Senior Capstone ℅ 2018

5-24-18

The Rise in Depression and Anxiety in Adolescents: An Autoethnography

Prisila S. Isem
Los Angeles Leadership Academy HS, ​pisem101468@laleadership.org
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Senior Capstone c/o 2018

The Rise in Depression and Anxiety in Adolescents: An Autoethnography

Abstract

Throughout the years, there has been an increase in teen depression and anxiety. This growing
epidemic seems to be at an all time high within this generation of adolescents. Pressure
stemming from school seems to be the major reason why the young adults of today are struggling
with mental illness more than ever.

Keywords
Depression, Anxiety, Adolescents

Acknowledgments
I’d like to acknowledge One Direction for providing me with music to dance out all my mental
breakdowns to in the midst of writing this research paper. I’d also like to acknowledge my
husband, Andrew Navarro, for supporting me throughout all my several crying sessions due to
this research paper.
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The Rise in Depression and Anxiety in Adolescents: An

Autoethnography

Prisila Isem
Los Angeles Academy HS, Los Angeles, California, USA

Throughout the years, there has been an increase in teen depression and anxiety. This growing
epidemic seems to be at an all time high within this generation of adolescents. Pressure
stemming from school seems to be the major reason why the young adults of today are struggling
with mental illness more than ever. Furthermore, treatment used on teens, whether
antidepressants or psychotherapy, aren’t always effective.

The Incident

It was a winter break night and like any other night since the break had started, I found

myself wide awake in bed. This particular night though, I could not get the thought of whether or

not people know when they’re losing their minds. On top of that, from the corner of my eyes I

kept seeing dark shadows that I was convinced were out to get me. Slowly, but surely, my hands

started to drip with anxiety. So, with sweat-filled hands, I pulled the blanket over my head, but I

was forced to emerge from underneath because I felt like I could not breathe. Despite my head

no longer being covered by the blanket, I found myself struggling to breathe. I attempted to gasp

for air, but one simple gasp did not suffice. I was continuously gasping for air and with each gasp

I found my heart beating harder and accelerating. Despite all the gasping, I still felt like I could

not breathe and I quickly became terrified, tears began to spill from my eyes.

In between gasps and tears, I managed to find my phone on my bed and send a text to a

friend that read, “I don’t know what’s happening, I feel like I can’t breathe and I’m crying and
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I’m pretty sure I’m hallucinating.” Despite the fact that it was one in the morning, my friend

managed to reply within a minute with a screenshot of a website named Calm Clinic describing

hallucinations as something caused by severe anxiety. He followed up the screenshot with a text

that read, “You’re okay, it’s just anxiety.” I did not know what to make of that word: anxiety.

Truth be told, I was far from okay. I had spent the previous months struggling with

intrusive thoughts that ranged from “I want to die” to “I’m just going to kill myself” and in the

midst of a panic attack I came to the realization that I no longer had control over my own body.

It was at that moment that I recognized the severity of my anxiety; it wasn’t simply having an

uneasy feeling anymore. My anxiety had transformed from a small voice within my head to a

loud, blaring voice that controlled my every thought and every action. After three hours of

back-to-back panic attacks, I became aware that I was no longer myself, I was nothing except for

a mixture of depression and anxiety.

Analysis

Introduction

At the age of 15, I experienced my first ever panic attack amongst several others that

occurred back-to-back within the timespan of three hours. After the first one, panic attacks

started occurring on a daily basis; I had panic attacks twice a week for a whole month before

voluntarily being hospitalized. While at the psych ward, my official diagnosis was a major

depressive episode amongst persistent depressive disorder and anxiety. I was not alone with a

diagnosis in which depression and anxiety came as a pair because several others within the psych

ward were struggling with the same issues. The youngest one in the hospital was merely twelve

years old and the oldest one there was seventeen. It became quite apparent to me between group
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therapies and talks from our rooms that we were all just a bunch of little kids who were severely

depressed and struggling with anxiety. Furthermore, all but a handful of kids in the psych ward

were put on either antidepressants or antipsychotics. It’s not normal for kids within the ages of

twelve and seventeen to be struggling with such severe levels of depression and anxiety that

requires medication.

