Adolescent Depression

If you were to type in the words “adolescent depression” into an online search engine, you would find hundreds of entries for this topic. Some of these entries are from online magazines and newspapers, while others are from non-profit organizations, like the American Psychological Association (APA) and American colleges and universities. Judging from the many websites published on this topic, one would infer that adolescent depression is a well-known and prevalent issue in today’s society. As a matter of fact, adolescent depression is more common today than fifty years ago (Johnson, Weber, & Zimbardo 475). Surprisingly enough, the average age of a depressed person nowadays is between the ages of 14 and 15, which is a dramatic change from the old days (Johnson, Weber, & Zimbardo 475). On top of that, teenage women are the most likely targets of depression as many researchers have found (qtd. in Honson, Weber, & Zumbardo 474). Some studies in the late 1990’s have also found that teens who are gay, lesbian, bisexual, as well as minorities are especially at risk for developing this illness (Evans, Schumacher, & Van Velsor).

Depression is a mental illness in which a person experiences intense sadness along with a loss of interest in daily activities. The symptoms of this illness in adults are similar to those in adolescents. However, the symptoms in adolescents can be difficult to notice because they can be mistaken with normal teen sadness. While short bouts of depression do occur in adolescents, most depression cases can be very serious and require immediate medical attention. It is important that adolescents suffering from chronic depression seek professional help immediately because delays may place them at risk of committing suicide. Not seeking treatment can also be harmful to their health both physically and mentally.

Youths who suffer from depression display a wide variety of physiological symptoms. One of the symptoms includes changes in appetite. In most cases, depression decreases a person’s appetite, whereas in some cases, it makes people eat more than usual. These changes in appetite can trigger eating disorders, which have been found to be associated with adolescent depression in a number of studies (Smith). In addition, depression changes depressed youths’ sleep patterns as well. It may cause them to sleep too much or too little. The low-quality of their sleep may lead to restlessness and irritation during the day. It is also not uncommon for depressed individuals to wake up repeatedly during the course of the night. Two other common physical problems that teens with depression often have are headaches and stomach aches.

Along with numerous physiological problems, depressed adolescents also suffer from cognitive problems. First of all, these people mainly think about everything in a negative manner, including how they think about themselves, their environment, and their future. Because of this negative attitude, they usually do not seem to enjoy the things that they used to enjoy doing. Furthermore, they have trouble focusing and remembering things, which consequently leads to a drop in their grades and school attendance. In addition, they also tend to feel hopeless, guilty, and worthless.

In order to get rid of the anxiety and sadness, some adolescents may turn to substance abuse, risky behaviors, and sexual activity (Smith). Depressed adolescents might even think of or actually try to kill themselves. It was found that out of the whole population of depressed individuals, 15% commit suicide, while an even higher percentage attempt to do so (Cohen). As a matter of fact, suicide is the third leading cause of adolescent deaths in the United States according to the U.S. Department of Health and Human Services (Brage & Meredith).
Some depressed adolescents may display other symptoms. For one, they might have delusions (false beliefs) and hallucinations (false sensory perceptions), which are common in a schizophrenic person (Cohen). Unlike depressed individuals who do not have these symptoms, these people tend to have longer hospital stays (Cohen). Another common symptom of depression is frequent crying, which can occur everyday or almost everyday. Aggression and feelings of anger can also occur in depressed adolescents. Overall, if an adolescent suffers from five or more depressive symptoms for at least two weeks, he or she is in need of professional help (Brody).

Depression is grouped into several categories on the basis of symptoms. The various forms are bipolar disorder, unipolar depression disorder, seasonal affective disorder, dysthymia, and major depression. People with bipolar disorder experience periods of depression followed by periods of mania. In other words, their mood alternates between sadness and happiness. Those who suffer from unipolar depression remain sad or depressed for long periods of time, but unlike people with bipolar disorder, they do not experience mania. People who have affective disorder (SAD), however, are depressed when they are not exposed to long daylight hours. They are especially depressed in the fall and winter months when the daylight hours are shorter. On the other hand, if a person has dysthymia, he or she may spend a few years suffering from low self-esteem and poor concentration. Some people who have dysthymia may also have occasional episodes of major depression. Major depression is the most severe type of depression and has more symptoms than any other type of depression.

