TEENAGE DEPRESSION
The condition and causes of adolescent depression
Adolescent depression pertains to a mental health disorder that is developed during the teenage years of an individual. The major features of adolescent depression include a general feeling of sadness, as well as a prolonged sense of discouragement. An adolescent experiencing depression also feels that he is worthless and this is usually reflected in his loss of interest in specific activities that he used to cherish.
The condition of depression may be regarded as a temporary reaction to difficult situations or stressful incidents. It should be understood that these types of conditions vary and these mainly depend on the age range of the individual. Stressful situations for adolescents are therefore different from that of adults and the elderly. Among adolescents, a number of difficult situations may trigger the development of depression. The normal physiological changes that occur during adolescence, such as the changes in the physical features of the body, may induce depression in an adolescent. The development of breasts among female adolescents or the lowering of the pitch of male adolescents may be stressful to these young individuals.
The adolescent stage is also physiologically linked to an increase in the production of the sex hormones, testosterone and estrogen. Aside from the primary effect of production of sex-specific physical features among adolescents, these hormones can also affect the mental health condition of these individuals, thus resulting in the condition of depression. The adolescent stage is also characterized by an urge to feel independent and thus conflicts usually ensue with the parents. Such stressful condition may also trigger the development of depression among adolescents.
There are also certain social situations that may impart difficulty to an adolescent, including the death of a loved one or a close friend. Depression may also result from a breakup with ones girlfriend or boyfriend. It is also possible that poor performance at school may also initiate the depressive disorder, as the young individual feels embarrassed over his failure in class. It is also possible that depression occurs when an adolescent is bullied, harassed or abused (Nguyen et al., 2010). A congenital condition or developmental delay in an adolescent can also influence the occurrence of depression.
Symptoms of adolescent depression
The major effect of depression on an adolescent is a change in the way he sees himself, as well as how he lives his life at that particular stage. One unique feature of depression during the adolescent stage is that the young individual sees everything else surrounding him with a negative association and that each item will bring in more difficulty to his current situation. In addition, an adolescent with depression often finds himself agitated and easily irritated. The depressed adolescent is also restless and thus finds it difficult to focus on a specific task at hand.
An adolescent with depression also suffers from a major change in appetite. It has been determined that adolescents with depression are more likely to loss appetite than to gain it, as compared to adult depression which can go either way (Henje Blom et al., 2010). The eating disorder, anorexia nervosa, is therefore strongly associated with adolescent depression, as the extreme loss of weight may be due to a depression caused by any of the aforementioned social causes.
A number of mental skills are also affected by adolescent depression. It is common to find an adolescent with depression to find difficulty during decision-making activities, as he often is incapable of concentrating on specific topics. There may also be episodes of memory loss in an adolescent with depression. As this young individual is plagued with problems that seem to be irresolvable at any point in time, then the adolescent therefore feels mentally drained and physically fatigued.
In certain cases of depression among adolescents, behavioral problems develop such as shoplifting and uncommon defiance to parents and teachers at school. It is common to observe irresponsible actions in an adolescent who is depressed because he feels that he is trapped and is therefore struggling to save himself from more misery. Other depressed adolescents would turn to drinking of alcoholic beverages as these drinks could numb their senses, unknowing that this effect is only temporary. Once the effect of numbness due to the alcohol is lost, the depressed adolescent would initiate another bout of drinking, to revive that pain-free sensation. The same principles are also employed with the use of illegal drugs.
An adolescent suffering from depression usually avoids interacting with his family members and other close friends because he often feels less stressed out if he keeps to himself. Unfortunately, family members usually treat such isolation as part of a tantrum that is a common characteristic of adolescents. It is therefore important that family members are observant enough to identify the causative factor of a tantrum and a depressed state. It is possible that certain adolescents find themselves in an advanced stage of depressed due to the misinterpretation by the parents of the adolescents tantrums.