Study of Focus
The following research will cover the topic of teen depression as well as anxiety. ​Psych

Central​ defines teen depression as having symptoms such as: frequently being sad and crying for

no reason, feelings of hopelessness, low self esteem, guilt and boredom, loss of interest in

activities, low energy, isolating themselves and having poor communication, being sensitive

towards rejection or failure, increasingly irritable, angry, or hostile, trouble maintaining

relationships, complaining of physical illnesses like headaches and stomaches, frequently absent

to school or poor academic performance, being unable to concentrate, talking about or trying to

run away from home, having thoughts or expressing suicidal or self-destructive behavior, alcohol

and drug abuse, and self injuring (Psych Central, 2016). It is important to understand what

depression is in order to grasp the concept that this is exactly what teenagers are experiencing.

In addition to defining depression ​Psych Central​ defines generalized anxiety disorder as

including three of more of these symptoms (children only need to have one symptom to fit the

criteria): feeling restless, irritable or on edge, easily fatigued, having difficulty concentrating or

mind going blank, muscle tension, and having trouble falling or staying asleep (​Bressert, 2018).

Symptoms must be present for more days than not over the span of six months in order to be

diagnosed as generalized anxiety disorder (​Bressert, 2018). Anxiety is much more than simply
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worrying, as stated above, it also results in negative physiological impact that deeply affects

teenagers.

Another term that will be used within this research paper is major depressive episode

(also known as MDE). In the book used to diagnose psychiatric conditions, Diagnostic and

Statistical Manual of Mental Disorders, 4th. Edition, a major depressive episode must have the

following symptoms present together for at least two weeks, with at least one of them being

depressed mood and lost of interest or pleasure ​(Mental Health Today)​. The symptoms to fit the

criteria for MDE, most occur nearly everyday, they are: depressed mood nearly (irritable mood

in children and teens), significant weight loss or weight gain, an increase or decrease in appetite,

insomnia or hypersomnia, ​psychomotor agitation or retardation, fatigue or loss of energy, feeling

worthless or excessive or inappropriate guilt, diminished ability to think or concentrate or

indecisiveness, recurrent thoughts of death, or recurrent suicidal ideation without a specific plan,

or a suicide attempt or a specific plan for committing suicide (Mental Health Today). In order to

be diagnosed as MDE, the symptoms must cause clinically significant distress, must not fit the

criteria for a mixed episode, are not due to the direct physiological effects of a substance or a

general medical condition (Mental Health Today). Major Depressive Episode differs from Teen

Depression due to the fact that it is a more severe form of depression.

According to the article “Teenage Mental-Health Crisis: Rates Depression Have Soared

in Past 25 Years”,“Rates of depression and anxiety among teenagers have increased by 70 per

cent in the past 25 years. The number of children and young people turning up in A&E with a

psychiatric condition has more than doubled since 2009...” (Bedell, 2016, para. 2). Due to there

being an increase of depression and anxiety in teenagers, more teenagers have gone to the
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accidents and emergency (A&E) department in England. There’s no doubt that adolescents

suffering with depression and anxiety have risen over the years, but the fact that it’s risen more

than 50 percent in the past 25 years is a problem. This growing epidemic is a problem since the

youth is the future and the type of future that is in store, if adolescents are depressed and anxious,

is not a very promising one. Awareness of adolescent depression and anxiety is needed in order

to help the youth of today advance and be able to create a bright future for generations to come.

From examining the statistics of depression and anxiety in adolescents within the last few

years, the causes behind adolescent anxiety and depression, and the way in which mental health

is being treated, it is clear that there has been an international rise in anxious and depressed

adolescents due to added pressure from school.

Claim #1: Statistics show a growth in adolescent depression and anxiety.

Throughout the years, the rise of

depression and anxiety in adolescents has

been monitored to some degree. As

reported by “More US Teens May Be

Facing Depression: Here's Why”​,​“From

2013 to 2014, about one in nine teens in the

United States had a major depressive

episode, up from about one in 10 teens

from 2012 to 2013, the researchers

found,”(Miller, 2016, para. 2). Although

not a major change, there was still an increase of teens having had a major depressive episode.
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This is a significant difference due to the fact that it occurred within the time span of one to two

years.

