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.

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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.