Adolescent Depression Essay, Research Paper

The Under Acknowledged Disease 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.

Blackman, M. (1995, May). You asked about… adolescent depression. The

Canadian Journal of CME [Internet]. Available HTTP: http://www.mentalhealth.com/mag1/p51-dp01.html.

Brown, A. (1996, Winter). Mood disorders in children and adolescents. NARSAD

Research Newsletter [Internet]. Available HTTP: 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: http://www.cybertowers.com/selfhelp/articles/cf/moodepre.html