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COSHE.COM : Social Issues : Depression

good overview

Click Here to Search COSHE’s Database Again

Adolescent Depression Depression (also known as melancholia) is the state of sadness, decreased

initiative, and introversion. It?s known as being blue, or just being down. Depression can be caused

by anything that?s disturbing to the individual, or can be caused by massive amounts of stress.

Anything that gives you a feeling of guilt can lead to depression. Adolescence is a time where there

are great amounts of stress due to mental, physical, and chemical changes in the body. This is the

time where many people feel down or depressed. It sometimes goes unnoticed because it?s felt that

these are just things kids have to go through, but speaking from personal experience not everything

is written in plain black and white. Adolescent depression is a big problem, and if nothing?s done

about it, it can lead to an emotional breakdown. Sometimes resulting in attempted suicides.

Adolescence is what scientists label a problem period. This is the time where children, become

young adults. They are being prepared for adulthood. To prepare for this the body must go through

a certain amount of changes. These changes are both physical and mental: ?Adolescence? comes

from the Latin verb adolescere, which means ?to grow,? or ?to grow to maturity.? Maturing involves

not only physical but also mental growth. On the physical side, it means the attainment of mature

stature…mentally a mature individual is one who has reached their maximum intelligence level.

During this time, weird things begin to happen to the mind and body that are scary but exciting at the

same time. But this time also brings huge amounts of pressure and stress. Some of which the child

may not be able to handle, causing them to feel ?weighed down? by life. The teen doesn?t have to

be troubled to feel depressed, all it takes is something negative that makes them feel insecure and

you have the beginnings of adolescent depression. During this period the youth is worried about

their new role in life. They are unsure of their abilities and this confuses them, adding stress to an

already stressful period:

A person is an adult when he can take his place and play his role in adult affairs, physically, socially,

and economically. A person is regarded as an adolescent until he operates as an adult.

During this period of the youths life, it causes them to be confused, uncertain, and anxious. This is a

transition period for the youth, and it may be too much for one to handle causing emotional


Like all transitions, adolescence is marked by shiftings backward and forward from old to new

behavior, from old to new attitudes. Instability and inconsistency are indications of immaturity.

This shows that the youth is unsure of themselves and they?re second-guessing their abilities, and

they are trying to adjust themselves to the new status that they must now assume in their new social

group. There are easy to read signs of transition (the beginning stages of depression). Because he

feels unsure of himself and insecure of his status, the adolescent tends to be aggressive,

self-conscious, and withdrawn. This causes them to shelter themselves and become more reserved.

They won?t talk much, and they?ll begin to feel less social, unwanted, and misunderstood. This is

from my personal experience. The teen years is when the depression usually goes unnoticed

because people feel this is just a phase and eventually they?ll grow out of it. Sometimes you do, and

sometimes you don?t. It?s like a time bomb ticking away that could go off at any minute. moods are

linked to physical functions. But when they last for several days and weeks, these are when the

sirens are going off. These are warning signs that there are severe disturbances of personality or

undesirable conduct. Although these are symptoms that all teens go through, they differ depending

on sex. As adolescents boys and girls worry about different problems, but they all lead to the same

thing. Girls are more concerned with school problems, relating to their parents, family adjustments,

social adjustments, personal attractiveness, and etiquette. Boys worry about money and problems

relating to their future. Being a teen is stressful enough but when you add all of these pressures, it

leads to mental and physical breakdown. Within themselves the adolescent years are already a

problem. This is a confusing time for youngsters because they have many changes and adjustments

to make. Society also helps add to the turmoil of the adolescent years. Society has a lot to do with

the failure of some adolescents in life. When you have something to prove it makes you tentative.

Here are some of the main reasons for failure:

Overemotional repression, oversuppresion of unsatisfied desires, the undue multiplicity of wishes,

failure to be properly introduced, when young, to the world of reality, which is followed

subsequently by the uncontrollable desire to flee from reality…

Too often, adolescents are judged by adult standards, thus putting massive amounts of pressure on

them. This is the time when adolescents usually get very unhappy. That?s because of the demands

placed on them by society. This is all on top of the demand placed on the youth by their social

group. This could be too much for a still developing mind to cope with. Peer group membership is

the essential feature of this phase of development. Other causes of pressure leading to depression

can come from home as well. I know when I became depressed at the beginning of the year it

started at home. Parents put lots of pressure on their kids. Yes, they want their kids to do well, but

by drilling that you must succeed in life into their heads, it makes the kid anxious, and nervous. And

when the child does fail at something, they think it?s the end of the world and that they?ve failed

themselves and their parents. Another thing that puts a lot of pressure on kids is school. School has

always played a big role in adolescent depression. This is where a lot of depression actually begins.

