The Under Acknowledged Disease Depression is a disease that afflicts the human psyche in such a way that the afflicted 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. It is now responsible for more deaths in youth aged 15 to 19 than cardiovascular disease or cancer (Blackman 103). Despite this increased suicide rate, depression in this age group is greatly under diagnosed and leads to serious difficulties in school, work and personal lives. Mood disorders in children are very prevalent and when should an adolescent with changes in mood be considered clinically depressed?
Many say the reason why depression is often over looked in children and teenagers are because “children are not always able to express how they feel (Brown 197).” Sometimes the symptoms of mood disorders take on different forms in children than in adults. Being a teenager is a time of emotional turmoil, mood swings, and gloomy thoughts. It is also a time of rebellion and experimentation observed that the “challenge is to identify depressive symptoms which may be superimposed on the backdrop of a more transient, but expected, developmental storm (Blacken 257).
Therefore, diagnosis should not lye only in the doctors hands but should be aided with parents, teachers and anyone who interacts with the child 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 204). Mood disorders are often accompanied by other psychological problems such as anxiety (Oster & Montgomery 204), eating disorders (Lasko 56), hyperactivity, substance abuse (Blackman, 134; Brown 107) and suicide (Blackman, 134). 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 204). Key indicators of adolescent depression include a drastic change in eating and sleeping patterns, significant loss of interest in previous activity interests (Blackman, 106) constant boredom (Blackman106), disruptive behavior, peer problems, increased irritability and aggression. Some doctors propose that “formal psychological 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 from increased emphasis on being popular. For other teens, some ways to become depressed from poor family relations, which could include decreased family support and perceived rejection by parents. Professionals 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 (Oster & Montgomery 126).
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? It is 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 (Brown 221). ” 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 stated that “it was only in the 1980’s that mood disorders in children were included in the category of diagnosed psychiatric illnesses (Brown 223). 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). It is said 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.
One physician remarked 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? There are two main avenues to treatment: “Psychotherapy and Medication.” The majority of cases of adolescent depression is mild and can be dealt with through several psychotherapy sessions with intense listening of advice and encouragement. Co-morbidity is not unusual in teenagers, and possible pathology, including anxiety, obsessive-compulsive disorder, learning disability or attention deficit hyperactive disorder (Brown 226) All of these should be searched for and treated, if present.
For the more severe cases of depression, especially those with constant symptoms, medication may be necessary and without pharmaceutical treatment, depressive conditions could grow and become fatal. Also 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.” (Brown 235) Until recently, health professionals have, largely ignored adolescent depression, but now several means of diagnosis and treatment exist.
Although most teenagers can successfully climb the ladder of emotional and psychological obstacles that lie in their paths, there are some that 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.
The Canadian Journal of CME. Home page. 9 Dec.1999. Brown, A.
NARSAD Research Newsletter. Home page. 9 Dec.1999. Winter.
Lasko, D.S., et al. Adolescent Depressed Mood and Parental Unhappiness.
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Moody or depressed: The Masks of Teenage Depression. Home page. 9 Dec.1999.