Adolescent Depression and Treatment

by Matthew Tiszenkel

Almost everyone deals with sadness at some point in their life. The death of loved ones,

loss of friends, and the end of romantic relationships tend to invoke a sadness that most people

can relate to. That sadness is, in many ways, what it is like to be depressed. The defining

differences between sadness and depression are duration and impact on ones ability to

perform in everyday life. Most people are able to pick themselves back up again and resume

living their lives to the fullest after a healthy amount of grieving time. Unfortunately, however,

others are unable to move past their sadness without some additional help. Often times, as one

matures, they grow more accustomed to dealing with lifes disappointments and the sadness

that follows those events. For this reason, the misfortunes that occur during ones adolescence

can have a more lasting impact that may result in clinical depression, or a sadness that one

cannot simply brush off after some time.

With the rise of suicide rates among adolescents, it is important for everyone to start

taking mental health issues amongst teens and young adults more seriously. While suicide is

one of the more shocking and visible manifestations of the effects of depression, many

adolescents are living with depression that may be difficult to see. There are many reasons why

someone may be struggling with depression, and just as many for why one may choose to

conceal it. Parents, peers and leaders must stop stigmatizing depression and start encouraging

those struggling to get the help they need and deserve.

 According to the National Institute of Mental Health (NIMH), 12.5% of US adolescents

aged 12 to 17 experienced a major depressive episode in 2015. The study defines such an

episode as, A period of two weeks or longer during which there is either a depressed mood or

loss of interest or pleasure, and at least four other symptoms that reflect a change in

functioning, such as problems with sleep, eating, energy, concentration, and self-image

(NIMH). In other words, one out of every eight adolescents in America suffered from

depression at some point in 2015. Sadly, according to another study funded by NIMH in 2011,

which analyzed responses from a representative sample of 6,483 adolescents, only 39.4% of

Americans, aged 13 to 18, suffering from depression received services specifically designed to

treat their illness (Merikangas et al., 2011).

With depression amongst American adolescents so high, and treatment rates so low, it

is paramount for parents, teachers and peers to learn to identify some of the signs of

depression so they can get their loved ones the help they need. Frequently, parents have

difficulty identifying depression in their children. This is likely due to an inability to imagine why

their child could be upset with the, seemingly nice, life they provided for them. As long as said

parents are not abusive, it is important for them to remember their childs depression is not

their fault. Adolescents can be depressed for a myriad of reasons and depression is frequently

caused by a buildup of many different stresses. One must try not to overwhelm themselves

with the pressure of needing to understand why their loved one is depressed. Instead, one

should focus on doing their best to identify the symptoms in order to get them the help they

need. According to Moreh and OLawrence (2016), common symptoms of depression are, loss

of interest in activities, insomnia or excessive sleeping, poor appetite, impaired concentration,

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irritability/restlessness, persistent sadness or hopelessness, significant weight loss or gain,

withdrawal from friends and family, fatigue or decreased energy, tearfulness or frequent crying,

persistent aches or pains, feeling of worthlessness and guilt, or thoughts of death or suicide. If

you notice anyone experiencing these symptoms for longer than two weeks, talk to them to

make sure they arent in immediate danger to themselves or to others. Then, determine how to

get them the help they need.

Understanding why someone is depressed is much more difficult than diagnosing them.

Usually, this is a large part of psychotherapy. The patient and therapist have regular sessions

where they talk about everything from day to day activities, to major events of the patients

past, to the patients relationships with peers, family and educators. It can take years for a

therapist and patient to uncover all of the underlying causes of their depression but

fortunately, patients usually start to see an improvement in their mood much before that.

Khan, Faucett, Lichtenberg, Kirsch, & Brown (2012) discovered, a 47% symptom reduction in

patients undergoing psychotherapy compared to only a 13% reduction in the waiting list control

group. This may not seem like a major difference but there are many factors that could have led

to some participants not experiencing a reduction in their symptoms including substance abuse,

an inability to escape a recurring abusive situation, patients omitting critical details to their

therapist, patients not taking the steps recommended by therapists to help combat some of

their symptoms, etc. Lastly, different people respond better or worse to different treatment

options but luckily there are other options the study found to be just as effective.

