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Adolescent Angst
by Cora Lucas
On top of the general surge of hormones,
young people are prone to experience depression. Stuck at the crossroads
of adulthood, adolescents customarily feel low on the totem pole of life
when they're under a lot of stress and duress. A poll on the most common
mental disorder says it all: Five out of 100 teenagers experience some degree
of depression each year, largely due to inconsistent parenting, stressful
life experiences and a negative way of viewing things.
The extent of the condition depends on how quickly one can shake it off or
let it seep in. Banishing low spirits, however, appears to be a tall order
as depression is not so much a weakness as a serious health disorder. When
the blues and the blahs go on for two weeks, it may have to be dealt with
head-on as a case of clinical depression.
A few signs that one has hit the depression button: sadness, loss of interest
in pleasurable activities, decreased appetite, sleep disturbance, fatigue,
difficulty concentrating, irritability, poor self-esteem and thoughts of
death or suicide. In adolescents, school difficulties inevitably arise as
a result of lack of concentration and fatigue. There is also a strong urge
to get off-line with the rest of the world and retreat to a "safe" harbor.
Unfortunately, young people often find this in alcohol or mind-altering drugs,
which only aggravate their bouts of depression.
No magic words can seem to take away the doom and the gloom of the person
stuck with depression, be it the sad kind (major depression), or the one
characterized by the alternately down and speeded up (manic depression).
In fact, no one is immune from depression and everyone at some point has
come to be at the mercy of a disheartening situation over which they have
no control. Statistics show that one out of four women and one out of 10
men are bound to develop depression during their lifetime, even as it affects
one in 50 children under 12 and one in 20 adolescents. More women are prone
to be victims, a fact attributed to the stereotype of femininity that zeroes
in on passivity, weakness and dependency. While depression strikes at any
age, adolescents who suffer from it are more prone to suffer the same fate
in adulthood and are at even higher risk of suicide attempts.
How much of it is due to heredity and
how much of it is born out of environmental causes is still a subject of
argument. Over the years, studies have pointed to a genetic link to depressive
disorders. Carol Watkins, M.D., a psychiatrist of the Northern County Psychiatric
Associates in Baltimore County, Maryland, affirms that depressed children
often have distressed or stressed parents. "Some suggest that parental patterns
of irritability and withdrawal lead to low self-esteem in the child and this
predisposes the child to depression. Some suggest that a genetically vulnerable
child is more likely to develop depression when exposed to family stress,"
she says.
But depression cannot be blamed on heredity alone. While clinicians agree
that children acquire a predisposition to anxiety, environmental factors
are viewed to be what really triggers the initial episode of major depression.
For instance, when depressed adults are quizzed on their childhood experience,
they are likely to talk about neglect, abuse rejection and parental conflict.
Complex life experiences and personal problems like difficulty in handling
stress, low self-esteem or extreme pessimism about the future can actually
increase the chances of depression. Besides, the genetic connection has yet
to be established in the absence of a proven "depression gene."
But then again digging into the biochemical roots that influence the way
nerve cells in the brain work, it appears that certain levels of these chemicals
may be inherited. This is why there is a tendency for depression to run in
the family. But inherited or not, this link between depression and brain
chemistry disputes the traditional medical theory that separates mind from
the body.
Psychologist Joseph M. Carver, Ph.D., explains that the brain operates on
fluids called neurotransmitters, some of which give energy, others control
movement and still others control mood. The neurotransmitter linked to depression
is called serotonin, which is associated with the whole body function
sleep, appetite, energy, alertness and mood. Very much like an automobile
that burns fuel faster during long distances, the brain burns its oil, serotonin,
at a higher rate during long-term stress. "The bottom line in depression
and stress: The brain burns up more serotonin that it can replace," explains
Carver. "In the end result, after many months of severe stress, the brain
is using serotonin faster than it can create or replace it. Your neurochemical
level of serotonin drops and you become depressed."
Except for the biological, chemical and emotional factors, orthodox medical
theories have failed to explain or resolve all the factors leading to depression.
But regardless of the cause, depression is difficult to diagnose. In fact,
50 percent of all depression cases remain unrecognized. On top of that, about
10 to 15 percent of depressed people take their own lives.
Still, the vast majority of depression cases between 80 to 90 percent
are treatable. According to the National Institute of Mental Health,
milder forms can respond well with psychotherapy alone although moderate
to severe cases would do better with antidepressants. A combined treatment
is said to be best: medication for quick symptom relief and behavioral therapy
for coping with life's difficulties.
"There is no cookbook technique," explains Watkins, saying the treatment
must suit the needs and schedule of the child and his family. Based on a
study of the National Institute of Mental Health, 55 percent of patients
with mild to moderate cases posted great improvement after 16 weeks of behavioral
treatment.
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Special thanks to our friends at Doctor George for allowing the reprint of this article.
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