The biological, cognitive, psychoanalytic, and behavioral approaches have been used to explain the causes of depression. The biological aspect suggests that people become depressed due to biological and genetic causes. According to the cognitive theories, however, psychological factors like low self-esteem and pessimism can trigger depression regardless of whether or not a person had a genetic predisposition. The psychoanalytic approach also argues that life experiences are responsible for depression. There are even cases where depression is caused by stress and environmental factors as behavioral theories claim. On the other hand, many psychologists believe that biology, a person’s mental health, stress, and environmental factors all contribute to depression (Cohen).

Biological abnormalities and genes have been linked to depression. Many studies have indicated that irregular amounts of brain chemicals called neurotransmitters are responsible for depression in some individuals. An imbalance of the neurotransmitter serotonin has been found to cause anxiety, sleep problems, and irritation, while an irregular amount of norepinephrine leads to fatigue and concentration problems. Some scholars believe that problems in the hypothalamus can lead to the psychological and physical symptoms of depression (qtd. in Caro & Oster 40). Low levels of vitamin B6 and vitamin B12 and folic acid can also contribute to depression (Cohen). Viral infections as well as brain disorders, like Huntington’s Disease and Alzheimer’s disease can also lead to depression. Depression may also be due to high levels of hydrocortisone, a hormone that is secreted when a person is stressed.

Another common finding is that depression tends to run in families. Compared to more distant relatives, immediate family members of a depressed individual are at higher risks for developing depression (qtd. in Caro & Oster 40). Psychologist David B. Cohen also support that genetics play a role in depression. Cohen reported that an identical twin is three more times likely to suffer from depression if his or her twin suffers from it. On the other hand, the likelihood of depression among fraternal twins is slightly smaller.

Psychological factors play a role in a person’s depression as cognitive theories have pointed out. Psychologist Aaron T. Beck supported this notion by saying that the way people think influences their depressive behavior. He indicated that depressed individuals tend to be sensitive to criticisms from others and that their thoughts are usually irrational. Their irrational thoughts, as a result, lead them to view everything negatively, which causes depression. In other words, people who have low self- esteem, are pessimistic, and are critical of themselves tend to become depressed. Martin Seligman, on the other hand, suggested that depression is due to a person’s learned helplessness. Learned helplessness is the belief that one cannot control how situations turn out because of extensive exposure to an escapable event. For example, a person who possesses an optimistic personality may become helpless after being held hostage for a month. It is this helplessness that leads him or her to become depressed. Lynn Abramson had a slightly different opinion toward depression. She thought that depression is not just the result of helplessness, but of hopelessness as well. She believes that self-blame and self-criticisms are key factors that trigger the hopelessness, which leads to depression.

Psychoanalytic theories believe that events in development are responsible for depression. Among these events, addictions, unexpressed anger, guilt, and unstable relationships can cause a person to become depressed. Sigmund Freud, an important figure in psychoanalysis, attributed depression solely to a person’s losses and failures. Such losses can include deaths of loved ones and divorce. Some failures may be academic, financial, or related to extra-curricular activities. He further believes that a weakened ego triggers the negative thoughts and actions that a depressed individual has.

Behavioral theories focus on environmental factors as the cause of depression. C. Ferster, a behaviorist, believed that depression is due to difficulties in seeking positive reinforcement. When such reinforcement is not present, a person reduces certain actions, which result in a cycle of reduced behaviors and end in depression. Peter Lewinsohn had a similar approach. He believed that the illness is due to a person’s inability to obtain positive reinforcement. In other words, those who do not have the skills to find reinforcement end up depressed.
In some cases, both genetics and environmental factors can play a role in causing depression. In other words, people who are already genetically predisposed to depression may develop the illness when exposed to certain environmental factors. First of all, if these people live in highly stressful conditions, the stress can trigger the depression. Young single mothers, for example, are vulnerable to the illness because they might be the only one raising their children; as a result, they might not have enough money to support themselves and their children.

