Teenage Depression has been the subject of epidemiological studies for several years. Although the figures vary somewhat depending on the country or the instrument of measurement, most international studies show that around 7% of adolescents have depression or “major depressive episode“. Another constant fact in these studies is the fact that twice as many girls as boys are affected by this disease. It is estimated that about 20 to 30% of young people suffer from a depressed mood.
A recent WHO (World Health Organization) report (2014) points out that depression is the leading cause of illness and disability in young people (aged 12-19).
It is estimated that two-thirds of teenage depression are not medically and / or psychologically treated. However, the consequences of these depressive episodes are numerous and serious: character disorders, school failures, suicidal behavior (70% of adolescents with a major depressive episode made a suicide attempt within the following 3 years, Jackson & Lurie, 2006 ) and dependency behaviors.
Table of Contents
A difficult to diagnosis of Teenage Depression
If the DSM IV or ICD-10 criteria are clear enough to understand the depressive phenomenon as a whole, diagnosing or studying teenage depression is less easy.
We can see different reasons …
First, the manifestations of this pathology differ greatly in children and tend to approximate those in adults as the adolescent develops. We are therefore in the presence of a progressive symptomatologyaccording to age.
Second, the nature of the disorder, and therefore its very definition, is confusing. The term depression has several meanings which depend both on the current in which the research is situated, and on the aim of the research itself.
Third, another difficulty is that few adolescents express complaints of a depressive nature. Because depression is above all a disease of affect and at this age, the adolescent either tries to fight against the disease by expressing other symptoms, or has difficulty in recognizing in him a change of mood in addition to all the purely developmental changes of this period.
Recent studies show that teenage depression has a different spectrum of symptoms than adults, with depression in young people more commonly associated with psychiatric disorders than in adults, further complicating the diagnosis. Thus, of all the disorders of childhood and adolescence, mood disorders are, in fact, among those most often associated with other symptoms or with other marked psychopathological disorders. Knowing these peculiarities better is of the utmost importance, as a better knowledge of the specific symptoms allows for better diagnosis, better treatment and better prevention.
Symptoms of Teenage Depression
The first observable symptoms of teenage depression are somatic complaints, such as headaches, backaches, stomach aches, or various somatic complaints that will not be explained by a physical cause. In general, parents, faced with these complaints, rather make an appointment with the attending physician. If the pain persists, a visit to a specialist is also common. In most cases, these investigations will not yield anything. But the qualitative leap from a somatic complaint to a psychological problem is rare, leaving the teenager and his parents without explanation. Somatic complaints are also higher in girls than in boys and tend to increase with age. Girls also suffer more from psychosomatic symptoms, reminding us that the line between physical and psychological symptoms is rather blurry.
Irritability will be more obvious than sadness, expressed little or no compared to adults. The teenager may get angry or cry for things which, usually, did not make him react like this: a missed bus, a dinner not ready on time, a family obligation … We also note a decrease in the ability to concentrate which is marked with the fall in school results. In general, this criterion is a reason for consultation for the parents, the teachers alerting the family that “something is wrong”. Very often, parents make an appointment with a psychologist to work on the young person’s motivation.
Teenage depression has trouble falling asleep and regularly wakes up at night. With regard to falling asleep, there is no particular anxiety or concern at night. Teenagers can’t explain why they can’t get to sleep. We observe the same thing during nocturnal awakenings. They wake up, don’t know why, and take a long time (30, 45 minutes, or even longer) to fall back to sleep. It is obvious that after a few weeks, extreme fatigue sets in and disrupts the ability to concentrate. Some teens who cannot sleep decide to occupy themselves by watching a movie or playing video games. It is important to distinguish between addiction to video games, where a teenager spends hours in front of his computer with gambling as an end in itself, and a teenager who gambles to fill his sleepless hours.
There may also be appetite disturbances. The adolescent may stop eating or, on the contrary, have binge eating attacks. In order not to confuse these disorders with anorexia or bulimia, it should be borne in mind that the anorexic adolescent is in hyper-control and hyperactivity, while a depressed adolescent will suffer from visible psychomotor slowing. He will be without energy and will have little courage.
Some adolescents will try to fight against depressive affects by a whole series of behaviors which can go from taking cannabis, alcohol, to endangering behaviors on the road, in their sporting practice… “When I climb there- high, I feel alive! We can thus speak of self-medication. By putting himself in danger (from the adult’s point of view), the adolescent escapes his suffering for some time. Thus, acting out, feeling-seeking behavior, the abuse of psychoactive substances, intense and unstable relationships, would be means of defense against depressive affects.
Unlike any adolescent who may doubt or be unable to project himself into a more or less near future, a depressed adolescent can no longer imagine a future. He feels at a dead end and is convinced that nothing and no one will be able to get him out of his condition.
Adolescents can have dark thoughts and thoughts of suicide. Sometimes their discomfort is so intense that they see suicide, not as the end of their life, but as the only possibility to break the deadlock in which they feel trapped. They want to stop suffering more than dying.
There is also a visible psychomotor slowing down. The movements are slower, the speech rate also, the tone of voice lower.
Depressive affects are marked by a feeling of sadness, emptiness or sudden and inexplicable crying attacks. The deep feelings of distress and hopelessness are usually most marked in the morning.
As we can see, the symptomatology of teenage depression is not “unique”. Many symptoms can be part of the clinical picture of depression.
Finally, remember that two thirds of children and adolescents with a major depressive episode also suffer from another psychopathological disorder. The most common associated disorders are anxiety disorders, disruptive disorders and substance use. In general, the associated conditions increase the risk of relapse and prolong the initial duration of the depressive episode.
To be able to make a diagnosis of depression, several of these signs must be present for a certain period of time. The most relevant indicators of a problem related to mood are the three types of fundamental biological manifestations (sleep, eating and psychomotor slowing), as well as mood disorders(irritability …) also called vegetative symptoms.
The causes of Teenage Depression
Rather, it is the conjunction of different elements (risk factors) that create a “depressogenic” developmental organization that can be the precursor of a depressive illness. The different factors are often interrelated and mutually dependent. Among them, we can cite a certain genetic vulnerability, hormonal factors (precocious or late puberty), family relationship difficulties or with friends, negative life events in the family (illness, bereavement, divorce), bullying (verbal, physical), school pressure… For some authors, the first depressive episodes are specifically triggered by one or more negative life events, associated with certain risk factors.
As we said, adolescents rarely express a complaint of a depressive nature. So these are other symptoms that may cause parents to worry and to seek psychological counseling. During the first consultation, the psychologist can then investigate all the symptoms both with the family and with the teenager alone. Thus, appropriate support can be put in place.
Whether the concerns come from parents, teachers or PMS centers, a consultation with a psychologist can clarify the situation. If the teenager suffers from a mild or moderate depressed mood, taking a few sessions in charge may be enough to deal with this somewhat more difficult passage in the teenager’s life. Obviously, the more the symptoms worsen, the longer the treatment will take, with, in extreme cases, the possibility of hospitalization, whether short or longer. However, research shows that the earlier a major depressive episode begins in life, the greater the risk of recurrence and the greater the recurrence.
Early identification of teenage depression and support can therefore make a difference. If depression is a serious illness, we should not underestimate the skills of adolescents who, sometimes, in a few sessions, find in them the resources to cope.