Adolescence

Adolescence is the period in a young person’s life when they go through many changes. The period of adolescence happens between childhood and adulthood. It is most commonly referred to as the teenage years in one’s life. During adolescence young people struggle with many changes such as emotional, physical, social and environmental changes (O’Donnell et al., 2015). Often young people will struggle with their self-esteem, confidence, identity, emotions and social integration difficulties. These challenges can cause mental health problems such as depression due to the lack of confidence, feelings of isolation and their struggle to discover their identity and place in society (Geldard et al., 2019). Many of these problems come from direct and indirect influences, such as pressure from their peer group, their struggle with authority figures, mass media, their educational environment and expectation, as well as their social economic and community influence (Geldard et al., 2019). These problems during adolescences can cause young people to seek out risky and harmful behaviour, such as underage drinking, smoking, vandalism, shoplifting, reckless driving, unhealthy weight loss, anorexia and substance abuse (Costello et al., 2008; Geldard et al., 2019).

Depression

There are numerous ways of defining depression, however it is most commonly defined as a mood disorder that causes significant loss of interest and causes the constant feeling of sadness. It not only affects the way one feels but affects their motivation and ability to complete tasks and socially interact with others. Depression in adolescence affects one in seven young people between the ages of 10 and 19 years old (World Health Organisation, 2021b). While for most people depression is only experienced from time to time, there are still many people who experience a major depressive episode. Adolescents make up approximately 14% of the global number of depression cases within the mental health statistics, within the same age group (World Health Organisation, 2021a). Depression in adolescence often affects a young person’s behaviour. They will experience sudden outbursts of emotions when they get worked up, such as yelling, throwing things, crying and storming off (Geldard et al., 2019). Sometimes their behaviour may seem reserved with parents describing them as having lowered self-esteem, being unmotivated, socially withdrawn, lack of concentration, poor grades and school and unhappy, with more serious signs being thoughts of death or harmful behaviour (Geldard et al., 2019). Depression in adolescence can cause alterations in biological functions such as an excessive sleep and a change in the eating habits. Adolescent episodes of depression have an appreciable period of time, and for some young people it may present a recurring problem (Wicks-Nelson & Israel, 2015). Many current views of depression in adolescent young people hold that there are multiple determinants that cause depression in young people (Geldard et al., 2019).

Evidence of Symptoms 

Research on depression in adolescents suggests that there a genetic component to depression and that there are also considerable environmental influences that affect depression. The biochemistry in the brain affects the neurons in the hippocampus part of the brain, which can cause the hippocampus to shrink causing memory loss and difficulties with concentration (Nestler et al., 2002). Dealing with a lack of concentration and memory loss for young people during adolescence can increase the feelings of stress, particularly at school due to the effect that it can have on their academic results (O’Donnell et al., 2015). This effect on the brain can also make completing familiar and simple tasks feel difficult, which can lead to feelings of guilt, anxiety and hopelessness. There are many different causes for depression.

Cognitive and behavioural theories present the idea that there are more than multiple contributing factors to depression, such as interpersonal and cognitive functioning aspects (Wicks-Nelson & Israel, 2015). Separation and loss or a learned perception of helplessness can invoke the feeling of having a lack of control in a young person’s life, which can lead to outbursts, dominating behaviour and toxic relationships with others (Wicks-Nelson & Israel, 2015). Interpersonal relationships can have a significant impact on the development of depression during adolescence (Wicks-Nelson & Israel, 2015). Relationships with a young person’s peers or family can slowly be impacted by depression due to a young person’s social influences and egocentric development. Negative social influences can cause the feelings of isolation and loneliness in a young person, with their egocentric development potentially developing feelings that nobody understands them or their difficulties, which can cause a young person to retreat into themselves and isolate themselves from their friends (Geldard et al., 2019).

There are multiple tools that can be used for identifying depression in young people going through adolescence. In order to assess for depression, it is important to gather and obtain information through a variety of measures. These assessment strategies include structured interviews, which can be used to narrow down the symptoms of depression (Wicks-Nelson & Israel, 2015). One of the most common tools used in diagnosing depression is self-reporting, this is due the broad spectrum of possible depressive symptoms (Wicks-Nelson & Israel, 2015). Self-reporting tools focus on the young person’s feelings such as worthlessness and sadness. Another strategy includes systematic observations of how a depressed young person interacts with others in a controlled environment (Wicks-Nelson & Israel, 2015). This is done to get an understanding of how a depressed young person is coping with social integration and their social behaviour (Wicks-Nelson & Israel, 2015). These techniques provide vital information for a counsellor so that they may know of the best counselling strategies and areas that a young person needs support with.

Impact on the Individual and Interactions

Depression has a significant impact on a young person going through adolescence. There are numerous situations which can cause a young person to experience depression, such as parental separation, death of a loved one, receiving very little positive reinforcement, living in an abusive or harmful environment or even moving schools or houses and leaving trust friends and family behind (Geldard et al., 2019). Young people going through adolescence respond to depression in many different ways. Adolescent boys tend to display feelings more openly, even when depressed, they may act out aggressively or storm off during an argument (Wicks-Nelson & Israel, 2015). However, girls tend in internalise their emotions in order to hide how they are feeling. They may show their depression by withdrawing themselves, worrying or getting anxious (Wicks-Nelson & Israel, 2015). Depression also causes a loss of motivation which can impact a young person education and add more negative feelings such as disappointment and stress (O’Donnell et al., 2015). Depression leaves a young person vulnerable to many risk factors, especially if left untreated. A young person may begin to engage in risky behaviour, such as underage drinking, smoking, vandalism, shoplifting, reckless driving and substance abuse (Costello et al., 2008; Geldard et al., 2019).

Suggested Interventions

There are multiple forms of treatment for depression, with the two most widely used methods being medication and cognitive-behavioural therapy (Wicks-Nelson & Israel, 2015).  Cognitive-behavioural treatments are designed to confront and alter a young person’s behaviour (Wicks-Nelson & Israel, 2015). In order to alter a young person’s behaviour, the root of the young person’s depression needs to be identified (Ivey et al., 2016). From there small goals can be made with the young person and the help of the counsellor. For example, if a young person is struggling with their self-esteem and views themselves as worthless, unhappy and useless – then small goals that focus on increasing enjoyment in life, relationship building, social interaction and coping skills, will be set to slowly help the young person to find enjoyment and coping skills that they can use to help them through their depression (Wicks-Nelson & Israel, 2015). Another example of this is, if a young person finds they cannot identify why they are feeling sad, then a coping skill can be used to help them deal with this (Wicks-Nelson & Israel, 2015). If they begin to struggle with negative thoughts, then they can use a strategy to alter their thoughts (Wicks-Nelson & Israel, 2015). If a young person finds themselves in a situation that makes them feel sad, then they can use a problem-solving strategy to change the situation (Wicks-Nelson & Israel, 2015). These strategies may include, talking to a counsellor about how the young person is feeling, which then may lead the young person to a mental health plan that could include setting small goals that focus on increasing positive thoughts and identifying the problems in different situations that make the young person feel sad. Programs like Cognitive Behavioural Therapy (CBT) are beneficial forms of therapy for people that struggle with depression as it provides guided therapy sessions that help emphasis and provide an understand of the importance of thinking and feeling. By developing a plan with a counsellor, a young person will be able to slowly figure out strategies to help them deal with the challenges of adolescence and their integration into adulthood.