In extreme cases of depression in an adolescent, it is possible that this young individual would even consider committing suicide as a possible escape from all the suffering that he is experiencing. It is unfortunate to find literature that describe that the incidence of suicide is highest among adolescents, as they find themselves alone in a cruel world. It is thus important to determine possible treatments and approaches that would alleviate this mental health disorder and ultimately save lives.
Diagnosis of depression among adolescents
Diagnosing depression in an adolescent is usually harder than that in adults and the elderly, as it is a common occurrence for an adolescent to have mood swings during this developmental stage. In addition, the mood swings usually last for hours or even days and thus it is important to differentiate a mood swing from the actual pathological depressed condition. One confusing approach to diagnosing an adolescent with depression is to ask him directly if he is happy. The common response of an adolescent, regardless of depression or mood swing, is that he is not happy and that everything around him seems to make his life difficult. It is therefore more helpful if the physician would ask the adolescent about the symptoms that are associated with depression.
In addition to the questions regarding the symptoms of depression, the physician also conducts tests that would facilitate in the diagnosis of this mental health condition. It is important for the physician to rule out other medical disorders and thus a blood test may be requested to determine cell counts and other protein levels in the blood. The blood test may also assist in determining the presence of alcohol or any other illegal drugs, which are substances that also generate a depressed condition in an individual.
A psychiatric assessment should also be conducted to determine the frequency and extent of the symptoms of depression in the adolescent. The co-occurrence of other mental health conditions, such as bipolar disorder and schizophrenia may also be detected during psychiatric examination of the adolescent (Miklowitz et al., 2010). The physician will also ask the adolescent if he has ever entertained thoughts of suicide or actions that would physically hurt his self. These questions are important because these will determine if the adolescent would be a threat to himself.
The assessment may also require the input of the parents and other family members of the adolescent, as well as his teachers at school. These interviews will provide the physician of the regular activities and the underlying conditions that the adolescent is experiencing in the last few months or years. The information collected from the interview will assist in the construction of the emotions that the adolescent may be expressing outside the clinical consult. Once a diagnosis has been formally made, the physician is then required to design a treatment plan that would personally fit the adolescent patient.
Treatment of depression among adolescents
There are currently a number of treatment regimens for adolescents who have been diagnosed with depression. The choice of the actual therapeutic approach mainly depends on the condition of the adolescent, as well as his capacity to adhere to the suggested treatment plan of the physician. In addition to the participation of the adolescent in the treatment regimen, the parents of the adolescent, as well as other sibling and family relatives, are also asked to engage in treatment. It is important for the individuals in the immediate environment of the adolescent to be aware and to understand the condition of depression, in order to provide support and care to their loved one.
Pharmacologic treatment of depression among adolescents. One of the most common treatment plans for individuals positively diagnosed with depression is to administer anti-depressant drugs. There is currently a wide range of drugs that could be employed in the treatment of depression, yet the usual initial treatment of an adolescent involves a selective serotonin reuptake inhibitor (SSRI). It should be understood that serotonin is a neurotransmitter that is released in the nerve endings of neurons. This neurotransmitter is responsible in sending messages from one nerve cell to another and thus a change in the amount of this molecule may result in changes in the mental health condition of a patient.
In the case of depression, it has been determined that the neurotransmitter serotonin is relatively high and is actually being maintained between the space between nerve endings. The transmission of messages between nerve cells is thus inhibited and this often results in an imbalance in the mental health condition of an individual, which in turn generates a depressed condition. The administration of a selective serotonin reuptake inhibitor thus prevents the return of serotonin to nerve endings, resulting in the progression of neurotransmission to the next nerve cell. This inhibition of reuptake of serotonin therefore reinstates the normal physiological functioning of nerve cells and ultimately diminishes the symptoms of depression.