Furthermore, it is stated in the study “State Estimates of Major Depressive Episode

Among Adolescents: 2013 and 2014”: “When the 2012–2013 national MDE estimate was

compared with the 2013–2014 estimate, the nation as a whole experienced a statistically

significant increase in the rate of past year MDE among adolescents (9.9 percent in 2012–2013

to 11.0 percent in 2013–2014),” (Lipari, Hughes, & Williams, 2016, para. 8). There was an

increase of 1.1 percent in the process of a year or two, this information only further proofs

evolvement of depression and anxiety affecting adolescents.

According to the article, “Depression is on the rise in the US, especially among young

teens”:​ ​“The results show that depression increased significantly among persons in the U.S. from

2005 to 2015, from 6.6 percent to 7.3 percent. Notably, the rise was most rapid among those ages

12 to 17, increasing from 8.7 percent in 2005 to 12.7 percent in 2015.” (ScienceDaily, 2017,

para. 4) Within a decade, there was a four percent rise in depression amongst 12 to 17 year olds.

Although there has been a significant increase in depression throughout all ages, it seems to

oiaffect teenagers the most. This is of importance due to the age range being

Over the years, there has been a significant impact of mental illness amongst the newest

generation. The previous three research results further prove a crucial growth in the development

of depression and anxiety affecting young adults. It seems that the youth of today’s society is

deeply affected by both depression and anxiety unlike previous generations.

Claim #2: A reason in the growing epidemic of adolescent depression and anxiety is

pressure due to school.

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As stated by Geraldine Bell in the article, Teenage mental-health crisis: Rates of

depression have soared in past 25 years, there has been research conducted by a mental health

charity named Young Minds that has found exams as being a source that is triggering for mental

health in young people (Bedell, 2016, para 9). Schools have felt inclined to give teenagers the

impression that they only have one opportunity to excel in exams that have the power to

determine the rest of their lives, despite it not being true (Bedell, 2016, para 9). Due to school

institutions themselves wanting to acquire great results, they portray exams as being of great

importance. Schools make students believe that they only have one chance at exams in attempts

of encouraging them to do well. Although, this seems to be counterintuitive, since then students

begin to excessively worry about taking said exams. As a result, students can begin to feel

overwhelmed and then experience anxiety. Once experiencing anxiety, the student may then feel

discouraged in an academic setting due to how anxious they are. Thus, putting the student in

such a position that may add depression to their anxiety since anxiety holds students back from

performing well at school.

It is reported in the same article that: “Responsibility for your parents' sense of self-worth

is a heavy burden to bear. Natasha Devon, the Government's first ever mental-health champion

for schools, who runs workshops through her organisation Self-Esteem Team, says she often

encounters young people at independent schools who are “hyper-aware of how much parents

have spent on their education and of the expectation that they will go on to university,” (Bedell,

2016, para. 10). Students then get the added pressure of doing good in school from their parents.

University and/or college tends to be an expectation that parents always have for their children.

Although parents always want the best for the children, the pressure to excel in school may be
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hard for some students to handle. In the process of trying to please their parents, students might

then begin to develop depression and anxiety in attempts to exceed in school.

Claim #3: The treatment of mental illness in teens is not always effective.

A research study, “National Trends in the Prevalence and Treatment of Depression in

Adolescents and Young Adults” states:​ ​“A larger proportion of adolescents with 12-month MDE

also reported receiving prescription medication for their depression in recent years. There was no

significant trend in the percentage of adolescents who perceived treatment overall or medication

treatment as helpful,” (Mojtabai, Olfson, & Han, 2016, para 28). Teens who were suffering with

a major depressive episode were given antidepressants as treatment. Antidepressants are SSRis,

which stands for Selective Serotonin Reuptake Inhibitors. (Swanson, 2013, para. 1). According

to Swanson this is how antidepressants work: “​SSRIs increase available levels of serotonin,

sometimes referred to as the feel-good neurotransmitter, in our brains. Neurons communicate via

neurotransmitters, chemicals which pass from one nerve cell to another. A transporter molecule

recycles unused transmitter and carries it back to the pre-synaptic cell”​ (Swanson, 2013, para. 2).

