THE INCREASING OF THE DEPRESSION IN THE ADOLESCENCE

ELABORETED BY António Costa TEACHER CLÁUDIO MIGUEL

INTRODUCTION
Depression is a common and serious medical illness that negatively affects how you
feel, the way you think and how you act. Fortunately, it is also treatable. Depression
causes feelings of sadness and/or a loss of interest in activities you once enjoyed. It can
lead to a variety of emotional and physical problems and can decrease your ability to
function at work and at home.

Depression symptoms can vary from mild to severe and can include:
• Feeling sad or having a depressed mood
• Loss of interest or pleasure in activities once enjoyed
• Changes in appetite — weight loss or gain unrelated to dieting
• Trouble sleeping or sleeping too much
• Loss of energy or increased fatigue
• Increase in purposeless physical activity (e.g., inability to sit still, pacing,
handwringing) or slowed movements or speech (these actions must be severe
enough to be observable by others)
• Feeling worthless or guilty
• Difficulty thinking, concentrating or making decisions
• Thoughts of death or suicide
Symptoms must last at least two weeks and must represent a change in your
previous level of functioning for a diagnosis of depression.

Also, medical conditions (e.g., thyroid problems, a brain tumor or vitamin deficiency)
can mimic symptoms of depression so it is important to rule out general medical causes.

Depression affects an estimated one in 15 adults (6.7%) in any given year. And one
in six people (16.6%) will experience depression at some time in their life. Depression can
occur at any time, but on average, first appears during the late teens to mid-20s. Women
are more likely than men to experience depression. Some studies show that one-third of
women will experience a major depressive episode in their lifetime. There is a high degree
of heritability (approximately 40%) when first-degree relatives (parents/children/siblings)
have depression.

After a decline in the 1990s, the number of young people that commit suicide has been
increasing every year. While no one can explain exactly why, many experts say

1
adolescents and teens today probably face more pressures at home or school, worry
about financial issues for their families, and use more alcohol and drugs.

DEVELOPMENT

Here are some disturbing statistics about teen depression. According

to suicide.org, teen and adolescent suicides have continued to rise dramatically in
recent years. Consider these alarming figures:

Every 100 minutes a teen takes their own life.

Suicide is the third-leading cause of death for young people ages 15 to 24.
About 20 percent of all teens experience depression before they reach adulthood.
• Between 10 to 15 percent suffer from symptoms at any one time.
• Only 30 percent of depressed teens are being treated for it.
Some teens are more at risk for depression and suicide than others. These are known
factors:

• Female teens develop depression twice as often than males.

• Abused and neglected teens are especially at risk.
• Adolescents who suffer from chronic illnesses or other physical conditions are at risk.
• Teens with a family history of depression or mental illness: between 20 to 50 percent of
teens suffering from depression have a family member with depression or some other
mental disorder.
• Teens with untreated mental or substance-abuse problems: approximately two-thirds of
teens with major depression also battle another mood disorder like dysthymia, anxiety,
antisocial behaviors, or substance abuse.
• Young people who experienced trauma or disruptions at home, including divorce and
deaths of parents.
are more apt to feel overwhelmed by hopelessness and the belief that they have no
control over their lives.” Jurich calls these feelings of hopelessness and helplessness “the
Molotov cocktail that triggers teen suicide.”
For youth, major depression increased 52 percent from 2005 to 2017 – from 8.7 percent to13. 2
percent, and it rose 63 percent in young adults ages 18 to 25 from 2009 (8.1 percent) to 2017
(13.2 percent)

SUICIDE

Suicide is the second leading cause of death in young people. A major cause of
suicide is mental illness, very commonly depression. People feeling suicidal
are overwhelmed by painful emotions and see death as the only way out, losing sight of
the fact that suicide is a permanent "solution" to a temporary state—most people who try
to kill themselves but live later say they are glad they didn't die. Most people who die by
suicide could have been helped. An individual considering suicide frequently confides in a
friend, who may be able to convince them to seek treatment. When the risk is high,
concerned friends and relatives should seek professional guidance.

