Adolescent Depression

6/4/24

What does adolescent depression look like, and what might be causing it?

While childhood depression is considered rare, we see a substantial increase in cases of youth depression following the initiation of puberty. This post pubertal increase can be explained by a number of changes like our biological development as well as changes to our social environment. Around this time, the adolescent mind is often flooded with hormones and the brain is left to regulate itself in this newfound environment. In addition, our external environment is likely to undergo a series of distinct changes during our adolescent years. Social connectivity can be threatened by the transition from middle to high school and a sense of competition rises among peers. With these factors in mind, it should come as no surprise that some adolescents begin to struggle with their mental health.

Central Symptoms

While our adolescent years are often viewed as an exciting coming-of-age period wherein we embark on novel experiences and mold our social environment, some adolescents are burdened by the presence of mental health impairments. Worldwide, approximately 10-20% of individuals will experience some form of mental disorder during childhood or adolescence (Lopez et al. 2006). More specifically, adolescence can evoke debilitating youth depression, which is among the top four medical disabilities in 10–19-year-olds. (Saluja et al. 2004). Adolescent depression is associated with a range of maladaptive behaviors like substance abuse, eating disorders, and academic issues.

Diagnosing Depression

Unfortunately, diagnosing depression in adolescents can be extremely difficult. Parents and teachers often site the common nature of mood instability in teens as one of the reasons they fail to detect youth depression. With this in mind, there has been a push to increase awareness and help the public better detect depression before it is able to progress. The DSM-5 outlines depression using the following criteria: The individual must be experiencing five or more symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure. Symptoms include the following:

1. Depressed mood most of the day, nearly every day.

2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.

3. Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.

4. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).

5. Fatigue or loss of energy nearly every day.

6. Feelings of worthlessness or excessive or inappropriate guilt nearly every day.

7. Diminished ability to think or concentrate, or indecisiveness, nearly every day.

8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

In a network analysis of depression symptoms in adolescents (featured below), researchers have found that loneliness and sadness appear to be two of the most central symptoms of depression. Additionally, loneliness is considered the most contributing factor to suicidal ideation in our youth (Gijzen). Therefore, the authors recommend that preventative efforts take experiences of loneliness into account when understanding adolescent depression.

It is absolutely pivotal that we continue to fund research aimed at understanding and mitigating youth depression. If we can better understand the underlying factors leading to depression during adolescence, we can adjust our societal structures to better accommodate our youth. Stay tuned for our blog post this coming Thursday (6/6) when we discuss the treatments available for teens with depression as well as the proposed changes to the more macro structures that have seemingly fostered the current rates of depression.

Depressive symptoms often increase linearly over time, and if untreated, can lead to severe negative outcomes. With this in mind, it has been advised that parents be cognizant of any distinct changes to their child’s mood and general affect.