Basically, antidepressants increase the chemical, serotonin, also known as the happy chemical,

within the brain. Although, the antidepressants as a form of treatment were not really of help.

Despite being given antidepressants as an attempt to treat teens, it has not proven to be effective.

In the study, “Treat depressed teens with medication and psychotherapy,” it is mentioned

that: “Many adolescents have a negative view of therapy and feel stigmatized by a referral to a

psychotherapist. They may also have a well-developed rationale as to why such treatment would

not work for them,” (Van Voorhees, Smith, & Ewigmanz, 2018, para. 20). The term

psychotherapy is used when referring to talk therapy. Psychotherapy is a form of treatment for
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teens suffering with a major depressive episode. Although, psychotherapy is not always effective

if the patient does not do it voluntarily. Therefore making psychotherapy an ineffective treatment

in those who refuse to participate.

Opinion: Depression and Anxiety are an ever growing epidemic within young adults.

​There has been an increase in depression and anxiety in the youth of today. There are

statistics in which a significant growth is shown in depression and anxiety levels within

adolescents. This generation is struggling more with mental illness than previous generations due

to added pressure in school.

Conclusion

​The youth of today are being widely affected by depression as well as anxiety and that’s

partly due to feeling pressured in school. Nowadays, young adults have the added pressure of

school, which is a factor in the ever growing epidemic of depression and anxiety affecting young

adults. Furthermore, although adolescents may be treated, it does not always mean the treatment

is effective. With this is mind, it is important to find a way to reduce teen depression and anxiety.

A way in which anxiety can be diminished in teens can be the implementation of mental health

care within schools. For example, schools can offer free yoga classes as a way for students to

reduce their stress levels. As a way to help students through depression and for them to feel less

alone in feeling this way, group therapy would be good option to offer in schools. Group therapy

would consist of students each saying how they feel and in turn feeling less lonely upon realizing

that some of their peers may feel this way.

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References

Bedell, G. (2016, February 27). Teenage mental-health crisis: Rates of depression have soared in
past 25 years.
https://www.independent.co.uk/life-style/health-and-families/features/teenage-mental-health-cris
is-rates-of-depression-have-soared-in-the-past-25-years-a6894676.html

Bressert, S. (2018). Generalized Anxiety Disorder Symptoms. ​Psych Central​.

https://psychcentral.com/disorders/anxiety/generalized-anxiety-disorder-symptoms/

Lipari, R. N., Ph.D, Hughes, A., M.S., & Williams, M., Ph.D. (2016, July 07). STATE
ESTIMATES OF MAJOR DEPRESSIVE EPISODE AMONG ADOLESCENTS: 2013 AND
2014. ​https://www.samhsa.gov/data/sites/default/files/report_2385/ShortReport-2385.html

Miller, S. G. (2016, August 10). More US Teens May Be Facing Depression: Here's Why.
https://www.livescience.com/55706-depression-rates-adolescents-teens.html

Mojtabai, R., Olfson, M., & Han, B. (2016, November 14). National Trends in the Prevalence
and Treatment of Depression in Adolescents and Young Adults.
http://pediatrics.aappublications.org/content/early/2016/11/10/peds.2016-1878

Van Voorhees, B. W., Smith, S., & Ewigman, B. (2008). Treat depressed teens with medication
and psychotherapy. The Journal of Family Practice, 57(11), 735–739a.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3183842/

Columbia University's Mailman School of Public Health. (2017, October 30). Depression is on
the rise in the US, especially among young teens. ScienceDaily.
https://www.sciencedaily.com/releases/2017/10/171030134631.htm

Swanson, J. (2013, December 10). Unraveling the Mystery of How Antidepression Drugs Work.
Scientific American.
https://www.scientificamerican.com/article/unraveling-the-mystery-of-ssris-depression/

Major Depressive Episode: DSM IV Diagnosis. ​Mental Health Today​.

http://www.mental-health-today.com/dep/dsm.htm

Psych Central. (2016). Teen Depression Symptoms. ​Psych Central​.

​https://psychcentral.com/lib/teen-depression-symptoms/
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