Untitled 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.

References 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.