the last decade. Brown (1996) added that an estimated 2,000
teenagers per year commit suicide in the United States, making it the
leading cause of death after accidents and homicide. Blackman (1995)
stated that it is not uncommon for young people to be preoccupied with
issues of mortality and to contemplate the effect their death would
have on close family and friends.
Once it has been determined that the adolescent has the
disease of depression, what can be done about it? Blackman (1995) has
suggested two main avenues to treatment: “psychotherapy and
medication.” The majority of the cases of adolescent depression are
mild and can be dealt with through several psychotherapy sessions with
intense listening, advice and encouragement. Comorbidity is not
unusual in teenagers, and possible pathology, including anxiety,
obsessive-compulsive disorder, learning disability or attention
deficit hyperactive disorder, should be searched for and treated, if
present (Blackman, 1995). For the more severe cases of depression,
especially those with constant symptoms, medication may be necessary
and without pharmaceutical treatment, depressive conditions could
escalate and become fatal. Brown (1996) added that regardless of the
type of treatment chosen, “it is important for children suffering from
mood disorders to receive prompt treatment because early onset places
children at a greater risk for multiple episodes of depression
throughout their life span.”
Until recently, adolescent depression has been largely ignored
by health professionals but now several means of diagnosis and
treatment exist. Although most teenagers can successfully climb the
mountain of emotional and psychological obstacles that lie in their
paths, there are some who find themselves overwhelmed and full of
stress. How can parents and friends help out these troubled teens? And
what can these teens do about their constant and intense sad moods?
With the help of teachers, school counselors, mental health
professionals, parents, and other caring adults, the severity of a
teen’s depression can not only be accurately evaluated, but plans can
be made to improve his or her well-being and ability to fully engage
life.
—
References
Blackman, M. (1995, May). You asked about… adolescent depression.
The Canadian Journal of CME [Internet]. Available HTTP:
www.mentalhealth.com/mag1/p51-dp01.html.
Brown, A. (1996, Winter). Mood disorders in children and
adolescents. NARSAD Research Newsletter [Internet]. Available HTTP:
www.mhsource.com/advocacy/narsad/childmood.html.
Lasko, D.S., et al. (1996). Adolescent depressed mood and parental
unhappiness. Adolescence, 31 (121), 49-57.
Oster, G. D., & Montgomery, S. S. (1996). Moody or depressed: The
masks of teenage depression. Self Help & Psychology [Internet].
Available HTTP:
www.cybertowers.com/selfhelp/articles/cf/moodepre.html.