Teenagers have been traditionally known to be withdrawn, isolated, uninteractive with family members, and desirous of being left alone most of the time. However, the manifestations of depression among teenagers can be commonly seen in outbursts of anger such as yelling and saying nasty/hurtful things to people, extreme isolation, repression of emotions/feelings, being withdrawn even from peers, having no interest in life, neglecting their appearance, and not minding if they have good personal hygiene or not. Some of these, coupled with the classic symptoms of depression as mentioned in the beginning, are telltale signs of depression in teenagers.
According to the latest edition of the Diagnostic and Statistical Manual (DSM-5), there are different types of depression that can be found within teenagers, such as major depressive disorder (MDD), persistent depressive disorder (PDD), pre-menstrual depressive disorder, and substance induced depressive disorder.
What is depression?
Depression is a mental health illness which can affect people of all ages, walks of life, or backgrounds. It can affect your relationships, social life, family dynamics, and quality of life. Depression is not just the usual mood changes or short-lived emotional responses to everyday life activities. It occurs when depressed moods are recurrent and persistent, with severe intensity. To be classified as depression, a teenager must be exhibiting symptoms persistently for at least two weeks for most of the day, and there should be a combination of at least five of the following symptoms:
- Loss of interest or pleasure in activities previously enjoyed
- Loss of appetite when not on a diet
- Feelings of sadness, emptiness and hopelessness
- Difficulty sleeping or excessive sleeping
- Feelings of worthlessness or inappropriate guilt most of the day
- Fatigue or lack of energy
- Diminished ability to make decisions or concentrate
- Psychomotor agitation
- Suicidal ideation and recurring intrusive thoughts about death
A special note is these reactions or changes may happen without any apparent trigger such as death of a loved one, loss of a lover/heartbreak or financial loss. Any of the triggers could warrant a response like a depressive episode, but what separates depression from these loss responses is the prolonged nature and cluster of symptoms for more than two weeks.
Depression among teenagers is a serious topic to be considered. As a child enters adolescence and puberty, their bodies begin flooding with hormones, whether male or female. These hormones cause a lot of bodily changes like development of breasts and hips for girls, and deepening of the voice and forming a more muscular frame for boys. Along with these physical changes, teenagers are also experiencing changes in their psychological make up, changes in the things which excite them, changes in the people they hang out with, and changes in the things peers will perceive as “cool”. As such, they find themselves in a state of flux, impressionability, and personality formation/character development. Such changes bring a lot of stress to their bodies, and some teenagers choose to withdraw. Perhaps they haven’t developed as fast as their classmates, they aren’t considered as cool as others, or any of the myriad effects of peer pressure in this stage. Other teenagers influenced by peers choose to experiment with alcohol, drugs, and sex to look cool. This also has its effects on their mental health. As such, teenagers are uniquely situated to deal with a host of mental health issues unlike any other group, as they find themselves on a path to self-discovery.
Statistics on depression among teenagers
Statistics show globally, one in seven 10-19 year olds experience a mental disorder, accounting for 13% of this age group’s global burden of mental disease. Depression is among the leading causes of illness and disability among adolescents, with suicide being the fourth leading cause of death among 15-19 year-olds. Depression is estimated to occur among 1.1% of adolescents aged 10-14 years, and among 2.8% adolescents aged 15-19 years. The statistics are a shocking and sober realization the consequences of failing to address adolescent mental health conditions will extend to adulthood, impairing both physical and mental health, and limiting their opportunities to lead fulfilling lives as adults.
Causes of depression in teenagers
One in six people are adolescents aged 10-19 years. The teenage period of life is a unique and formative time, when physical, emotional and social changes are made. However, this period is also where exposure to poverty, abuse, and violence can make teenagers vulnerable to mental health problems. According to the National Institute of Mental Health, around 3.2 million teenagers aged 12 to 17 had one major depressive episode in 2017. Here are the five main causes of depression in teenagers:
1. School demands
Demands of high school and advancing education may lay heavy on the minds of young adolescents, causing great stress. Adolescents can develop a sense of worthlessness and inadequacy over their grades in school. If school performance is overly emphasized, this leaves a long-lasting effect on the adolescent’s self-esteem. They may have reduced coping skills to deal with the increased responsibilities and end up feeling angry and frustrated, even at minor things.
2. Seasons of change and transition
Adolescence is a period of many changes. It is a transition to a more independent and unfamiliar life. It is also a period of a lot of mental, social, and physical changes where your mind, body, and brain are going through a major evolution. These changes may become overwhelming and you may become irritable because of them, losing interest in activities which previously gave you much joy.
Hormonal changes in this adolescent period may also wreak havoc, with mood swings being prevalent. This may cause you to isolate, for example, because of insecurities due to acne, voice changes, or other bodily changes. Teenagers are also seeking independence. Overprotection can cause them to lack faith in their abilities, making them less confident. Overly nagging or distant parents can cause teenagers to withdraw and close all lines of communication.
3. Identity crises
In an era of questioning your identity, whether cultural, racial or ethnic, society can lay a lot of pressure on you as an adolescent to figure out who you are and what you want to do. A lot of energy in this period is used towards “finding yourself”. But what happens when you don’t seem to be able to figure yourself out? You could end up very stressed and emotionally vulnerable.
Perceived failures at school or in relationships also have a big blow to adolescent egos which are seeking affirmation. During disciplining, punishment with negative reinforcement or by shaming can make an adolescent feel more worthless and provide fodder for unhealthy thoughts of themselves.
4. Substance use and abuse
Adolescents are at a high risk to abuse substances based on peer pressure, appearing desirable and with the “in” crowd, and their nature of curiosity. This experimentation may seem harmless on the surface and in the presence of friends, but when in isolation, the effects can’t be ignored. Substance use increases the risk of other mental health illnesses, depression being one of them.
5. Environmental exposures
Early negative experiences which adolescents experience as children shape their overall well-being and development. Traumatic experiences at home with parental conflict, absenteeism, dysfunctionality, or at school with bullying, or in digital spaces with trolling, pose a negative exposure to young minds. In addition, exposure to physical violence, or poverty or illnesses of a parent/caregiver increases the risk of depression among adolescents.
Solutions to the problem
Teenagers with depression are vulnerable to social exclusion, discrimination, stigma affecting their readiness to seek help, educational difficulties, increased risk-taking behaviors, and human rights violations when people take advantage of them. It is hence essential to protect teenagers from adversity, promote their socio-emotional learning and emotional well-being, and make sure they have access to mental health care.
When you feel depressed, seek help from a medical professional. It may be challenging to address the emotions with others out of fear, for example with your parents, but seek out a a trusted source who can guide you to the help you need. Acknowledging the condition and finding help can be overwhelming, but overcoming that is the first hurdle to getting proper treatment. A trained healthcare professional can talk to you about depression and give you treatment in the form of psychotherapy, medication, or a combination of the two.
American Psychiatric Association. (2013).Diagnostic and statistical manual of mental disorders (5th ed.). https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425596