When a student feels like they are not understanding something, instead of going to get help they?ll

just forget about it. They?ll pretend nothing?s wrong and that they don?t really need school to

succeed in life. They won?t ask for help because they?re afraid of what will be thought of them.

Adolescents always worry about what others think, this is what gets them down. Treating

depression can be very difficult, because before you can treat someone for depression, they have to

acknowledge the fact they have a problem. This is the hardest part of trying to treat depression.

Before anything can be done, the person has to want help. After the person acknowledge that they

have a problem, counseling is the first stage of recovering. Talking to a counselor about all of their

problems will help relieve some of the pressure they feel. Counseling can help adolescents adjust to

their new roles in society. But this is not always the best way to go. Counselors are just there to

talk, if the person is really depressed, other treatments are going to be needed. Counselors are there

for talking. For reassurance, to let the youth know that they can get through any of their problems.

Depending on the type of problem, treatments are different. Kinds of Problems

Everyday Problems Friendships Family School, etc. Experience Education (Guidance)

Special Problems Educational Vocational Premarital Personal, etc. Guidance (Counseling)

Adjustment Problems Emotional Sexual Social Religious Moral Counseling (Psychotherapy)

Mental health and personality problems Neuroses Homosexuality Alcoholism Drug Addiction

Psychosis Psychopathy, etc.

Psychotherapy (Medical Treatment) Medical problems Injury Disease, etc. Medical Treatment

A person must first be diagnosed with having a problem before any type of psychotherapy or

medical treatment. They must be diagnosed by a professional MD. For the other types of problems,

the youth may come to an adult telling you what?s wrong with them. All treatments should be done

by professionals, but if the youth just wants to talk, it?s okay for you to listen to their problems, but

do not under any circumstances try and perform your own personal counseling session. These are

serious problems and they need to be treated that way.

Dysthymia Dysthymia is a mild or moderate form depression. Is has been observed as form of

depression since 1980 . Dysthymic disorder is characterized by an overwhelming yet chronic state

of depression, exhibited by a depressed mood for most of the days, for more days than not, for at

least 2 years. (In children and adolescents, mood can be irritable and duration must be at least 1

year.) The person who suffers from this disorder must not have gone for more than 2 months

without experiencing two or more of the following symptoms: · poor appetite or overeating ·

insomnia or hypersomnia · low energy or fatigue · low self-esteem · poor concentration or difficulty

making decisions · feelings of hopelessness No Major Depressive Episode has been present during

the first two years (or one year in children and adolescents) and there has never been a Manic

Episode, a Mixed Episode, or a Hypomanic Episode, and criteria have never been met for

Cyclothymic Disorder. The symptoms are not due to the direct physiological effects of the use or

abuse of a substance (alcohol, drugs, and medications) or a general medical condition. The

symptoms must also cause significant distress or impairment in social, occupational, educational or

other important areas of functioning. During the 2-year period (1 year for children or adolescents) of

the disturbance, the person has never been without the symptoms for more than 2 months at a time .

Dysthymic disorder can begin in childhood and in adulthood. Like most for the depression,

Dysthymia is more common in women then in men. Most people who suffer from this disorder

cannot remember when they first became depressed. Up to 3 percent when people suffer from

Dysthymic disorder. 5-15 percent of people in a local doctor’s office has the disorder . If someone

is the criteria for Dysthymia they should go discuss the matter with a physician. The physician will

then determine whether the symptoms are because of depression the outside factors such as thyroid

disorders. Also a full diagnostic interview is held. When possible collaborative information from

family and friends is utilized. Information on the causes of Dysthymia remains largely incomplete.

There are several series on the matter. It has been observed that Dysthymia runs in families. This

would suggest that Dysthymia may be hereditary but the family environment may also play a role.

There’s also a theory that Dysthymia may be the result of a change in the brain involving the

chemical Serotonin, which would hinder the ability of the affected person to maintain social or

interpersonal relationships . Since the calls the Dysthymia is not known there seems to be no exact

way to prevent it. According to Dr. Martin Keller, executive psychiatrists-in-chief at Brown

affiliated hospitals in Providence RI, the best way to deal with Dysthymia early detection. Since

most people who suffer from Dysthymic disorder at some point in their lives experience chronic

major depression the diagnosis of Dysthymia can be used to help prevent these cases . Treatment

for Dysthymic disorder is also very broad topic. According to Dr. Phillip Long medication is usually

not an issue for someone who suffers from this disorder. Most patients show no additional

improvement with the addition of an antidepressant medication, Long-term treatment of this disorder

with medication should be avoided; medication should be prescribed only for acute symptom relief.

