Adolescent Depression

Depression in adolescents affects society today because they are the future of tomorrow. Depression is a disease that affects the human mind in such a way that the afflicted tends to act and react strangely toward others and even to themselves, without knowledge of this strange behavior. Therefore it comes to no surprise to find that adolescent depression is strongly related to teen suicide. Adolescent suicide is now held responsible for more deaths in adolescents aged 15 to 19 than cancer or cardiovascular disease (Blackman, 1995). Despite this increased suicide rate, depression in this age group is frequently under diagnosed and often over looked, and therefore leads to severe difficulties in work, school, and personal relationships, which can often continue into their adult lives. Depression can be caused by many things, such as: school, work, relationships, etc.

One might ask, how prevalent are mood disorders in adolescents and when should an adolescent with changes in mood be considered clinically depressed? Brown (1996) has stated that the reason why depression is often over looked in adolescents is because “children are not always able to express how they feel.” Often the symptoms of mood disorders are expressed in different forms in children than in adults. Adolescence in general is a time of emotional chaos, mood swings, dim thoughts, and extreme sensitivity. It is also a time of rebellion and experimentation on many levels.

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 lie only in the hands of physicians, but also in the hands of parents, teachers, friends, and anyone who interacts with the adolescent on a daily basis.
Unlike adult depression, symptoms of adolescent depression are often disguised. Instead of expressing feelings of sadness, teenagers may express boredom and irritability, or may choose to engage in risky or deviant behaviors (Oster & Montgomery, 1996).

Literature Review

In 1996, Dr. Brown wrote about mood disorders and their causes in children and adolescents in the NARSAD research newsletter.

In 1995, Maurice Blackman, a clinical professor and director of the division of child and adolescent psychiatry, wrote the article “You Asked About… Adolescent Depression” for the Canadian CME journal.

Oster, G. D., & Montgomery, S. S. wrote an article in 1996 for Self Help and Psychology relating to the masking of adolescent moods.

Data Analysis

1/5 children have some kind of mental/behavioral problem
1/10 children have a serious emotional problem
1/8 children have depression

Out of all of these troubled children, only 30% receive some sort of help or treatment. The other 70% of these troubled children struggle through the pain and suffering and attempt to make it to adulthood.

Mood disorders, such as depression, are often accompanied by other psychological problems such as anxiety (Oster & Montgomery, 1996), eating disorders, hyperactivity (Blackman, 1995), substance abuse (Blackman, 1995; Brown) and suicide (Blackman, 1995; Brown, 1996; Oster & Montgomery, 1996) all of which can make it hard to see depressive symptoms. The most common signs of clinical depression include: increased changes in mood and associated behaviors that range from sadness, withdrawal, and a lack of energy to intense feelings of desperation and suicidal thoughts.

Depression is often described as an exaggeration of the duration and intensity of “normal” mood changes (Brown 1996). Major signs of adolescent depression include a drastic change in sleeping and eating patterns, observable loss of interest in previous activity interests (Blackman, 1995; Oster & Montgomery, 1996), constant boredom (Blackman, 1995), disruptive behavior, peer problems, and increased aggression and irritability (Brown, 1996). Blackman (1995) projected that “formal psychologic testing may be helpful in complicated presentations that do not lend themselves easily to diagnosis.”

For many adolescents, the symptoms of depression are directly related to low self esteem coming from the increased emphasis on popularity in school and other extracurricular activities. For many others, depression arises from an unsturdy, un happy home environment. 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” can possibly include increased disruptive behavior, self-inflicted isolation from peers and family members, and even verbal threats of suicide.

How can a physician or psychologist determine when a patient should be diagnosed as depressed or suicidal? Brown (1996) suggested the most efficient 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 spoken threats of suicide within the last two to three months, previous attempts to commit suicide, indication of severe mood problems, or excessive alcohol and substance abuse.

Several physicians often incorrectly refer to depression as an illness of adulthood. It was only in the 1980’s that adolescent depression was really recognized as an issue. In reality, before the age of 15, 7-14% of children will experience an “episode” of major depression. 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) stated that the suicide rate for adolescents has increased more than 200% over the last one hundred years. Brown (1996) added that about 2,000 teenagers per year commit suicide in the United States, making it the leading cause of death after homicide and accidents.

Blackman (1995) stated that it is not uncommon for adolescents to be preoccupied with the issues of death and also to contemplate the effect that their own death would have on their family and friends. Once it has been determined that the adolescent has the disease of depression, what is the treatment? Blackman (1995) has suggested two main options of treatment: “psychotherapy and medication.” The majority of the cases of adolescent depression are mild and can usually be dealt with through several psychotherapy sessions.

For the more severe cases of depression, especially those with constant symptoms, medication may be needed and without pharmaceutical treatment, depressive conditions could escalate and become dangerous, or even 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.”

Conclusion

Until recently, adolescent depression has been largely ignored by health professionals, which is a problem in society because if the problem is ignored, it doesn’t just go away, 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 stressed out and out of control. With the help of teachers, school counselors, mental health professionals, parents, and other caring adults in society, 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 and society.