The Adolescent Experience of Depression and Mood Swings - Essay Example

The Potential Adolescent Experience of Depression and Mood Swings As a child becomes a teenager there are a variety of challenges that they face. Since hormones are running wild and they are going through growth spurts many teenagers find that they begin to experience depression and mood swings. Some of this happens because they are going through so many changes and sometimes this is a clinical challenge for the individual. Often parents do not know what is gong on and they dont often seek help for the child because they think it is just a phase they are going through. For some teens this is a phase but for others it can be a clinical experience. CURRENT STATISTICS ON TEEN DEPRESSION It is alarming to understand that 20% of teens experience some sort of depression or mood swing in their adolescent years. Many will be diagnosed as bipolar as they come into adulthood. According to About Teen Depression one in five teenagers experience some sort of mental, emotional or behavioral problem and one in ten have a serious emotional problem (par. 1). Of these only about 30% receive the treatment they need while the other 70% go untreated. The challenge for teen depression is when it goes untreated many children will grow to be more depressed in adulthood, they can get into trouble with the law and they often will commit suicide. All of these challenges can be presented at a very early age; some as young as 10 or 11 years old. The challenge for many parents is that the teenage years are supposed to be a time when teens go through a variety of problems. They are used to seeing mood swings and what looks like depression but they just chalk it up to a part of adolescence. They do not recognize the symptoms unless something more dramatic happens that creates more of a challenge for the child (e.g. trouble with the law because of a fight, an attempted suicide). CAUSES OF DEPRESSION IN ADOLESCENTS There are a variety of factors that contribute to an adolescents depression and it is a complex situation. There are several theories about why it happens. Some say it is a genetic condition and others say that genetics are just one part of the problem and state environmental factors as a contributing factor. Sometimes an individual may have a medical illness that triggers depression or a prolonged period of stress. Teens can also exhibit behavior problems or become anxious when they have had a situation that triggers their sadness. As an example, an individual who looses a significant parent or other nurturing person can develop depression, mood swings, behavior difficulties or a combination of all three. Unfortunately there are no theories that relate to why adolescents have depression except to say that it is triggered by some factor during this period. In the literature surrounding the cause of adolescent depression there are only "guesses" as to what is happening because the medical community has not developed an answer. There are a few assumptions that have been made for some of the reasons. According to Allen (2003) one of the major theories of depression comes from the work of psychiatrist Aaron Beck. In Becks theory depression was more about an individuals self-concept that it was about the depression itself. He believed that those individuals suffering from depression had a negative view of themselves. He further suggested that this negative view of self was brought about by dysfunctional thinking (Allen, par. 1). Becks theory has been well researched by other people who were looking at different reasons why an individual may develop depression and most found that his theory did not go far enough. According to Watkins and Byrnes (2007) there are several theories that are supported by research as to the causes of adolescent depression. Many researchers feel that children can have a predisposition to depression and anxiety but it may not appear until something triggers it in their environment ("Causes of Depression" in Watkins and Byrnes 2007). Adults who took part in the research said that their childhoods had problems with neglect, abuse, rejection or parental conflict. Contributing factors can include inconsistent parenting, stressful life experiences, negative ways of viewing the world or a family history of mood disorders (Watkins and Byrnes, 2007 "Causes of Depression" in Watkins and Byrnes 2007). Many children with depression also have other types of psychiatric problems like ADHD, anxiety disorders or substance abuse problems. Many adolescents with this duo-diagnosis will eventually attempt or commit suicide. SYMPTOMS OF DEPRESSION IN ADOLESCENTS As said previously depression is difficult to see in teens because it is a natural state of this