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- Psychology
- Adolescent Depression: 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.