Depression is one of the most prevalent mental disorders that can affect people’s life severely. Research shows not only such mental condition is capable of influencing adolescents’ cognition, personality, as well as behaviour, but also the origin of one’s depression, can often trace back to teenage years (Hankin, 2006). Despite the fact that one in eight adolescents is affected by depression, teenage depression is often unrecognised as young people often have trouble expression emotion (Blackdoginstitute.org.au, 2018). The difficulty of distinguishing mood swing from depression in adolescents also contributed to the ignorance of adolescent depression, as they tend to experience emotions intensely. However, with an accurate diagnosis which identifies the problem and effective clinical management which usually involves psychological intervention and medical treatment, adolescent depression can be restrained and eventually cured (Thapar et al., 2012).
1. What is adolescent depression?
As known as a major depressive disorder, depression is a mental illness that leads to persistent sadness and loss of pleasure in daily activities (Parekh, 2017). Adolescent depression can cause significant negative impacts on the way a teenager thinks, feels, and behaves, as it occurs at a stage when young people go through rapid personal changes (Lynch and Duval, 2011).
Depression within adolescents differs from the feeling of sadness of grief, which are natural and normal responses to negative experiences such as the end of an intimate relationship or death of a loved one. Although a teenager feeling grief and another having depression could both be subjected to intense sadness and withdrawal from daily activities, grief is temporal as the feeling often decreases within two weeks, while untreated depression usually lasts for months or even longer (Encyclopedia Britannica, 2013). Furthermore, contrary to people in grief who tend to experience sadness in waves intermixing with positive memories from the past, depression is persistent and frequently accompanied with self-loathing and a sense of worthlessness (Parekh, 2017).
2. What Are the Signs and Symptoms of Depression in adolescents?
Although depression could occur at any stage of life, symptoms of such condition could differ from adolescents to adults. Furthermore, it can be hard to distinguish adolescent depression from emotional turmoil. Therefore it is crucial to look for specific emotional, as well as behavioural signs and changes to identify depression (Blackdoginstitute.org.au, 2018).
When an adolescent is suffering from depression, the most noticeable change is the persistent feeling of sadness, which is often accompanied with feeling moody or irritable (Encyclopedia Britannica, 2013). If the teenager is unwilling to express his/her emotions, behaviours such as crying for no obvious reason or sudden outbursts of anger over trivial matters may indicate the person is experiencing intense emotional changes (Mayo Clinic, 2017).
The feeling of emptiness and hopelessness acts as another common symptom of adolescent depression (Mayo Clinic, 2017). The emotion is often identified by the teenager’s reduced capacity to experience pleasure in activities. Vary from the severity; the teenager may experience loss pleasure in executing hobbies he/she used to enjoy, lack of motivation in performing current activities, disinterest in anything in the future (Raising Children Network, 2016). The person might describe as feeling “numb” or “empty”. Other shifts such as the reduced desire for social interactions, feeling guilt or worthlessness, having difficulty concentrating, thinking, as well as making rational judgements are also signs of adolescent depression.
Adolescent depression also evokes physical symptoms. Teenagers who are depressed might have significant changes in weight or appetite (Blackdoginstitute.org.au, 2018). Change in sleeping patterns, which lead to insomnia or sleeping too much is another physical sign of a young person experiencing depressed mood (Raising Children Network, 2016). Additionally, though people generally associate tiredness with depression, restlessness such as fast pacing, rapid speech rate, as well as inability to sit still are also symptoms of depression (Raising Children Network, 2016). It is suggested if major symptoms have shown by an adolescent and depression is suspected, an official assessment should be instantly sought by a mental health professional.
3. What are the causes of depression in adolescents?
The single reason that causes adolescent depression is yet to be found. However, research suggests a combination of factors, including biochemical, genetic, and environmental elements could contribute to the occurrence of it.
Research involving brain-imaging technologies demonstrate that brains of adolescents who suffer from depression are structurally different from the brains of normal adolescents (Psychology Today, 2011). Teenagers with depression are found in their parts of the brain that govern the release of hormones and neurotransmitters, which are critical in regulating emotion and cerebral communication, abnormal or damaged. This leads to changes and impairments of the nervous system as well as nerve receptors, eventually causing depression (Mayo Clinic, 2017).