Khan et al. (2012) also found, antidepressants were responsible for a 46% symptom

reduction in depression sufferers. Interestingly, the same study found that while there was a

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slight improvement in symptom reduction in patients utilizing antidepressants and

psychotherapy at 52%, there was not a significant difference in symptom reduction between

patients who were either undergoing psychotherapy, taking antidepressants, or utilizing

alternative therapies such as acupuncture or exercise. The researchers arrived at an interesting

conclusion where they claim, these data suggest that the type of treatment offered is less

important than getting depressed patients in an active therapeutic program (Khan et al.,

2012). This is an incredibly interesting notion, that it is not the treatment type that matters as

much as the act of going to seek treatment. The first and possibly most important step to

recovering from depression is admitting that there is a problem that needs help.

Once someone discovers there is a problem, it is typically a good idea to try and

determine what brought on the depression in the first place so if a similar issue arises in the

future, it can be better managed. Sometimes the inciting incident is obvious, the loss of a friend

or family member, a lovers quarrel, and physical, psychological or sexual abuse come to mind.

But oftentimes depression is caused by a buildup of different factors. Moreh and OLawrence

(2016) state that hormonal changes during puberty greatly increase the incidence of depression

in adolescents. This is especially common in adolescent girls because they tend to avoid

discussing their changing feelings and sexuality with others (Moreh & OLawrence, 2016). In

contrast, adolescent boys embrace the changes they experience during puberty because these

changes are viewed as positive by most societies (Moreh & OLawrence, 2016). Moreover, the

researchers address how Western media emphasizes unrealistic standards for women which

could negatively impact the self-esteem of many adolescent girls (Moreh & OLawrence, 2016).

Family predisposition was also shown to improve an adolescents chances of depression as the

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apple does not fall far from the tree (Moreh & OLawrence, 2016). If a child is brought up in a

happy and supportive family they are less likely to experience depression than in a family that

has a depressed parent.

Substance abuse, often considered self-medicating, is another commonly associated risk

of adolescent depression. In a 2015 study, the Substance Abuse and Mental Health Services

Administration (SAMHSA) (2015), determined substance use in depressed adolescents, aged 12

to 17, to be over double that of peers who were not experiencing depression. 31.5% of

depressed adolescents used illicit drugs compared to 15.3% of their peers who were not

suffering from depression (SAMHSA 2015). Among the depressed teens, 1.7% were heavy

alcohol users and 1.8% were daily cigarette users compared to 0.8% and 0.7% respectively

among their non-suffering peers (SAMHSA 2015). One might extrapolate that many substance-

using adolescents believe the substances are helping them overcome their depression.

However, more often than not, the substances are doing them more harm than good.

In conclusion, depression amongst adolescents is a serious issue that is not getting any

less significant. Parents, friends and teachers need to educate themselves and their loved ones

on the signs and symptoms so they can identify a depressive episode if it arises. Depression is

very cyclical so it is critical that everyone works together to create safe environments and helps

put an end to the suffering.

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 References

Khan, A., Faucett, J., Lichtenberg, P., Kirsch, I., & Brown, W. A. (2012). A Systematic Review of

Comparative Efficacy of Treatments and Controls for Depression. PLoS ONE, 7(7),

e41778. http://doi.org/10.1371/journal.pone.0041778

Merikangas, K. R., He, J., Burstein, M. E., Swendsen, J., Avenevoli, S., Case, B., . . . Olfson, M.

(2011). Service Utilization for Lifetime Mental Disorders in U.S. Adolescents: Results of

the National Comorbidity Survey Adolescent Supplement (NCS-A). Journal of the

American Academy of Child and Adolescent Psychiatry, 50(1), 3245.

http://doi.org/10.1016/j.jaac.2010.10.006

Moreh, S., & O'Lawrence, H. (2016). Common Risk Factors Associated With

Adolescent and Young Adult Depression. Journal of Health & Human Services

Administration, 39(2), 283-310. Retrieved from

http://search.ebscohost.com.libprox1.slcc.edu/login.aspx?direct=true&db=aph&AN=11

9548716&site=ehost-live

National Institute of Mental Health. Major Depression Among Adolescents.

Retrieved from https://www.nimh.nih.gov/health/statistics/prevalence/

major-depression-among-adolescents.shtml

Substance Abuse and Mental Health Services Administration (2015). Results from the 2015

National Survey on Drug Use and Health: Detailed Tables.

Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-

2015/NSDUH-DetTabs-2015/NSDUH-DetTabs-2015.htm#tab9-9b