Understand depression in teenagers with Meri Sehat. Gain insights and support for proactive mental well-being

Depression In Teenagers

Disclaimer: Information presented in this article may be triggering for some people.

Introduction

If you&rsquo;re a teenager or a parent to one, I&rsquo;d like you to do this small exercise. Repeat after me:

&ldquo;<a href="https://merisehat.pk/article/eight-lifestyle-interventions-for-major-depression">Depression</a> is a real illness.&rdquo;

&ldquo;Depression is not sadness.&rdquo;

&ldquo;Depression can happen to anyone, regardless of their age or gender.&rdquo;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
&nbsp;

Good job!

With so many myths and misconceptions afloat about mental health and depression in particular, we must shed our biases and approach the topic with a clear mind.

This article will help you determine symptoms of depression, identify possible triggers, and where to seek help in case you or a loved one is experiencing this mental disorder. 
&nbsp;

Globally, one in seven 10-19-year-olds experiences a mental disorder, accounting for 13% of the global burden of disease in this age group<a href="#accordion">[1]</a>. Depression is among the most common mental disorders and affects 1.1% of 10-14 year-olds and 2.8% of 15-19-year-olds<a href="#accordion">[1]</a>.

It is often confused with persistent depressive disorder (dysthymia), mood dysregulation disorder, premenstrual depressive disorder, and adjustment&nbsp;disorder.

According to the DSM-5, a person must exhibit low mood, loss of interest in usual activities, feelings of sadness, and a change from their previous level of functioning for at least two weeks to be diagnosed with major depression<a href="#accordion">[2]</a>. 
&nbsp;

These symptoms must be accompanied by at least five other common symptoms of depression, such as<a href="#accordion">[2]</a>:

<ul>
	<li>Difficulty sleeping (insomnia) or sleeping too much (hypersomnia)</li>
	<li>Feeling worthless and hopeless</li>
	<li>Feeling guilty</li>
	<li>Gaining or losing weight with a change in appetite</li>
	<li>Unusually slow or agitated movements</li>
	<li>Fatigue</li>
	<li>Inability to focus or concentrate at home or school</li>
	<li>Thinking about death or suicide attempts 
	&nbsp;</li>
</ul>

These symptoms should:

<ul>
	<li>Cause significant distress</li>
	<li>Interfere with daily life</li>
	<li>Not be due to an underlying medical condition or a result of substance abuse 
	&nbsp;</li>
</ul>

Depression can be mild and short-lived or severe and long-lasting. There may be just a single episode or there may be multiple episodes. 
&nbsp;

Understanding Depression in Teenagers

You may belong to a perfect family with fun and supportive parents, loving siblings, and a pet or two. You may also be a high-achiever at school, part of the student body, and excellent in extra-curricular activities. An outsider might say, &lsquo;Hey! This kid has got it all. Nothing&rsquo;s wrong in their life&rsquo;. You may even repeatedly hear people asking you to be grateful for each day. But all that &lsquo;perfection&rsquo; does not mean, you cannot be depressed.

Unfortunately, a lot of young depressed people are good at masking. They go about doing their routine tasks without letting anyone know how they&rsquo;re feeling. Some of them even fail to recognize they&rsquo;re depressed themselves. Especially if they&rsquo;ve been taught to think that they have no reason to be sad or depressed. Or they&rsquo;re just not sad enough to qualify as depressed. 
&nbsp;

Others do not report their symptoms because they think these issues are related to daily stress that they can sort out and don&rsquo;t require professional help. Moreover, there is a reluctance to discuss personal issues with another person and a stigma associated with antidepressant medications or psychotherapy that makes children and young adults deny their condition. 
&nbsp;

While unexplained anxiety, distraction, and a sudden and apparent lack of interest in personal hygiene are strong indicators of silent depression, other symptoms can include<a href="#accordion">[3][4]</a>:

<ul>
	<li>Lack of energy waking up or rapidly getting tired during the day even when rested</li>
	<li>Apathy</li>
	<li>Overworking to divert thoughts</li>
	<li>Restlessness</li>
	<li>Body pain, including headaches, low back pain, and stomachaches, without an obvious cause</li>
	<li>Avoid meeting or communicating with friends or loved ones</li>
	<li>Loneliness</li>
	<li>Persistent and intense mood swings, including nervousness, irritability, anger even over small matters, crying without reason</li>
	<li>Exaggerated self-criticism</li>
	<li>Pessimism</li>
	<li>Fixation on past failures</li>
	<li>Low self-esteem</li>
	<li>Trouble making decisions</li>
	<li>Frequent absences from school and poor school performance</li>
	<li>Consuming excessive amounts of prescription medication or other drugs to subdue symptoms</li>
	<li>Constantly expecting adverse situations to occur or negative self-talk (e.g., &ldquo;I feel unhappy/sad&rdquo; or &ldquo;I want to kill myself&rdquo;)</li>
	<li>Indulging in risky, rebellious, and even criminal behavior (e.g., shoplifting) 
	&nbsp;</li>
</ul>

If you&rsquo;re here, you&rsquo;re probably wondering if you are depressed.

You don&rsquo;t slack, you don&rsquo;t cry when a pet dies, and most importantly, you socialize. But then you&rsquo;re overwhelmed with hopelessness, you suddenly feel frustrated with schoolwork, you quit pursuing your favorite hobby, you think about running away from home, you start feeling ugly, and you find your addiction to your smartphone and the internet an escape from the real world.

If you&rsquo;ve been an overachiever all your life, you may now be extremely sensitive to criticism. If you&rsquo;re a boy, you may be turning aggressive or violent. 
&nbsp;

As a teenager, it&rsquo;s possible you feel excessively or inappropriately worthless or guilty due to the following:

<ul>
	<li>Perceived failures at school</li>
	<li>Social status (compared to your peers)</li>
	<li>Bullying by peers</li>
	<li>Lack of social support 
	&nbsp;</li>
</ul>

It&rsquo;s also possible that your depression is an outcome of struggling with:

<ul>
	<li>Environmental stress, including family problems</li>
	<li>PTSD, including the loss of a loved one</li>
	<li>Obsessive-compulsive disorder (OCD)</li>
	<li>Family history of depression</li>
	<li>Eating disorders</li>
	<li>ADHD</li>
	<li>Learning disorder</li>
	<li>Bipolar disorder</li>
	<li>Chronic illness</li>
	<li>Physical disabilities</li>
	<li>Drug abuse 
	&nbsp;</li>
</ul>

<h5>Adult Intervention</h5>

18-24 years olds form one of the most vulnerable groups at risk of death by suicide. This is why the United States Preventive Service Task Force advises screening for anxiety in individuals aged 8-18 years and for major depressive disorder in individuals aged 12-18 years<a href="#accordion">[6]</a>. 
&nbsp;

Here&rsquo;s how parents and teachers can help support a child through depression:

<ul>
	<li>Spend Time With Them</li>
</ul>

While they may not specifically be asking for it, you must give them time so they feel comfortable communicating their concerns. If they&rsquo;re hesitating, you can initiate an honest, open discussion by letting them know the changes you&rsquo;ve observed and asking them to share what they&rsquo;re going through.

Your focus should be on listening closely. Connect on their comfort level. Set a time to talk each day, face-to-face and without distractions. Suicidal thoughts, especially, are often a cry for help. 
&nbsp;

<ul>
	<li>Give Them Breathing Space</li>
</ul>

There&rsquo;s no need to school them all the time. Let them make mistakes. Let them enjoy activities they like and experience life as they want. Guide them, yes. But don&rsquo;t make decisions on their behalf, overprotect them, or force them to follow your career trajectory. It will crush their confidence.