Depression runs in families, which means the mental condition can be passed down through family trees (Mayo Clinic, 2017). Adolescents whose parents or blood relatives have depression are more likely to develop the condition.
As teenagers’ coping mechanisms are yet to be fully-developed, traumatic events in early stages of life can lead to a long-lasting effect on their mental health (WebMD, 2015). Life events such as loss of a parent, physical or emotional abuse and other traumatic experiences could trigger adolescent depression to a significant extent. Furthermore, adolescents who are frequently exposed to negative mentality are more prone to depression. Being persistently subjected to pessimistic thinking from their closed ones, teenagers often develop a sense of hopelessness rather than the motivation to overcome them when encountering challenges, potentially leading to depression (Mayo Clinic, 2017).
4. What are the impacts of depression in adolescents?
Depression is capable of affecting adolescents in multiple aspects of life. First, depression influences teenagers’ education significantly. Due to the condition, teenagers’ attendance rate, memory function, and the ability to concentrate could be affected, leading to substantial inhibition of academic performance (Ryan, 1987). Also, research suggests depression could increase the occurrence of dangerous behaviours among teenagers (Shanok and Lewis, 1977). Adolescents with depression are considerably more likely to perform substance abuse and other behaviours that involve the juvenile legal system. Additionally, depression leads to self-harm behaviours. (Gould et al., 1998). As depressed youths are often subjected to emotions of feeling empty and numb, self-harm behaviours usually serve as a mean to increase affective experiences (Gould et al., 1998). By cutting or stabbing themselves, depressed individuals can feel “real” or “alive” through the pain and the excitement of performing such behaviours. Furthermore, depression raises suicide rates among adolescents. Approximately 60 % of depressed teenagers have a suicidal thought, and 30% attempt suicide once or multiple times (Sheldon, Cook and Peterson, 2009). The is often the result of the combination of the mental condition, interpersonal conflict, and substance abuse (Gould et al., 1998).
5. How can depression be treated in adolescents?
Treatment of adolescent depression is often achieved by psychotherapy and pharmacotherapy. While the therapy should correspond with the type as well as the severity of the patient, a combination of counselling and medication is proved effective for most of the depressed teenagers (Mayo Clinic, 2017).
Also known as psychological counselling, psychotherapy helps the patient to overcome depression through personal interaction and talking with a mental health professional. Cognitive behaviour therapy (CBT) and interpersonal therapy (IPT-A) are two of the most effective psychotherapy treatments for adolescent depression (WebMD, 2015). CBT consists of sessions which teaches depressed adolescents the methods to improve communication skills, coping skills, and problems solving. The therapy also trains the patient to acquire techniques of combating negative mentality and regulating one’s emotion (Legg, 2016). Contrary to CBT, IPT-A empathises on the changes in current interpersonal relationships with the patient’s significant others and discovering new personal identity (Legg, 2016). The therapy is found to be effective in treating acute depression within adolescents, as it improves the patient’s social functioning significantly, reducing the clinical severity of depression symptoms to a great extent, which leads to lower hospitalisation rate and suicidality (Mufson and Fairbanks, 1996).
Although psychotherapy plays a significant role in treating adolescent depression, it is sometimes necessary to utilise medication considering on the severity and the history of the patient. Due to their mild nature which evokes fewer side effects, selective serotonin reuptake inhibitors (SSRIs) are among one of the most frequently prescribed antidepressants when dealing with adolescent depression (Legg, 2016). However, every patient responds differently to medication. Therefore, close physical and emotional monitoring is always preferred, as it helps to access and identify any potential adverse effects. If major improvements and no unusual behaviour are observed, pharmacotherapy session is generally considered safe to performed (Sheldon, Cook and Peterson, 2009).
As one of the most common mental illnesses among adolescents, adolescent depression is able to cause functional impairment and a considerable amount of suffering. Evoked by abnormalities in biochemical releasing, genetic makeup, and hostile environment, adolescent depression can cause symptoms such as persistent sadness and meaninglessness, which leading to vary negative impacts on youth’s wellbeing, self-harm behaviours, even suicide. However, with proper treatments involving psychotherapy and pharmacotherapy, depression symptoms can be reduced, and the condition can be finally treated.