Suicidal thoughts may be fleeting or more frequent, passive (e.g., "What if I were
dead?") or active (e.g., thinking of ways to kill oneself, making a plan). Preparations for
death, such as giving away possessions or acquiring a gun, are cause for great concern. A
sudden lift in spirits in a depresed person can be a warning sign that they are planning to
kill themselves. Any level of suicidal thinking should be taken seriously.
SIGNS OF DEPRESSION

Anyone who feels down most of the day nearly every day for weeks or months may be
clinically depressed. Depressed individuals may experience:
• Loss of pleasure in virtually all activities
• Feelings of fatigue or lack of energy
• Frequent tearfulness
• Difficulty with concentration or memory
• A change in sleep pattern, with either too much or too little sleep; the person
may wake up in the night or early morning and not feel rested the next day
• An increase or decrease in appetite, with a corresponding change in weight
• Markedly diminished interest in sex
• Feelings of worthlessness and self-blame or exaggerated feelings of guilt
• Unrealistic ideas and worries (e.g., believing no one like them or that they have a
terminal illness when there is no supporting proof)
• Hopelessness about the future
• Thoughts of suicide
HOW CAN TO HELP A DEPRESSED PERSON?

It helps to listen in a way that shows you care and empathize. This does not mean
entering into the person's despair; an attitude of careful optimism is appropriate. However,
avoid minimizing the person's pain or making comments like "Everything's fine" or "Your
life is good—you have no reason to feel suicidal!" Try saying something like "I can see
how hopeless you feel, but I believe things can get better" or "I hear you; I want to
help." Advice should be simple and practical; for example, "Let's go for a walk and talk
more" or "I am here for you, but you need more professional advice; let's look up some
numbers together."

Change can be slow. Trying to help someone who is depressed and is not
responding to your attempts can be frustrating and anxiety provoking. It's important to take
care of yourself and get support, too. If you don't take care of yourself, you may burn out,
feel angry, or give up on the person. It is a good idea to seek help and support well before
you reach this point.

If a person is expressing that they have suicidal thoughts or you see signs of
possible suicidality, it's important to take it seriously. Sometimes, a suicidal person may
ask you to keep their situation a secret. It can be tempting to promise to keep this secret
and/or to take on the burden of supporting them all on your own; however, these are not
good ideas. Consider the possible consequences of failing to get the person professional
help. It is a sign of caring to get help for someone who is at risk of killing themselves, even
if it makes them angry at you. If you are unsure of what to do, you can call CAPS for
advice at (831) 459-2628 or call a suicide hotline (see below).

If a person is threatening to kill themselves in the immediate future, is actively

trying to kill themselves, or has just made a suicide attempt, call
 CONCLUSION

Depression is one of the most common conditions in primary care, but is often
unrecognized, undiagnosed, and untreated. Depression has a high rate of morbidity and
mortality when left untreated. Most patients suffering from depression do not complain of
feeling depressed, but rather anhedonia or vague unexplained symptoms. All physicians
should remain alert to effectively screen for depression in their patients. There are several
screening tools for depression that are effective and feasible in primary care settings. An
appropriate history, physical, initial basic lab evaluation, and mental status examination
can assist the physician in diagnosing the patient with the correct depressive spectrum
disorder (including bipolar disorder). Primary care physicians should carefully assess
depressed patients for suicide. Depression in the elderly is not part of the normal aging
process. Patients who are elderly when they have their first episode of depression have a
relatively higher likelihood of developing chronic and recurring depression. The prognosis
for recovery is equal in young and old patients, although remission may take longer to
achieve in older patients. Elderly patients usually start antidepressants at lower doses than
their younger counterparts.

Most primary care physician can successfully treat uncomplicated mild or moderate
forms of major depression in their settings with careful psychiatric management (e.g.,
close monitoring of symptoms, side effects, etc.); maintaining a therapeutic alliance with
their patient; pharmacotherapy (acute, continuation, and maintenance phases); and / or
referral for psychotherapy. The following situations require referral to psychiatrist: suicide
risk, bipolar disorder or a manic episode, psychotic symptoms, severe decrease in level of
functioning, recurrent depression and chronic depression, depression that is refractory to
treatment, cardiac disease that requires tricyclic antidepressants treatment, need for
electroconvulsive therapy (ECT), lack of available support system, and any diagnostic or
treatment questions.