Melomed Articles


4 December 2019 - Dr. Barry Fortuin

Teenage Depression


Introduction

The teenage years mark the transition from childhood to adulthood.It involves emotional,social and thinking pattern development.

The emotional changes involve rapidly fluctuating emotions as they learn to cope with many new situations.The social development in the modern era is complicated by the huge social networks ( Facebook, Instagram etc.) outside the family. The social support of family, peers, teachers, coaches etc. helps them manage the stress of the challenges they face.

The teen years are extremely tough and the vulnerable teenager is prone to emotional breakdowns.Depression affects teenagers far more than we realize.In fact it is estimated that one in five adolescents from all walks of life will suffer from depression.

Depression can destroy the essence of your teen's personality causing an overwhelming sense of sadness, despair or anger.


What causes Teen Depression 

A combination of factors can trigger depression in teens:

- A imbalance of neurotransmitters or brain chemicals that carry signals in the brain, this can be due to genetics or environmental stresses

- Traumatic life changes eg. a move, divorce, death of a loved one/friend/boy/girlfriend 

- Academic difficulties, bullying (also cyber bullying on social media), rejection or exclusion from the peer group

- Chronic illness, some medications, or severe physical injuries

- Negative lifestyle choices eg.poor eating habits,lack of exercise or mixing with antisocial groups

- Early childhood trauma eg, abandoned by parent/s, abuse (sexual/physical, emotional), violence in the environment, poor adult role models


 Signs of Teen Depression

1. Sadness or hopelessness 


2. Irritability, anger hostility


3. Withdrawal from friends/Family


4. Tearfulness or frequent crying


5. Loss of interest in activities 


6. Poor school performance 


7.  Changes in eating and sleeping tablets 


8. Restlessness and agitation


9. Feelings of worthlessness and guilt


10. Lack of motivation 


11. Fatigue or lack of energy 


12. Difficulty concentrating 


13. Unexplained aches and pains


14. Thoughts of death or suicide


In terms of areas of concern about depression parents should look out for:

Problems at school, running away from home, drug or alcohol abuse, low self-esteem, smartphone addiction and/or reckless behavior.

Suicide warning signs in depressed teens:

1. Talking or joking about committing suicide


2. Saying things like I'd be better off dead I wish I could disappear forever or There's no way out


3. Speaking positively about death, romanticizing dying (If I died people might love me more)


4. Writing stories and poems about death, dying or suicide


5. Engaging in reckless behavior or having a lot of accidents resulting in injury


6. Giving away prized possessions


7. Saying goodbye to friends and family as if for the last time


8. Seeking out weapons, pills or other ways to kill themselves


 

Treatment of Teen Depression 

What can the teenager do with depression 

The adolescent may feel ashamed to tell parents or anyone about how they are are struggling with depression, may think friends will make fun of them or feel they can deal with it on their own. They wear a mask of happiness to hide their condition. The illness then silently worsens.

The depression makes the teen want to withdraw from everyone and society. He/She May be secretly doing self harm eg. cutting with blades on arms where no one sees it. It is difficult for them to reach out for help.

The first step in getting help is for the teenager to share their emotional pain with someone they trust. If not a parent, then a best friend, school counselor or a helpline service.

This opens the door for interventions needed and can prevent the destructive consequences of depression eg. suicide, drug use or dropping out of school.


What can parents do to help depressed teenager

Parents need to be aware of the early warning signs of depression as noted earlier in this article. They must talk to their child about depression being a real illness and that they are there to listen to them and help them through it. They must show empathy and try to understand the child's illness and not challenge their feelings. Trying to teach the teen problem solving skills eg. healthy daily routines is better than wanting to fix the problem themselves. Giving the teen resources to use eg. books, self help group contacts is useful. The parent must monitor if the condition is improving and advise a medical check to rule out medical causes of depression. Encourage the teen to join family functions to prevent them isolating.Giving them unconditional love and acceptance boosts their self-esteem.Finally encourage that they see a mental health professional if they are too ill or not improving.


Mental Health Professional treatment of Teen Depression 

The health professional can be a psychiatrist, psychologist, school counselor, social worker or a minister. Some teenagers with mild depression can be helped by natural therapies eg, a herbalist, art therapy or social support networks eg. a sports club.

The treatment of Teen Depression has to be done on multiple levels. Individual sessions with the teen, involving parent/ caregivers in family therapy, interventions at school level and other groups such as social workers or organizations eg. places of safety.

The treatment usually involves psychotherapy (talk therapy) with or without medication.

In psychotherapy the first step is for the therapist to gain the teen's trust. This trusting relationships helps the teen open up and share what they are feeling. The therapist helps the teen feel that their experience is real and offers hope that help is available. By making them feel that many teenagers struggle with depression it eases the teen into sharing their most painful traumas underlying their condition.

A vital part of therapy is to build the young person's self- esteem and sense of self worth.

They they gain self confidence as they are taught positive coping skills. Helping the teen understand that their raging emotions are part of the challenges of this phase of their life let's them feel comforted. Therapy then focuses on helping them modulate the feelings of anger, guilt, sadness or loneliness and to verbalise these feelings in a healthier way.

Family interventions are a crucial part of building a support network for the teenager to prevent further relapses of the depression. Family conflicts, secrets and relationships are worked through over time.

The therapist has to reassure the teen that their recovery is a slow.ongoing process that involves the teen participating in the healing journey.


Medication

In mild cases of depression various herbal therapies are helpful, but if no change in the depression is noted medication scripted by a Doctor is essential.

One of the factors causing depression is a imbalance of chemicals in the brain.

The Antidepressants that are available have been scientifically researched as treatment for depression. There are many myths that these medications can harm the teenager's brain.

However, if given under medical supervision side effects are monitored by the psychiatrist and medication is adjusted.


Clinic Admission 

In severely depressed teens (suicidal, poor academics, poor physical health and parents/school unable to manage their behavior) there are Adolescent Clinics with a psychotherapy program run by Psychologists, Psychiatrists and Occupational Therapists which stabilises the patient with full interventions and a follow up support group.


Conclusion

In our modern, rapidly changing, fast-paced world teenagers are a very vulnerable group as they try to grappling with all it's stressors. As adults we must not only be role models to guide and support them, but also be mindful when they are depressed and need our full attention, love and care. There is hope for the depressed teenager and we must help them out of their suffering to a healthier, happy future.


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