time of life. Biological and physiological factors contribute to mood swings, depression and anger during this period and some of this behavior is expected. When it becomes more clinical the symptoms can become chronic and the symptoms can increase. Major symptoms of depression in teens include: Sadness or hopelessness Irritability, anger, or hostility Tearfulness or frequent crying Withdrawal from friends and family Loss of interest in activities Changes in eating and sleeping habits Restlessness and agitation Feelings of worthlessness and guilt Lack of enthusiasm and motivation Fatigue or lack of energy Difficulty with concentration Thoughts of death or suicide (HelpGuide.org, 2008, Signs and Symptoms Depression) Teen Depression Linked With Suicide The Center for Diseases Control (2007) states that suicide was the third leading cause of death for youth in the United State between the ages of 10 and 24 years of age (par. 1). Females between the ages of 10-19 used suffocation by hanging or poisoning as their method of choice (par. 3). It is not exactly clear why this happens more often for girls than boys but Crow, Eisenberg, Story, and Neumark-Sztainer (2008) studied the issue because they thought it might have something to do with body image and the way that girls particularly looked at weight fluctuation. What they found was that suicide and weight in their particular study were not related. However, they do make the point that studies prior to their 2008 study showed that there was a correlation between suicide and body development. They saw that one of the reasons it may not have such an effect today is because being a little overweight in adolescence is more accepted today than years ago. Teen Depression And Interpersonal Relationships Interpersonal relationships among teens with depression become difficult over time. Parents are not sure what to do in the situation and often do not see their child as having problems with depression. Depressed teens tend not to go out, they do not make friends easily and they are not able to express their feelings easily. Millikan, Wamboldt, M and Bihun (2002) found through their study of 200 teens and their twins that depression was linked to a teenagers perception of their family and they can be associated with neuroticism. The more neurotic symptoms and teen exhibits, they more likely they are to exhibit symptoms of depression because they see their family in a negative light (p. 1386). Paunesku, Ellis, Fogel, Kuwabara, et al (2008) found that if teens felt they were not connected to their parents and if they saw a lot of parental conflict the situation was more prone to create depression in teens (p. 160). This was also a reality when teens reported that their parents were unaffectionate and controlling. In many situations children do not have the support that they need from their parents or from peers which also can lead them into problems with depression. Some children have not been socialized with other children so they are loners. Sometimes this can be depressing if the teen wants to reach out and does not have the tools to do so. Feelings of inadequacy, feeling that their life has no meaning and feelings of the lack of opportunity can be a contributing factor to their interaction with interpersonal relationships. Co-Morbidity Issues in Adolescent Depression Experts state that most teens with depression also have other contributing factors like ADHD, psychosis, impulse control and some social disorders. These are only a few of the other problems that can be present. Many teens can become addicted to drugs or alcohol if their depression is left untreated; this is an attempt to dull the emotional pain (Aspen Education Group, 2007). Generally depression is considered a "co-morbid" situation when it affects the teen on all levels and they are unable to come back from their feelings of sadness and anxiety without intervention. TREATMENT OF TEEN DEPRESSION The desired treatment for teens who suffer from depression is a combination of drugs and therapy. Van Voorhees, Smith, Ewigman, and Hickner (2008) suggest that a combination of psychotherapy, particularly Cognitive Behavior Therapy (CBT) and serotonin uptake inhibitor (SSRI). According to their study they also suggested that the information from the Guidelines for Adolescent Depression in Primary Care (GLAD-PC), a report conducted in 2007 reported that primary care physicians should take a stronger role in working with adolescent depression and that there should be this same combination (p. 736). They also quote two studies that show that this method of working with teen depression is appropriate for what needs to be done especially when it comes to treating teens with severe depression. Walden Behavioral Care (2008) states that the combination of CBT and antidepressants is the treatment of choice for teen depression. The antidepressants should be used with caution however because there is a possibility that some of these drugs will make teens think of suicide more often and can actually make them try it. Cognitive Behavior Therapy (CBT) for adolescents is based on the premise that teens are depressed because of a distorted view of themselves, the world and their future (Walden Behavioral Care). If they can see themselves and the world differently, they will be able to move out of the depression; CBT is working with mild to severe depression. When the teenager is in therapy it can be a good idea to also create a space for family therapy as many of the problems for the adolescent will stem within the family. One challenge for teens who do not receive a diagnosis of depression is that they turn to drugs and alcohol for self-medication to try and alleviate their depression. According to an article in Science Daily (2008) this only creates more problems. The article is taken from the White House Office of National Drug Control Policy (ONDCP) report that states that two million teens in the last year reported that they were depressed and the report shows that those who are depressed are more likely to use drugs to deal with it (par. 2). According to the report, "Teen Marijuana Use Worsens Depression: An Analysis of Recent Data Shows Self-Medicating Could Actually Make Things Worse," (2008) Teens who smoke marijuana at least once a month are three times more likely to have suicidal thoughts than non-users; Using marijuana can cause depression and other mental illnesses; The percentage of depressed teens is equal to the percentage of depressed adults, but depressed teens are more likely than depressed adults to use marijuana and other illicit drugs; Teen girls who use marijuana daily are more likely to develop depression than girls who do not use marijuana; Depressed teens are also more likely than non-depressed teens to engage in other risky behaviors such as daily cigarette use and heavy alcohol use. (Science Daily, 2008, p. 5, Office of National Drug Control Policy, p. 1). The other factors that this report points out is the fact that girls are more often involved with depression and under the influence of drugs or alcohol are more apt to take a chance with risky behaviors like sexual promiscuity (Office of National Drug Control Policy, p. 4). CULTURE AND TEEN DEPRESSION There are several aspects to culture that have to be considered when looking at teen depression. The American culture is the first aspect because the pressures from today will often be contributing factors to teen depression. Our society is changing rapidly and with the dependence on technology teens are inundated with information. The Office of National Drug Control Policy has already cited that teens are indulging in sexual activity more often if they are using drugs and alcohol; this is but another way that teens are attempting to deal with their depressed emotions. According to Grohol (2009) technology has increased a teens ability to indulge in sexual activity because they can send nude pictures of themselves to other people via text messaging and/or the computer. This is called the "online inhibition effect" and it allows teens to be more aggressive and forward. In America and globally this can make a teen more vulnerable for a variety of problems including depression, substance abuse and sexual predators. Stress is another large factor for teens in the global culture. Many are pressed to do well in sports or in school, but others have a lack of social interaction and others are inundated with the fact that they are different socially, racially or because they have a different religion (Harrington, 2009, p. 1). These feelings of stress can lead to depression which also can create thoughts of suicide; in many treatment centers 20% of teens who enter for assistance have already attempted suicide at least once. Ethnicity and Teen Depression In many cultures to admit to depression is to admit that you are mentally ill. This is not necessarily true but it is the way that some cultures perceive it. As an example, Davis (2008) gives the example of the young African American boy who committed suicide last year. This young man suffered was bipolar and chose to take an overdose of pills. The nation heard about this young man because he did this during a controversial Webcast that people all over the world were able to see. In the article, Davis points out that in the African American community "mental illness" is often not talked about in families and more African American boys are being affected by it; it is the third leading cause of death among