When It Hurts to be a Teenager

What is Depression?

Depression is a treatable medical illness, and distinguishing depression from adolescents’ normal mood swings can be difficult. Most high school students experience brief, sometimes intense episodes of the blues, irritability, or rebellion. Depression, particularly in teenagers, is often described as the invisible illness as its symptoms can easily masquerade as part of the normal tumult of adolescence, a time not noted for level moods or stable behavior. Rapid changes in hormonal balance, physical and cognitive development, response to peer pressure and perceptions of the world, combined with conflicting desires to be independent but free of responsibilities, make adolescence a time of emotional turmoil and behavioral extremes.

Clinical depression is generally defined as a persistent experience of sad or irritable mood as well as “anhedonia,” a loss of the ability to experience pleasure in nearly all activities. Teens are more affected by their social environment, more irritable than sad, and more chronically depressed. Adolescents are often more defiant and oppositional than depressed adults and symptoms can manifest themselves in school as behavior problems, lack of attention in class, an unexplained drop in grades, cutting class, dropping out of activities or fights with or withdrawal from friends. These behaviors are distinguished from normal teenage behavior by their duration, intensity, and the degree of dysfunction they cause.

Depression also may include a range of other symptoms and the following could be warning signs:

· Agitation, defiance or sullenness

· Withdrawal or crying

· Unexplained physical complaints

· Lethargy or chronic boredom

· Poor concentration or inability to make decisions

· Negative thoughts about self, the world and the future

· Self blame, guilt and failure to recognize one’s success

· Change in appetite or weight gain or loss

· Changes in physical habits and appearance (e.g, hygiene and dress)

· Excessive sleeping or disrupted sleep patterns

· Increased risk behaviors (e.g., sexual risk-taking or abuse of drugs or alcohol

· Suicide ideation or attempts

The presence of one, or even all of these signs and symptoms does not necessary mean that a particular individual is clinically depressed. However, if several of the above characteristics are present, and last longer than two weeks, are markedly out of proportion to an event or situation, and impair a student’s academic or social performance, further evaluation may be warranted.

Risk factors for Depression can include:

· Existing or history of mental health problems

· Poor academic functioning

· Poor physical health or chronic illness

· Ineffective coping skills or social skills

· Low self-esteem

· Behavior problems

· Problems and frequent conflicts with family or friends

· Poor school and family connectedness

· Major life stressors (e.g., divorce, death in family, break up with significant other, natural disasters)

· Substance abuse

· Family history of depression or suicide

· Uncertainty about sexual orientation

· Cigarette smoking

In addition, students who experienced significant trauma or abuse, are bullied, or do not feel welcome or accepted at school are much more susceptible to depression. Depressed adolescents often self-medicate or seek thrills to alleviate their pain. Some seek relief through self-injury, such as cutting or extreme physical risk-taking. Depression affects the entire person and changes the way one feels, thinks and acts. It is not a personal weakness or character flaw and youth with depression cannot just “snap out of it” on their own. Though symptoms may reside, the adolescent with clinical depression is likely to experience further episodes in the future.

Depression affects 8-10% of adolescents but virtually everyone who receives proper, timely intervention can be helped, but early diagnosis and treatment are necessary. Untreated depression is the leading risk for suicide in adolescents. If you have concerns about your adolescent, don’t hesitate to contact your family physician, school counselor (906-6771) or school psychologist (906-6769) to share your concerns and request a mental health screening. A thorough diagnostic evaluation may include a physical examination, laboratory tests, and interviews with the youngster and his/her parents, behavioral observations, psychological testing and consultation with other professionals. A comprehensive treatment plan often involves psychotherapy, ongoing evaluation and monitoring and in some cases, psychiatric medication. Optimally, this plan and treatment decisions are developed with the family and the adolescent.

This article was written with reference to NASP Resources.