Additionally, prescription of medication may interfere with the effectiveness of certain

psychotherapeutic approaches. Consideration of this effect should be taken into account when

arriving at a treatment recommendation . When appropriate to treat a concurrent major depressive

episode, Tricyclic antidepressants are effective and inexpensive. Phillip W. Long, M.D. suggests

that, "a patient should not be considered a failure until the equivalent of 200 mg to 300 mg of

Imipramine has been evaluated for at least 6 weeks." Selective Serotonin reuptake inhibitors may

also be appropriate for prescription. Phillip W. Long, M.D. also states, "A number of drugs are not

of value for long-term treatment. Those drugs include the amphetamines, the barbiturates, and the

benzodiazepines. Those drugs are often prescribed for patients with chronic symptoms of insomnia,

fatigue, or tension. However, clinical experience and systematic research indicate that they are little

better than a placebo and are at times worse." As with many chronic disorders psychotherapy is the

recommended treatment of choice. Is important for the initial physician to conduct a complete

diagnostic evaluation to assess the patient’s ability to function, suicidal tendencies, etc. a cycle

therapeutic approach seems to work best because the therapist can provide us to produce change

oriented personalized environment for treatment. Therapy should be generally conducted with

respect to the client’s pace and level of functioning. Attempts to focus on change too early in therapy

could lead to early termination of therapy. This likely occurs because the patient feels the therapist

didn’t respect or care enough about him or her to move at their rate. Psychotherapy approaches for

this disorder vary widely. Short-term approaches are preferred, however, because they emphasize

realistic, attainable goals in the individual’s life, which can usually bring them back to their normal

level of functioning. This level, however, may be markedly less than what is expected in the average

person. A person who suffers from Dysthymic disorder has generally learned to live with a fair

amount of chronic unhappiness in their lives. Realistic goals should be established early on and the

focus of therapy, instead of focusing on the person’s mood state. Group therapy has been shown to

be an effective modality for individuals suffering from this disorder. A group can be more supportive

to an individual than any one therapist can and help point out inconsistencies in the patient’s thinking

and behavior. It should be considered, if not initially, then later on in treatment as the client regains

his or her own self-confidence and can interact in a social context. Issues of self-esteem often

accompany individuals who have Dysthymic disorder, so care must be employed not to place the

person into a group situation (where failure may be imminent) too soon. Family therapy may also be

helpful for some individuals. Couples therapy can bring the individual’s spouse or significant other

into the therapeutic relationship to create a therapeutic (and more powerful) triad. Goals will vary

according to type of therapy. Cognitive therapy emphasizes changes in one’s faulty or distorted way

of thinking and perceiving the world. Interpersonal therapy focuses on an individual’s relationships

with others and how to improve and strengthen existing relationships while finding new ones.

Solution-focused therapy looks at specific problems plaguing an individual’s life in the present and

examines how to best go about changing the person’s behavior to solve these difficulties. Social

skills training focuses on teaching the client new skills on how to become more effective in social and

work relationships. Usually, psychoanalytic and other insight-oriented approaches will be less

effective because of their focus on the past and emphasis on lengthy therapy. While incorporation of

therapy into a person’s chronic condition might be quite financially lucrative for the therapist, it is not

the most change-effective and timely approach to help the individual overcome his or her difficulties.

Because the clinician must move at the client’s pace, progress with any type of therapy can be slow.

Therapists should resist the temptation to try and "speed up" the process or force the client in a

direction he or she is not yet ready to try. Closely related to this issue of the pace of therapy is being

aware of the clinician’s frustration with lack of progress or boredom within the therapy session. It

can be an emotionally draining experience for some therapists. Additionally, Phillip W. Long, M.D.

adds, "The patient’s unrealistic and idealistic expectations of himself or herself may, for example, be

transmitted to the therapist and give rise to overlying optimistic expectations of progress in therapy.

