Adolescent Depression Essay, Research Paper

Adolescent Depression

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.