How Was I To Know, Depression In Young Adults Essay, Research Paper
How was I to Know?
Current Perspectives on
Depression is a disorder that affects the human psyche in such a way that the affected tends to act, and react abnormally toward others as well as themselves. Therefore it comes as 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 cancer (Blackman, 1995). Despite this increased suicide rate, depression in this age group is greatly under diagnosed and leads to serious difficulties in school, work, and personal adjustment, which may often continue into and occasionally through adulthood.
The question we must ask ourselves as clinicians is, how prevalent are mood disorders in children and adolescents. Since all adolescents exhibit frequent mood swings, changes in eating habits and other observable changes during the individuation process, when is an adolescent with these changes in mood considered clinically depressed? Some researches have said the reason why depression is often over looked in children and adolescents, is because children are not always able to articulate how they feel. Often 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 when the child begins to individuate and separate from parents. It is also a time of rebellion and experimentation. It was Blackman observed that the challenge is to identify depressive symptomatology which may be superimposed on the backdrop of a more transient, but expected, development storm. What this means is, 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 childhood and adolescent depression are often masked by what may be considered to be normal age appropriate behavior and action. In lieu of expressing sadness or pain, these emotions may manifest themselves as boredom and irritability. The adolescent may choose to engage in extreme, risky, quite possibly dangerous and even fatal behaviors such as sexual promiscuity, excessive drinking and drug abuse. (Oster & Montgomery, 1996).
Mood disorders are often accompanied by various other psychological problems such as anxiety disorder, eating disorders, hyperactivity, substance abuse and suicide (Blackman, 1995; Brown, 1996; Lasko, 1996; Oster & Montgomery, 1996) all of which can hide depressive symptoms.
Some of the signs that should alert adults to the presence of clinical depression include but are not limited to marked changes in mood and associated behaviors that range from sadness to withdrawal, decreased energy to intense feelings of hopelessness as well as suicidal thoughts.
In the past, depression has been 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 relation problems, increased irritability and aggression (Brown, 1996). Blackman proposed that formal psychological testing might be helpful in complicated presentations that do not lend themselves easily to diagnosis.
For many adolescent s, symptoms of depression are directly related to low self-esteem stemming from increased emphasis on peer pressure and a myriad of other social pressures. For other adolescents, depression arises from familial dysfunction which may include decreased family support and perceived rejection by parents (Lasko, 1996). Oster & Montgomery 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-generated isolation and even verbal threats of suicide.
So how can the clinician determine when a patient should be diagnosed as depressed or suicidal? Brown suggested the best way to diagnose is to screen out the vulnerable groups of children and for the risk factors of suicide, then refer them to treatment. Some of these risk factors include verbal signs of suicide within the last three months; prior attempts at suicide, indication of sever mood changes, or excessive alcohol and substance abuse. Many people, including some in the mental health profession, tend to think of depression as an illness of adult hood. In fact, I recently learned 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(Lasco 1996).
In a sampling of 100,000 adolescents, two to three thousand will have mood disorders, out of which 8-10 will eventually commit suicide as a result of their disorder (Brown,1996). Blackman remarked that the suicide rate for adolescents has increased more than 200% over the last decade. Brown added that an estimated 2,000teenagers per year commit suicide in the United States. Making it the leading cause of death after traffic accidents and homicide. Blackman 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 disorder of depression, what can be done about it? Blackman has suggested two main avenues to treatment: psychotherapy and or medication. The majority of adolescent depression cases are mild and can be dealt with through several psychotherapeutic sessions of intense listening, advice and encouragement. With regards to the issue of comorbidity, it is not unusual in teenagers, and possible pathology, including but not limited to anxiety, obsessive-compulsive disorder, learning disability or attention deficit hyperactive disorder, should be searched for and treated if present (Blackman, 1995).
In the more severe cases of depression, especially those with perpetual symptoms, medication may be necessary and without pharmaceutical treatment, depressive conditions may vary well escalate becoming fatal in the worst case scenario. I feel that regardless of the modality or method of treatment chosen, it is important for children suffering from mood disorders to receive prompt treatment for the simple reason that early onset places children at a greater risk for multiple episodes of depression throughout their life.
Until recently, mental health professionals have largely ignored adolescent depression. However as of late, several means of diagnosis and treatment have been and will continue to be developed. Although most children and adolescents’ can successfully climb the mountain of emotional and psychological obstacles that lie in their paths. However, there are those who find themselves overwhelmed and full of stress. How can parents and friends help out these troubled kids? 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 s experiences.