Note: This doesn&rsquo;t overlook the fact that you need to set boundaries to combat unhealthy behaviors, like staying up late or eating junk food. 
&nbsp;

<ul>
	<li>Support Them</li>
</ul>

Children need support both at home and at school, especially if they&rsquo;re being bullied or being preyed on by sexual predators. Don&rsquo;t shame or punish them for being a victim. Don&rsquo;t judge them for their choices. Acknowledge their feelings. Be patient and understanding. 
&nbsp;

<ul>
	<li>Take Them Seriously</li>
</ul>

Children who threaten to kill themselves, act violently, abuse drugs, or continually express that no one cares about them, should be taken seriously. If they claim nothing is wrong but can&rsquo;t explain their depressed behavior, trust your gut. Seek help from a mental health professional immediately! 
&nbsp;

<ul>
	<li>Limit Social Media Use</li>
</ul>

Teenagers who spend more time on social media have a higher risk of depression than those who don&rsquo;t[5]. Online interaction increases their fear of missing out &ndash; seeing others enjoying themselves and feeling excluded. They compare their own lives to what they see online.

Also, scrolling through media on the phone leads to a sedentary lifestyle, which negatively affects mental health. It also interferes with sleep, eventually affecting their mood. 
&nbsp;

Invite friends over or encourage them to go out with friends to overcome social isolation. Involve them in after-school clubs or sports, volunteering for a cause, or whatever activity interests them. Set an example by turning off your phone as well. 
&nbsp;

<ul>
	<li>Involve Them In Treatment Options</li>
</ul>

There is no universal treatment that works effectively for every individual. If you&rsquo;re going to a therapist, make sure that choosing the specialist is not just your decision. If your child is feeling uncomfortable in the presence of that psychiatrist or psychologist, they won&rsquo;t be motivated at all to attend these sessions. It&rsquo;s important to find someone your child connects with and is comfortable with.

It&rsquo;s the same with medications. They come with their own set of side effects like increasing the risk of suicidal thinking in some teenagers, especially if they have previously attempted suicide. Make sure you keep reminding them that they&rsquo;re valued and accepted throughout the treatment. 
&nbsp;

Important!

<ul>
	<li>Remember to prioritize your own mental and physical health.</li>
	<li>As a parent or guardian, you also have the added responsibility of ensuring that other family members, especially other children, don&rsquo;t feel ignored.</li>
	<li>DO NOT blame yourself or another family member for the teenager&rsquo;s depression. 
	&nbsp;</li>
</ul>

While severe depression may require hospitalization, remember that your condition can be managed through psychotherapy and medications. If family conflict is affecting your mental health, then family therapy is also recommended. 
 
&nbsp;

During COVID-19, the implementation of curfews limiting social interaction had a major impact on the mental health of adolescents worldwide. The closure of schools and colleges was a significant factor. On one hand, children who had access to various resources in their educational setups were deprived of them. On the other hand, children living in abusive households had no escape and experienced higher levels of loneliness and increased anxiety.

Moreover, with therapies suspended, especially in the case of children with special needs, the disruption in daily routine led to a relapse of their mental conditions. 
&nbsp;

The period, however, reinforced the idea that teen users have got the option to benefit from both remote learning and remote healthcare via technology. Not only were they able to connect with their teachers and peers over Google Classroom and Zoom, virtual reality applications promised a greater degree of control for doctors to customize and reproduce treatment parameters as per the individual&rsquo;s needs, making it less scary and more private and accommodating, something which is not feasible in a traditional hospital environment<a href="#accordion">[7][8]</a>.&nbsp; 
&nbsp;

Conclusion

It is important to remember that it is not possible to always be optimistic and anyone expecting it from you &ndash; yourself included &ndash; is being unrealistic. Depression is real and not something to be ignored. Take the first step and put yourself first. Don&rsquo;t be afraid to ask for help. You&rsquo;ve got this! 
&nbsp;

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