Two major drugs that are classified as selective serotonin reuptake inhibitors are fluoxetine and escitalopram. Fluoxetine, more commonly known by the drug brand ProzacTM, and escitalopram, of drug brand name LexaproTM, are the only drugs that have been approved by the Federal Drug Administration for the treatment of adolescents, between the age of 12 and 17 years old, who have been positively diagnosed with depression. For children of age 8 years old and below, only fluoxetine has been approved for administration.
One side effect of selective serotonin reuptake inhibitors and its analogues is that this drug could increase the likelihood to commit suicide. The packaging of these drugs therefore carries a warning sign that states that such risk is associated with its intake. Despite anecdotal reports on the increase in incidence of suicide among children and teenagers under this medication, there is still a need to establish a direct connection between the occurrence of suicide and the actual drug.
In order to prevent possible incidences of suicidal attempts among children and adolescents under selective serotonin reuptake inhibition medication, a number of guidelines have been established with its administration. Firstly, the physician should make regular check-ups on the young patient to identify any side effects that may develop soon after the initiation of therapeutic intervention. Another guideline is for parents to be observant of their child as soon as he starts taking the anti-depressant drug. Specific side effects, including any changes in the behavior, as well as signs of nervousness should be immediately reported to the physician. They should also be vigilant for signs of agitation or indications of irritability in their child. In addition, if these changes worsen through the days, then the medication should be stopped immediately, despite the knowledge that his depression would eventually return.
Talk therapy as treatment for depression among adolescents. The talk therapy approach for the treatment of adolescents who have been positively diagnosed with depression appears to be effective in this specific age range. The most plausible explanation for the effectiveness of talk therapy among adolescents is that these young individuals are not often engaged in expressing their emotions and concerns to other people. Such inhibition is strongly associated with this developmental age and therefore the mental health disorder of depression often results in the deterioration of the total well being of an adolescent. Once a young individual has initiated talk therapeutics, he feels that there are other individuals who care for him and that he is not alone anymore. In addition, the adolescent also learns during talk therapy that there are various methods on how to deal with his depression. There are currently three major types of talk therapy.
Cognitive-behavioral therapy is a type of talk treatment that educates individuals diagnosed with depression on how to fight negative ideas and emotions on a daily basis. In the case of an adolescent with depression, cognitive-behavioral therapy allows the young individual to learn which external factors commonly trigger his development of symptoms of depression. In addition, this type of therapy assists the adolescent in detecting factors that make his mental health condition worse. Cognitive-behavioral therapy therefore equips the adolescent with skills that will allow him to solve his own problems. It is expected that once the adolescent is cognizant of these external factors, he is now capable of handling difficult situations that have earlier influenced him to reach a depressed state.
Another type of talk therapy is family therapy, which technically involves the participation of the members of the adolescents family. In this setting, the adolescent and his loved ones, and possibly some teachers from his school, engage is a discussion of how they feel about the adolescent. It should be understood that a psychiatrist or therapy counselor is always present during these sessions because he is responsible in regulating and directing the discussion. This type of therapy is often suggested in cases where conflict within the family has been influential on the development of depression in the adolescent. The principle behind family therapy is that a discussion will allow each member of the family to express his concerns, thoughts and ideas regarding the adolescent, all in a positive way that will help the adolescent in recovering from his depression. These sessions are also aimed to make the adolescent feel that he is not alone and that there are people who care for him and are willing to support him through his journey to recovery.
Psychotherapy is another form of talk therapy that assists a depressed adolescent in understanding specific issues that are observed to be causing him to remain in that mental health condition. This approach mainly involves the adolescent and a psychiatrist, where this one-on-one correspondence allows the young individual to reflect on his emotions and his concerns in life. The psychiatrist generally asks the adolescent a battery of questions that are designed to make the young person realize that there are solutions to each of his problems. The aim of psychotherapy is to empower the adolescent with realizable principles that would guide him through his daily life. The psychiatrist plays an instrumental role in guiding the adolescent in his personal assessment of his thoughts, as well as behavior.
