The Southern African Association for Pastoral Work (SAAP)

Teen Depression

Source: http://www.helpguide.org/mental/dealing_depression_treatment.htm

What is depression in teenagers?

Occasional melancholy, bad moods and short periods of feeling down are common in adolescence. Major depression, however, limits an adolescent’s ability to function normally. Depression in teenagers is characterised by a persistent sad mood, irritability, feelings of hopelessness or the inability to feel pleasure or happiness for an extended period of time - weeks, months or years.

What are the symptoms of teenage depression?

Early symptoms of adolescent depression can be difficult to diagnose because they appear to be a normal part of the difficulties adolescents face. Depression may be indicated if an adolescent experiences an unusual degree of the following symptoms:

• Changes in eating and sleeping habits (eating and sleeping too much or too little).
• Significant weight gain or loss.
• Missed school, poor school performance and/or a sudden decline in grades.
• Withdrawal from friends and family.
• No longer enjoying activities that were once pleasurable.
• Indecision, lack of concentration, or forgetfulness.
• Feelings of worthlessness or guilt.
• Overreaction to criticism, irritability.
• Feeling that nothing is worth the effort.
• Frequent health complaints when no physical ailment exists.
• Anger, rage, anxiety.
• Lack of enthusiasm and motivation.
• Drug/alcohol abuse, thoughts of death or suicide.

Symptoms such as insomnia, panic attacks, delusions or hallucinations can indicate extreme depression, with particular risk for suicide.

What triggers depression in teenagers?

Depression may result from a confluence of factors:

• Significant events such as the death of a loved one, parents’ divorce, moving to a new area, or breaking up with a girlfriend or boyfriend can prompt symptoms. Adolescent depression can occur from neglect, prolonged absence from someone who is a source of care and nurturance, abuse and bullying, damage to self-esteem, or too many life changes occurring too quickly. In some teenagers, any major change may provoke depression.
• Earlier traumatic experiences such as abuse or incest often emerge and cause great distress as the child becomes a teen. This is because as a young child the victim did not have the life experience or language to process these painful experiences, or to protest. When such memories emerge in adolescence, the distress can be compounded if adults deny or discount the information.
• Stress, especially if the adolescent lacks emotional support.
• Hormonal and physical changes that occur during puberty also cause new and unexpected emotions. Moodiness and melancholy are often experienced and labelled as depression.
• Medical conditions such as hypothyroidism can affect hormone balance and mood. Chronic physical illness also can cause depression. When a medical condition is diagnosed and treated by a doctor, the depression usually disappears.
• Substance abuse can cause changes in brain chemistry.
• Allergies to foods such as wheat, sugar, and milk cause or exacerbate symptoms of depression.
• Nutritional deficiencies may be caused by an amino acid imbalance or vitamin deficiency.
• Genetics can predispose a teen to depression when the illness runs in the family.

What are the effects of depression in teenagers?

Many teen behaviours or attitudes that are annoying to adults are actually indications of depression:

• Drug and alcohol use: Depressed teens often use substances in an attempt to self-medicate their symptoms.
• Low self-esteem: Depression can intensify feelings of ugliness and unworthiness.
• Eating disorders: Anorexia, bulimia, binge eating, or yo-yo dieting are often signs of unrecognized depression.
• Self injury: Cutting, burning, head banging, or other kinds of self-mutilation are almost always associated with depression.
• Acting out: Depression in teenagers may appear as agitation, aggression, or high risk behaviours rather than - or in addition to - gloominess
• Suicidal thoughts or attempts: Teens who are seriously depressed or despondent often think, speak, or make “attention-getting” attempts at suicide, which should be taken seriously.

What are the risk factors for suicide in teenagers?

An alarming and increasing number of teenagers attempt and succeed at suicide. Suicide is now the third highest cause of death in adolescents, and children as young as five have been reported to have committed suicide.

It is also probable that suicidal statistics for teens are underreported, as they might overlook those whose reckless or dangerous behaviour resulted in death, or those in which the cause can not be definitely identified.

There are several high-risk factors associated with teen suicide:

• Previous suicidal behaviour.
• History of psychiatric disorder or substance abuse.
• Family history of suicide, psychiatric disorder or substance abuse.
• Loss of parent through any means.
• History of abuse, violence or neglect.
• Social isolation/alienation, including because of being gay or being bullied.

How is teenage depression treated?

Depression is commonly treated with therapy or with therapy and medication. A combination of approaches is usually most effective:

• Cognitive-behavioural therapy focuses on the causes of the depression and helps change negative thought patterns.
• Group therapy is often very helpful for teens, because it breaks down the feelings of isolation that many adolescents experience (sometimes it helps just to know that “I’m not the only one who feels this way”).
• Family therapy as an adjunct to individual therapy can address patterns of communication and ways the family can restructure itself to support each member, and can help the teenager feel like others share the responsibility for what happens in the family.
• Physical exercise is helpful in lifting depression, as it causes the brain’s chemistry to create more endorphins and serotonin, which change mood.
• Creative expression through drama, art or music is often a positive outlet for the strong emotions of adolescents.
• Volunteer work is sometimes helpful for adolescents. Helping someone else whose problems are greater than one’s own offers a perspective and also an opportunity to be helpful, which can increase one’s sense of purpose and meaning.
• Medication for depression should be used with great caution, and only under careful supervision. Recent studies by both the UK government and the FDA have led to warnings that not all psychiatric drugs may be appropriate for teenagers and children. Seek a physician who works specifically with teenagers.
• Hospitalization may be necessary in situations where a teen needs constant observation and care to prevent self-destructive behaviour. Hospital adolescent treatment programs usually include individual, group and family counselling as well as medications.
• Special schools, wilderness challenges, or “boot camps” are sometimes recommended for troubled teens. These alternatives are intended to help adolescents learn coping skills, develop confidence, learn to trust and work with others, improve academics and/or deal with negative behaviours.

Whether or not they are good options largely depends on the staff running the program. In many cases, they are not trained mental health professionals and may use confrontation, humiliation and punitive measures designed to break down resistance rather than build up internal strengths.

Sometimes these programs do more harm than good, and can even result in worse outcomes for adolescents. Before considering such alternatives, do careful research on their philosophy, methods, and the background of their employees.