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Christi Corpus City Of Corpus Christi christi corpus Information
The Under Acknowledged Disease Depression is a disease that afflicts the
human psyche in such a way that the afflicted tends to act and react abnormally
toward others and themselves. Therefore it comes to no surprise to discover that
adolescent depression is strongly linked to teen suicide. Adolescent suicide is
now responsible for more deaths in youths aged 15 to 19 than cardiovascular
disease or cancer (Blackman, 1995). Despite this increased suicide rate,
depression in this age group is greatly underdiagnosed and leads to serious
difficulties in school, work and personal adjustment which may often continue
into adulthood. How prevalent are mood disorders in children and when should an
adolescent with changes in mood be considered clinically depressed? Brown (1996)
has said the reason why depression is often over looked in children and
adolescents is because "children are not always able to express how they feel."
Sometimes the symptoms of mood disorders take on different forms in children
than in adults. Adolescence is a time of emotional turmoil, mood swings, gloomy
thoughts, and heightened sensitivity. It is a time of rebellion and
experimentation. Blackman (1996) observed that the "challenge is to identify
depressive symptomatology which may be superimposed on the backdrop of a more
transient, but expected, developmental storm." Therefore, diagnosis should not
lay only in the physician's hands but be associated with parents, teachers and
anyone who interacts with the patient on a daily basis. Unlike adult depression,
symptoms of youth depression are often masked. Instead of expressing sadness,
teenagers may express boredom and irritability, or may choose to engage in risky
behaviors (Oster & Montgomery, 1996). Mood disorders are often accompanied
by other psychological problems such as anxiety (Oster & Montgomery, 1996),
eating disorders (Lasko et al., 1996), hyperactivity (Blackman, 1995), substance
abuse (Blackman, 1995; Brown, 1996; Lasko et al., 1996) and suicide (Blackman,
1995; Brown, 1996; Lasko et al., 1996; Oster & Montgomery, 1996) all of
which can hide depressive symptoms. The signs of clinical depression include
marked changes in mood and associated behaviors that range from sadness,
withdrawal, and decreased energy to intense feelings of hopelessness and
suicidal thoughts. Depression is often described as an exaggeration of the
duration and intensity of "normal" mood changes (Brown 1996). Key indicators of
adolescent depression include a drastic change in eating and sleeping patterns,
significant loss of interest in previous activity interests (Blackman, 1995;
Oster & Montgomery, 1996), constant boredom (Blackman, 1995), disruptive
behavior, peer problems, increased irritability and aggression (Brown, 1996).
Blackman (1995) proposed that "formal psychologic testing may be helpful in
complicated presentations that do not lend themselves easily to diagnosis." For
many teens, symptoms of depression are directly related to low self esteem
stemming from increased emphasis on peer popularity. For other teens, depression
arises from poor family relations which could include decreased family support
and perceived rejection by parents (Lasko et al., 1996). Oster & Montgomery
(1996) stated that "when parents are struggling over marital or career problems,
or are ill themselves, teens may feel the tension and try to distract their
parents." This "distraction" could include increased disruptive behavior,
self-inflicted isolation and even verbal threats of suicide. So how can the
physician determine when a patient should be diagnosed as depressed or suicidal?
Brown (1996) suggested the best way to diagnose is to "screen out the vulnerable
groups of children and adolescents for the risk factors of suicide and then
refer them for treatment." Some of these "risk factors" include verbal signs of
suicide within the last three months, prior attempts at suicide, indication of
severe mood problems, or excessive alcohol and substance abuse. Many physicians
tend to think of depression as an illness of adulthood. In fact, Brown (1996)
stated that "it was only in the 1980's that mood disorders in children were
included in the category of diagnosed psychiatric illnesses." In actuality,
7-14% of children will experience an episode of major depression before the age
of 15. An average of 20-30% of adult bipolar patients report having their first
episode before the age of 20. In a sampling of 100,000 adolescents, two to three
thousand will have mood disorders out of which 8-10 will commit suicide (Brown,
1996). Blackman (1995) remarked that the suicide rate for adolescents has
increased more than 200% over the last decade. Brown (1996) added that an
estimated 2,000 teenagers per year commit suicide in the United States, making
it the leading cause of death after accidents and homicide. Blackman (1995)
stated that it is not uncommon for young people to be preoccupied with issues of
mortality and to contemplate the effect their death would have on close family
and friends. Once it has been determined that the adolescent has the disease of
depression, what can be done about it? Blackman (1995) has suggested two main
avenues to treatment: "psychotherapy and medication." The majority of the cases
of adolescent depression are mild and can be dealt with through several
psychotherapy sessions with intense listening, advice and encouragement.
Comorbidity is not unusual in teenagers, and possible pathology, including
anxiety, obsessive-compulsive disorder, learning disability or attention deficit
hyperactive disorder, should be searched for and treated, if present (Blackman,
1995). For the more severe cases of depression, especially those with constant
symptoms, medication may be necessary and without pharmaceutical treatment,
depressive conditions could escalate and become fatal. Brown (1996) added that
regardless of the type of treatment chosen, "it is important for children
suffering from mood disorders to receive prompt treatment because early onset
places children at a greater risk for multiple episodes of depression throughout
their life span." Until recently, adolescent depression has been largely ignored
by health professionals but now several means of diagnosis and treatment exist.
Although most teenagers can successfully climb the mountain of emotional and
psychological obstacles that lie in their paths, there are some who find
themselves overwhelmed and full of stress. How can parents and friends help out
these troubled teens? And what can these teens do about their constant and
intense sad moods? With the help of teachers, school counselors, mental health
professionals, parents, and other caring adults, the severity of a teen's
depression can not only be accurately evaluated, but plans can be made to
improve his or her well-being and ability to fully engage life.
Bibliography
Blackman, M. (1995, May). You asked about... adolescent depression. The
Canadian Journal of CME [Internet]. Available HTTP:
http://www.mentalhealth.com/mag1/p51-dp01.html. Brown, A. (1996, Winter). Mood
disorders in children and adolescents. NARSAD Research Newsletter [Internet].
Available HTTP: http://www.mhsource.com/advocacy/narsad/childmood.html. Lasko,
D.S., et al. (1996). Adolescent depressed mood and parental unhappiness.
Adolescence, 31 (121), 49-57. Oster, G. D., & Montgomery, S. S. (1996).
Moody or depressed: The masks of teenage depression. Self Help & Psychology
[Internet]. Available HTTP:
http://www.cybertowers.com/selfhelp/articles/cf/moodepre.html
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