Recognizing Adolescent Depression
Adolescent depression is increasing at an alarming rate. Recent surveys indicate that as many as one in five teens suffers from clinical depression. This is a serious problem that calls for prompt, appropriate treatment. Depression can take several forms, including bipolar disorder (formally called manic-depression), which is a condition that alternates between periods of euphoria and depression.
Adolescent depression is increasing at an alarming rate. Recent surveys indicate that as many as one in five teens suffers from clinical depression. This is a serious problem that calls for prompt, appropriate treatment. Depression can take several forms, including bipolar disorder (formally called manic-depression), which is a condition that alternates between periods of euphoria and depression.
Depression can be difficult to diagnose in teens because adults may expect teens to act moody. Also, adolescents do not always understand or express their feelings very well. They may not be aware of the symptoms of depression and may not seek help.
These symptoms may indicate depression, particularly when they last for more than two weeks:
- Poor performance in school
- Withdrawal from friends and activities
- Sadness and hopelessness
- Lack of enthusiasm, energy or motivation
- Anger and rage
- Overreaction to criticism
- Feelings of being unable to satisfy ideals
- Poor self-esteem or guilt
- Indecision, lack of concentration or forgetfulness
- Restlessness and agitation
- Changes in eating or sleeping patterns
- Substance abuse
- Problems with authority
- Suicidal thoughts or actions
A quick, easy and confidential way to determine if you may be experiencing depression is to take a mental health screening. A screening is not a diagnosis, but a way of understanding if your symptoms are having enough of an impact that you should seek help from a doctor or other professional. Visit www.mhascreening.org to take a depression screening.
Teens may experiment with drugs or alcohol or become sexually promiscuous to avoid feelings of depression. Teens also may express their depression through hostile, aggressive, risk-taking behavior. But such behaviors only lead to new problems, deeper levels of depression and destroyed relationships with friends, family, law enforcement or school officials.
Mental disorders affect nearly 20 percent of American adults; nearly 4 percent are severely impaired and classified as having serious mental illness. These disorders are often associated with chronic physical illnesses such as heart disease and diabetes. They also increase the risk of physical injury and death through accidents, violence, and suicide.
Suicide alone was responsible for 42,773 deaths in the United States in 2014 (the last year for which final data are available), making it the 10th leading cause of death. Among adolescents and young adults, suicide is responsible for more deaths than the combination of cancer, heart disease, congenital anomalies, respiratory disease, influenza, pneumonia, stroke, meningitis, septicemia, HIV, diabetes, anemia, and kidney and liver disease.
The treatment of mental illness has long been held back by the sense that disorders of emotion, thinking, and behavior somehow lack legitimacy and instead reflect individual weakness or poor life choices. Not surprisingly, there has been a mismatch between the enormous impact of mental illness and addiction on the public’s health and our society’s limited commitment to addressing these problems. Here are three examples of how that plays out:
- Most emergency departments are ill-equipped to meet the needs of patients in the midst of mental health crises.
- Most insurance plans view mental illness and addiction as exceptions to standard care, not part of it.
- Despite an overall cultural shift towards compassion, our society still tends to view the mentally ill and those with addiction as morally broken rather than as ill.
Why the disconnect? Psychiatry has been hampered by an inability to observe and record the physical workings of the brain. Because of that, psychiatric assessments and treatments have been viewed as somewhat mysterious. Even today, the underlying mechanisms behind some of the most powerful and effective psychiatric treatments are still poorly understood. All of that translates into the difficulty that many people have finding help for real, disabling symptoms attributed to a mental illness or addiction.
However, just as other fields of medicine have evolved as knowledge advanced during the past century, psychiatry has also made profound gains. Advances emerging from unlocking the brain’s physiology and biochemistry are coming at a time when mental health care is being integrated into traditional health care. The potential has never been greater to finally bring psychiatry quite literally under the same roof as the rest of medicine.Today, the hospital can address mental health issues as effectively as it treats trauma or cardiac arrest. This shift is occurring nationally, with community-involved, comprehensive mental health integration into hospitals in cities and rural communities alike.
Will the stigma of mental illness finally fade? Better understanding of the human brain and the biological nature of the mind will help, but it won’t be enough. How we think about mental health matters. When mental health is ultimately recognized as essential to physical health, not an extraneous element of it, then we will have access to true, complete, modern medicine.
John V. Campo, MD, is professor and chair of the Department of Psychiatry and Behavioral Health at The Ohio State University Wexner Medical Center in Columbus, Ohio.