Depressed adolescents usually do not seek treatment because they feel ashamed and embarrassed to do so. School officials and their families are often the ones that refer them to mental health professionals. It is highly unlikely that these adolescents are referred on the basis of depression. In most cases, rebellious behaviors, such as drug abuse, suicidal behavior, or sexual activity lead others to refer them. Only after they have been receiving treatment, do mental health professionals diagnose them with depression.
Depression can be treated through antidepressant drugs, which work by altering the serotonin and norepinephrine levels in the brain. There are three types of antidepressants: tricyclics, monoamine oxidase inhibitors (MAO inhibitors), and selective reuptake inhibitors
(SSRI’s). Antidepressants have proven to be effective in 70% of the patients who have taken them for depression (Cohen). Another advantage of taking these drugs is that its effects are quick, working after only to 2 to 3 weeks of usage. One setback is that depressed individuals might have to take different antidepressant drugs in order to find the right one that works best for them. Furthermore, patients taking these drugs are not supposed to eat foods that contain tyramine because doing so raises their blood pressure. Tyramine is found in foods like cheese, beer, and wine. In addition, patients must keep using these drugs for several more months after recovery in order to prevent their depressive symptoms from coming back. Tricyclics work by allowing the body to take in less neurotransmitters. Some tricyclics include Elavil, Tofanil, Norpramin, Pamelor, and Sinequan. A few common side effects of tricyclics are insomnia, nausea, drowsiness, blurred vision, and constipation. MAO inhibitors, on the other hand, create more norepinephrine by reducing the activity of the MAO enzyme. Like tricyclics, these drugs have similar side effects. As for SSRI’s they include Prozac, Zoloft, and Paxil. The most popular antidepressant drug today is Prozac. Patients who take it would say that it gives them a better outlook on life, higher self-esteem, and more energy (Cohen). However, Prozac along with other SSRI’s do have side effects. Their side effects are not as intense as other antidepressants, but include anxiety, headaches, drowsiness, and insomnia.

Lithium carbonate is another effective antidepressant drug, which is only used to treat bipolar disorder. It works by reducing the intensity of mood swings in bipolar individuals. However, its side effects can be dangerous. For one thing, if taken in large amounts, it can cause intoxication. Doctors advise that patients using this drug take small doses. It is also recommended that these people have their blood examined weekly in order to make sure that there is not an overdose of lithium. Physical problems, like stomach aches, are also possible when taking this medication.

Research shows that psychotherapy can work as well as antidepressants in treating mild to moderate depression (Cohen). Compared with those who choose drug therapy, people treated with psychotherapy are at lower risks of experiencing relapses (experiencing the illness after just recovering from it). The disadvantage of psychotherapy, however, is that it does not work as quickly as antidepressants do. It can also be very costly and time-consuming. In psychotherapy, a therapist helps organize a patient’s thoughts and actions. There are several types of psychotherapies: behavioral, cognitive, cognitive-behavioral, psychodynamic, and humanistic. Behavioral therapists try to treat the disorder by changing a patient’s actions and habits. Behavioral therapy basically assumes that depression is due to a person’s learned habits, not due to biological factors. In cognitive therapy, however, the way a person thinks causes the depression. As a result, cognitive therapists try to change a patient’s thoughts. The cognitive-behavioral therapist, on the other hand, combines the techniques of the cognitive and behavioral therapies by changing a person’s thoughts and actions. On the contrary, the psychodynamic approach suggests that mental disorders result from unresolved problems in childhood. A therapist using this approach will explore a person’s childhood and find out how past conflicts are related to his or her illness. Unlike all the other therapies, the humanistic therapy promotes human potential and achievement. The goal of this therapy is to help patients work on their troubled relationships and maintain a positive view of life.

Depressed individuals who do not find antidepressants and psychotherapy helpful may turn to electroconvulsive therapy (ECT). ECT treats people by sending electric shocks to the brain for a few seconds until a seizure occurs. Over the course of a few weeks, patients will be given 6-10 ECT sessions. The benefit of this type of therapy is that its effects are quick, working after three or four days. On the other hand, brief periods of disorientation as well as memory loss are common side effects.

Adolescent depression is a common problem in today’s society. Those who suffer from this illness experience many mental and physical symptoms that are damaging to their daily lives. If we learn to recognize the symptoms of depression, we can help many adolescents deal with their depression. When a person we know displays such symptoms, the best action to take is to give them emotional support. However, if the condition is serious enough, we can refer him or her to a mental health professional. In turn, the adolescent can receive effective treatment for their illness. It will either be through psychotherapy, antidepressants, or even ECT. Whatever alternative he or she chooses, it will hopefully help the person get out of his or her depressed state. By getting the treatment they need, many depressed individuals will be discouraged from committing suicide, which ultimately will lead to declines in adolescent suicide rates.