If the patient shows no subjective improvement over time, the therapist may inadvertently respond

somewhat in the way significant individuals in the patient’s life have responded. Interpretation of such

personal experiences by the therapist can, in the proper context, be therapeutic." Seasonal Affective


?I just feel a little bit under the weather, that?s all?? is a phrase some may use to explain a slight

feeling of depression that they feel. However, the weather and the change of seasons may cause a

harsher form of depression, known as seasonal affective disorder. Seasonal affective disorder is the

feeling some get, every year at the same time of year, that makes them feel depressed for extended

periods of time. This period of time is usually between the months of September and the following

May, and so this form of depression is also commonly known as the winter blues or winter

depression. However, during the rest of the year, the patient feels perfectly normal and mentally

healthy. Hence the disease is named the seasonal affective disorder, because though the majority of

the cases occur during the September to May period, there are the few occurrences of the

depression during the spring or summer. The existence of the term seasonal affective disorder has

had a short life span. The term ?seasonal affective disorder? was coined in 1982 by Norman

Rosenthal after he had researched what they perceived as regular patterns of depression in

Rosenthal and one of his colleagues, Herb Kern. In the mid 1970?s, Kern, a research technician at

the National Institute of Mental Health, noticed some regular changes that occurred every year. He

noticed that every winter, he would become unhappy, slow, and lazy, while in the summer and

spring and fall, he would behave normally, more quickly and more productively. Rosenthal theorized

that these changes were due to the change in the amount of sunlight one received throughout the

year, and theorized that daily doses of bright light would be able to cure the condition during the

winter. The research team settled for two doses of three hours each of bright sunlight-like light

exposure everyday. After just three days of treatment, Kern felt better, more lively, and his

colleagues also noticed that he was more energetic and generally more friendly. These studies led to

the conclusion that although the symptoms pertaining to seasonal affective disorder could be

triggered by anything, such as stress, most cases of seasonal affective disorder were caused by lack

of bright light due to a lack of time spend outdoors during elongated periods of time. Stress,

however, is still a major factor. If a painful or stressful time in a person?s life is associated closely

with a specific season or time, the person is susceptible to seasonal affective disorder during that set

amount of time. Further studies were conducted, and the results conducted showed early on what

seasonal affective disorder was about. During certain seasons, most likely winter, some people will

try to stay inside more, and not go out as much as they would normally. This kind of behavior is

likely to cause slothfulness in a person, as well as certain extents of depression, weight change, and

lack of energy. This is somewhat natural, but when the change of season affects a person to the

point of what is referred to as clinical seasonal affective disorder, one may not be able to leave the

house and may feel a greater sense of depression. If one notices a set pattern during several years in

which there is a repetition of feelings of depression during a certain season, one can easily seek help,

and this is a treatable disorder, with almost a 90 percent treatment effective rate. There has been,

since the creation of the clinical term ?seasonal affective disorder?, many revelations made by

various scientists and their research groups. One is that a vast percentage of the world suffers from

any range of degrees of the types of seasonal affective disorder from clinical seasonal affective

disorder to a degree in which one just feels a little sad during the winter. In his original study, Dr.

Rosenthal suggested that almost one of twenty five adults in America suffered from a change in

season, especially the transition between fall and winter, the time in which the most light hours were

lost. He also conjectured that another 14 percent, roughly one in eight adults, had a milder form of

the disorder, known as winter blues or winter depression, which is the label for cases strictly in

winter and less severe than the clinical versions of the disorder. Another 30 percent of the

population was shown to suffer from Sub-syndromal seasonal affective disorder, a condition or

state in between the states of full-blown seasonal affective disorder and the more common winter

blues. Another factor that may be favorable for getting seasonal affective disorder may be one that a

person cannot immediately control. That factor is his/her location. According to various studies

conducted in the twenty-year history of seasonal affective disorder, it has been found that people

living in certain zones are more susceptible to the adverse effects of seasonal affective disorder. For

example, 10 percent of Alaska residents have been reported to have clinical-level seasonal affective

disorder, while the rest of the population only suffers from milder levels. Also, in Britain, almost one

in three adults between the ages of 20 and 40 are shown to have some level of the disorder. On the

contrary, those who lived in Florida only showed a total of one percent suffering from any stage of

seasonal affective disorder. Thus it is generalized that the closer one is to the equator, since there

are periods of sunshine, the lesser chance of one getting the disorder, while on the other hand, the

closer one finds oneself to the polar caps, the chance of getting seasonal affective disorder grows

exponentially. Whatever the cause, seasonal affective disorder usually causes one or several

problems in a patient. These symptoms have tolls on both the mind and body. For the mind, the

disease may cause such symptoms as: depression, guilt, low self-esteem, loss of confidence,

hopelessness, apathy, loss of feelings, irritability, avoidance of human contact, despair, suicidal

feelings, anxiety, inability to tolerate stress, paranoid thoughts, poor memory, poor concentration,

difficulty ?thinking straight?, difficulty concentrating or making decisions, panic attacks, abusive

behavior, weeping, seasonal alcohol and drug abuse, and seasonal bulimia. For the body, symptoms

may include: fatigue, lethargy, debility, too much sleep or trouble staying awake/waking up,


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