A support group is another form of talk therapy that involves a number of individuals who have been also diagnosed with depression. In the case of the adolescent, it is possible that he participates in a group that is composed of individuals of his same age range. This setting will allow the adolescent to feel that there are other adolescents who are struggling with the same mental health condition and therefore he should not feel alone. If this setting is ineffective, the adolescent may also participant in a support group that has members of different ages. It should be noted that the support group allows an individual to see the condition of depression through the eyes of different personalities. The aim of engaging in a support group is for an individual to express his feelings and thoughts, as well as hear other individuals who have the same mental health disorder, in the hope of learning from such engagement.
Additional approaches for the treatment of depression among adolescents
The symptoms of depression may vary from one individual to another, and thus it is important for the physician to recognize certain features that would need to be addressed during treatment. One important feature that has to be recognized during the diagnosis of depression is the severity of the mental health condition. Individuals with mild depression are generally easy to treat because this typically requires a low dose of anti-depressants. On the other hand, individuals with severe depression need more extensive treatments because the risk of committing suicide is generally higher in these cases.
In the case of an adolescent, the participation of the parents and teachers at school would be helpful in monitoring the condition of the young individual. However, it is often recommended that adolescents with depression be hospitalized in a mental health institution, which specializes in monitoring such clinical cases. In these healthcare institutions, highly trained healthcare professionals constantly monitor patients with regards to their activities. The monitoring of an adolescent with depression may be more difficult in a home setting because the parents or siblings may not be present at all times. If the depressed adolescent shows suicidal thoughts or may simply indicate plans of harming himself, then hospitalization may be the best option for the young individual.
Mental health institutions are equipped with personnel that engage is talk therapies. These regular sessions, similar to the talk therapies previously described in this report, allows the adolescent to learn how to identify factors that influence him to develop his condition of depression. Behavioral patterns are also taught, so that the adolescent may be empowered with actions that would prevent him from being affected by external stress stimuli. Pharmacologic treatments are also administered to adolescents in mental health institutions, mainly to stabilize their condition.
An adolescent with depression should also be empowered with the knowledge, as well as skills, on how to deal with stressful events that he may encounter on a daily basis. In addition, it will also be helpful for the adolescent to learn important things in his treatment. Firstly, the adolescent should be educated on what medications he has been prescribed. It will be helpful if the adolescent understands the effect of the actual drug he is taking and what are the possible side effects that might occur once he has started his medication. The physician should also educate the adolescent on the effects of stopping his medication without physicians advice. It would also be beneficial if the adolescent were taught of the importance of patient adherence, especially in terms of the prescribed treatment regimen for his diagnosed depression. The adolescent should also understand that if he feels that his condition has worsened, he should inform his physician, as well as his parents, of this change so that the appropriate action could be immediately performed.
An adolescent with depression should also engage in exercise because this activity improves the circulation of blood in the body. This improvement in circulation provides sufficient oxygen to the brain, which is the main organ that is affected by depression. Exercise also serves as an activity that keeps the adolescent busy and far from concentrating on personal issues associated with depression. The adolescent should also refrain from taking alcoholic beverages because these may interact with the anti-depressant drug that he is taking. Illegal drugs and other narcotics should also be avoided, in order to prevent any adverse effects from the medication.
Depression is a mental health disorder that is characterized by a general feeling of sadness and helplessness. This disorder affects individuals of various ages and therefore it is important to consider the age of an individual during diagnosis. Adolescent depression is generally more difficult to diagnose and to treat due to the inherent characteristics of this developmental stage. A number of factors influence the development of depression in an adolescent, including social, physiological and hormonal factors. It is important for a physician to carefully examine an adolescent during the diagnosis of depression, which is usually performed by asking questions regarding the symptoms of the condition. An adolescent diagnosed with depression may be treated with pharmacologic drugs, as well as talk therapy. The progress of the treated adolescent should be regularly monitored in order to determine the improvement of his condition. Additional treatment measures may also be conducted in order to assist the adolescent in his recovery from depression.
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