African American youth after homicides and accidents (par. 6). Gay teenagers are also prone to depression and suicide because of their lack of acceptance by their peers and often their family. The social oppression that precludes their coming out can create problems for them. Star (2006) points out that gay teens are three times more likely to attempt suicide because of the harassment and bullying they receive (par. 5). Michael Faenza, former president of The National Mental Health Association states that: "When bullied, gay youth and those thought to be gay face an increased risk for depression, anxiety disorders, school failure and suicide," (as cited in Star 2006, par 6). The bottom line is that all youth, regardless of ethnicity or sexual orientation need to receive assistance with depression before it exacerbates to the point of suicide. Conclusion Teen suicide is a very difficult situation to diagnose and as our world becomes more face paced, many teens feel more sad, hopeless and emotionally damaged than in years gone by. They are dealing with issues inside their families, the current economic crisis and many other situations that create a feeling of depression for them. Without proper treatment many of them are at risk for other health problems. There are a variety of studies that show that people who are under a lot of stress are at risk for high blood pressure, heart disease, emotional and psychological problems and cancer. Teens also are at risk for these health conditions when they are dealing with stress. As the United States begins to look at a revamp of the healthcare system it is important that they look at the needs of children who are dealing with the stresses of life that many at their age should not have to deal with today. References About Teen Depression. 2004. Statistics: Adolescent depression. [WWW] . [Accessed 11 February 2009]. Allen, J. P. 2003. An overview of becks cognitive theory of depression in contemporary literature. [WWW] . [Accessed 11 February 2009]. Aspen Education Group. 2007. Parenting Resources: Teen addictions and Other Mental Health Issues. [WWW]< http://www.aspeneducation.com/Article-addictions_mentalhealth.html>. [Accessed: 11 February 2009]. Davis, H.L. 24 November 2008. Black teens suicide highlights mental illness. The Daily Voice Online. [WWW]< http://thedailyvoice.com/voice/2008/11/black-teens-suicide-highlights-001380.php. [Accessed 11 February 2009]. Center for Disease Control 2007. Suicide Trends Among Youths and Young Adults Aged 10--24 Years --- United States, 1990--2004. [WWW] . [Accessed 11 February 2008]. Harrington, T.(2008) Counselors help students and parents with teenage stress and depression. Contra Costa Times, [WWW]< http://www.contracostatimes.com/ teens/ci_11280706. [Accessed 11 February 2009]. Helpguide.org. 2008. Teen Depression: A guide for parents and teachers. [WWW] . [Accessed 11 February 2009]. Millikan, E., Wamboldt, M. Z., Bihun, J. T. 2002. Perceptions of the family, personality characteristics, and adolescent internalizing symptoms. Journal of the American Academy of Child and Adolescent Psychiatry 41(12)  1486-1494.  ProQuest Database [Document ID: 248273721]. [Accessed 12 February 2009]. Office of National Drug Control Policy Executive Office of the President. 2008. Teen Marijuana Use Worsens Depression: An Analysis of Recent Data Shows Self-Medicating Could Actually Make Things Worse Washington DC. [WWW] < http://www.theantidrug.com/pdfs/teen-marijuana-depression-report.pdf>. [Accessed 11 February 2009]. Paunesku, D, Ellis, J., Fogel, J., Kuwabara, S., et al (2008). Clusters of behaviors and beliefs predicting adolescent depression: implications for prevention. Journal of Cognitive & Behavioral Psychotherapies. 2008, 8(2), p147-168, Academic Search Premier database [AN: 34615005] [Accessed 12 February 2009]. Science Daily. 10 May 2008. Teen Self Medication For Depression Leads To More Serious Mental Illness, New Report Reveals. [WWW] < http://www.sciencedaily.com /releases/2008/05/080509105348.htm. [Accessed 12 February 2009]. Star, L.L. 10 April 2006. "The Trevor Project: Help for Suicidal Gay Teens". The Forum For Youth Investment: Connect for kids. [WWW]< http://www.connectforkids.org /node/4120. [Accessed 9 February 2009]. Van Voorhees, B., Smith, S., Ewigman, B. and Hickner, J. 2008. Treat depressed teens with medication and psychotherapy. Journal of Family Practice. 57 (11). p735-739. Academic Search Premier [AN: 35265823]. [Accessed 12 February 2009]. Walden Behavioral Care. 2008. Teen Depression: Treatment. [WWW] < http://www.waldenbehavioralcare.com/teen_depression.asp>. [Accessed 12 February 2009]. Watkins, C.E. and Byrnes, G. 2007. Depression in Children and Adolescents. County Psychiatric Associates. [WWW] Read More