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Adolescent depression: how to respond to your children's misery

For some American children, the struggles of adolescence are more serious than high school drama and hormones. Depression poses a serious health risk for a growing number of teens and should be treated like an illness, not a behavior problem.
Emily Hales, Deseret News Modified: July 17, 2014 at 8:31 pm •  Published: July 21, 2014
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When Cheryl Cobb’s daughter Mary was a teenager, she started simply refusing to go to school or church. Family friends advised Cobb to force Mary to do what was expected, saying that the young woman was being defiant. It didn’t work out well.

“I would literally be pulling on her arm to make her get out of the car,” Cobb said. “I would walk her into the office to sign in, walk her to her locker and then to class. Leaving her there in tears was so traumatic, for both of us.”

After a few years of trying the “tough love” technique, Cobb realized that something more serious than teenage rebellion was going on.

She took Mary to see a psychiatrist, where the young woman was diagnosed with depression.

Like Mary, adolescents around the world experience depressive symptoms in their teenage years, and the number of cases is growing. A survey released by the World Health Organization in May found depression to be the No. 1 cause of illness and disability in adolescents worldwide. Mental health experts have identified a number of reasons for the rise, ranging from media to genetics, but the rise and severity of adolescent depression requires a response.

“The world has not paid enough attention to the health of adolescents,” says Dr. Flavia Bustreo, assistant director-general for Family, Women and Children’s Health, part of WHO, in a press release that says "if adolescents with mental health problems get the care they need, this can prevent deaths and avoid suffering throughout life."

Young people at risk

The World Mental Health Survey, which was supported by WHO, found that half of those who suffered from mental health problems, including depression, first experience symptoms at age 14. In high-income countries, like the United States, fewer than half of adolescents with a mental health problem receive treatment.

The Centers for Disease Control reported that a survey of students in grades 9-12 at schools in the United States revealed “16 percent of students reported seriously considering suicide, 13 percent reported creating a plan, and 8 percent reported trying to take their own life in the 12 months preceding the survey.”

In America today, high school and college students are five to eight times as likely to suffer from depressive symptoms as were teenagers 50 or 60 years ago, according to Psychology Today.

Depression rates for adolescents are on the rise for a variety of reasons, according to Manpreet K. Singh, director of the Pediatric Mood Disorders Clinic and an assistant professor of psychiatry and behavioral sciences at Lucile Packard Children’s Hospital at Stanford.

“Some suggest it’s because children are more exposed to stress and childhood adversity, which has significant implications for how a child develops over time and can increase vulnerability for anxiety and depression and other problems down the line,” Singh said. “Other people suggest the role of family and media."

Media in particular has come under scrutiny as the entertainment industry becomes more pervasive. A study from the National Institutes of Health found that media portrayals of body image and the “ideal” life create unrealistic expectations for teenagers, disrupting their “normal identity development” and leading to depression.

In addition, the NIH study found that violent or graphic media augments depressive tendencies by creating an idea that the world is worse than it is.

Boys are less likely than girls to develop symptoms of depression, and a report from the Substance Abuse and Mental Health Services Administration found that girls at age 15 are three times as likely to suffer a “major depressive episode” as girls at age 12. In 2011, 1.4 million girls ages 12-17 in the United States experienced an episode of depression.

A family history of depression or anxiety, childhood trauma or abuse and chronic medical illness are all risk factors for depression, according to a report published by British Columbia Medical Journal.

“Another factor could be that we’re recognizing it more,” Singh said. As more parents and doctors understand the symptoms of adolescent depression, they are better able to differentiate between teenage moodiness and severe medical issues.

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