Depression, anxiety, and behavioral disorders are among the leading causes of illness and disability among adolescents. Worldwide, one in seven young people between the ages of 10 and 19 face a mental disorder, according to the World Health Organization (WHO).
The period of rapid growth and development makes childhood and adolescence critical stages for mental health. The cognitive, social and emotional skills acquired at this stage of life can shape the mental health of individuals in adulthood.
The lack of attention and care for mental conditions in this age group can lead to future damage, including limitations to a full life. According to WHO, the quality of the environment where children and adolescents grow up determines their well-being and development. Furthermore, early negative experiences at home, in the school environment or digital spaces, such as exposure to violence, bullying and poverty, increase the risk of mental disorders.
Impacts of depression for teenagers
Emotional disorders such as depression and anxiety are common among teenagers. Anxiety disorders are most prevalent in this age group and are most common among older teens. It is estimated that 3.6% of 10- to 14-year-olds and 4.6% of 15- to 19-year-olds suffer from an anxiety disorder.
Depression affects about 1.1% of adolescents between 10 and 14 years old and 2.8% of those between 15 and 19 years old. Depression and anxiety share some of the same symptoms, including rapid and unexpected mood swings, which can be confused with common behaviors of this stage of life.
However, unlike typical age reactions, anxiety and depressive disorders can profoundly affect school activity, relationships and family life.
Physicians consistently report a lack of confidence in their ability to care for adolescents with depression. In this context, Canadian researchers carried out a review study on the diagnosis and care of depression in this age group.
According to research, the prevalence of depression among teenagers increases with age. Prior to the Covid-19 pandemic, the prevalence of major depressive disorder among adolescents was around 13% to 15%.
A recent analysis found that around 1 in 4 young people experienced clinically significant depressive symptoms during the pandemic, with higher rates associated with older age and female gender.
Onset of depression before adulthood is associated with greater illness severity in adulthood, with an increase in the number of depressive episodes, hospital admissions and risk of self-harm and suicide, poorer physical health outcomes (including obesity, diabetes and cardiovascular disease ), in social and occupational relationships.
Multifactorial factors of depression
The cause of depressive disorders is multifactorial, including genetic, environmental and individual factors.
First-degree relatives of individuals with major depressive disorder have a 2 to 4 times higher risk of developing the disease than the general population, according to the Brazilian Society of Pediatrics (SBP).
In the environmental context, adverse childhood experiences are considered as a potential risk factor. Negative affect experiences also increase the likelihood of depressive episodes.
Stigma and experiences of bullying have been linked to increased rates of depression among LGBTQIA+ adolescents. Data from the United States suggest that the intersectionality of race and gender exacerbates depression.
How is depression diagnosed in children and adolescents?
The Brazilian Society of Pediatrics (SBP) recommends that pediatricians investigate issues related to the behavioral and emotional status of children and adolescents. Consultations should include conversations about mood and feelings, in addition to observing possible inappropriate routines or indications of toxic stress.
The diagnosis of depression should be carried out by specialized professionals. In general, criteria present in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (called DSM-5) are considered.
In this context, clinicians should consider five or more symptoms (see below ), present for at least two weeks and which represent changes in the adolescent’s life. Manifestations include depressed mood and loss of interest or pleasure. Depressed mood can be defined by intense and permanent sadness, most or all days, with a feeling of emptiness and lack of hope.
The following symptoms are also considered for the diagnosis of depression in adolescents, when intense or when manifested almost every day:
- Severe weight loss or gain unrelated to dieting;
- insomnia or excessive sleepiness;
- agitation or motor slowness;
- fatigue and loss of energy;
- feelings of worthlessness or excessive or inappropriate guilt;
- decreased ability to think or concentrate, in addition to indecisiveness;
- recurrent thoughts of death; suicidal ideation (thinking or planning one’s own death).
In the Canadian study, the researchers highlight that, compared to adults with depression, children and adolescents may be more likely to have irritability and unstable mood, rather than depressed mood, in addition to sociability difficulties. Compared with younger children, adolescents are less likely to experience anxiety, physical symptoms, psychomotor agitation, and hallucinations.
Experts argue that risk assessment is a critical component of diagnosing depression. and includes review of suicidal intent and plan, as well as criteria such as recent hopelessness, perceived burden and impulsivity, previous suicide and self-harm attempts, and stressors.
Study
The Canadian study reviews the latest evidence and clinical practice guidelines from Canada, the United States, the United Kingdom, Australia, and New Zealand. Key topics include points about diagnosis, triage, and care.
Diagnosis: irritability and sad or depressed mood, fatigue, sleep disturbances, decreased enjoyment of activities and difficulty concentrating may indicate the diagnosis of depression in adolescents.
Screening: although more research is needed on universal screening for adolescent depression in primary care, it may be appropriate in some cases. Clinicians should use a validated screening tool and recognize that screening is not a substitute for diagnostic evaluation.
Careful: a multifaceted approach is required, which may include psychotherapy and medication, as well as addressing stressors.
“Depression is an increasingly common but treatable condition among teenagers. Primary care physicians and pediatricians are well positioned to support first-line assessment and treatment of depression in this group, helping patients regain their health and function,” the authors write.
They say future research is needed to address unanswered questions, including the effects of the Covid-19 pandemic on depression, whether universal screening improves outcomes, and how to best personalize depression treatment to optimize effectiveness.
Sources: Depression in childhood and adolescence, scientific document from the Brazilian Society of Pediatrics (SBP); Diagnosis and management of depression in adolescents, from the Canadian Medical Association Journal.
Source: CNN Brasil
I am an experienced journalist and writer with a career in the news industry. My focus is on covering Top News stories for World Stock Market, where I provide comprehensive analysis and commentary on markets around the world. I have expertise in writing both long-form articles and shorter pieces that deliver timely, relevant updates to readers.
