Theme 2 - Depression and Suicide - Why is this a Global Issue?

Depression

 Depression is defined as a chronic disorder that lasts for at least two consecutive weeks and considerably impedes one’s abilities to live a normal life. Common symptoms include difficulties in interpersonal relationships, academic and social life, as well as increased alcohol and substance abuse. Depressed teenagers often have low self-esteem, may feel unworthy and unloved.

Since it is a mental illness, depression is often difficult to diagnose or recognize. However, depression affects almost 10% of adults in the US. It is also one of the most common psychological problems affecting adolescents with recurrence rates of almost 70%. In 2017, 3.2 million adolescents aged 12 to 17 in the United States had at least one major depressive episode. (NIMH, Major Depression)

Suicide

 Depression is commonly linked with the increased risk of teenage suicide. Suicide is defined as “death caused by self-directed injurious behavior with intent to die as a result of the behavior” (National Institute of Mental Health, 2019). Suicide ideation can arise from a variety of reasons. Teenagers may experience “feelings of stress, self-doubt, pressure to succeed, financial uncertainty, disappointment, and loss” and may equate suicide as “a solution to their problems.” (Suicide in Children and Teens, 2018)

 Suicide has been declared as the third largest cause of death amongst adolescents, by the World Health Organization and Center for Disease and Control. According to data provided by the National Institute of Mental Health (2019), “there were more than twice as many suicides (47,173) in the United States as there were homicides (19,510)”. Suicidal rates have been consistently higher for Non-White populations and the total suicide rate in United States has increased by 31% (NIMH, 2019). These alarming trends are reason enough for the emphasis on the issue of teenage depression and suicide.

 

Causes

Teen depression is a relatively new observation in medical science and not easily recognized. Depressed teens may show signs of sadness, negative outlook or general morbidity but these symptoms are often ignored or overlooked as mood swings or a part of biological changes during puberty.

 Clinical depression can be caused by a number of factors including changes in neurotransmitters, negative thinking patterns, hormonal changes caused by gender differences, co-occurrence of other medical conditions, side effects of medications, genetic history or external traumatic episodes such as divorce, death of loved one, etc. (Mental Health America, Depression.)

 One of the primary causes of the occurrence of depression is the inability of young teens to handle their emotions. Emotionally-sensitive teens who may be subjected to traumatic changes in life such as bullying, parental divorce or even abuse, may be highly susceptible to getting depressed. However, this does not mean that depression will not affect teens that have not experienced such episodes in life. Such depression can be accounted to heredity and genetics.

 A study by Pena, Matthieu, Zayas, Masyn, & Caine (2012) concluded that Black and Hispanic members have higher suicide rates than their White counterparts. This research suggests that ethnic and racial differences also account for rising rates of suicide and depression in certain communities. An article by Stanford Health Care focusing on Understanding Teenage Depression proposed that “for teens, a stressful home environment or neighborhood poverty and violence can lead to depression.” Thus, environment and external circumstances are also imperative causes to the internal turmoil faced by growing teenagers.

            Social media has also become another rising cause of depression. Modern-day teens are connected to technology and electronic communication so much more than the past. Social media and the like have increased social connected while also bringing their own set of troubles and challenges. Some studies even relate excessive social media use to unhappiness and loneliness. Adolescents excessively involved in these platforms are constantly a part of a blind competition of self-worth and self-analysis. Incompetency and inability to portray a good social media image is often a huge concern facing these teens. Such concerns may also encourage depression and suicidal ideation.

 

Impact

Both depression and suicide have a tremendous impact on youth potential. Depressed teens often do not perform well academically, physically and socially. They may drop out of high school or college or not focus on grades, thereby affecting their careers. A study conducted by Jaycox, Stein, Paddock, Miles, Chandra, Meredith and Burnam, (2009) found that “teens with depression and their parents reported more impairment in all areas, compared with teens without depression at baseline, and reported more coexisting emotional and behavioral problems.” Depressed teens often simultaneously struggle with other issues such as substance abuse, alcohol addiction, eating disorders, physical illnesses, bullying, criminal behavior, self-harm etc. and their consequent effects. Depression influences “mood, outlook, thoughts, and behavior (and) can cause fatigue, irritability, loss of appetite, headaches, and insomnia” (Stanford Child Health, Understanding Teenage Depression). A majority of health care costs incurred by adolescents are also attributed to depression. In addition, depression has a major impact on latter life including higher risk for other mental disorders and decreased work performance in professional life.  

Depressed teens frequently look towards suicide as an ultimate solution to all their problems and are at an increased risk of acting upon these thoughts. Suicide is associated with a large amount of emotional and physical loss. However, alarming suicide trends have synergistically impacted economy of the country as well. According to a report by the Center for Disease and Control (2013), suicide accounted for a whopping $50.8 billion (24%) of the medical and work-loss costs of fatal injury in 2013.

 

Why does it matter

The frequency of both depression and suicide amongst teenagers and the link between the two has made these conditions a matter of urgent importance, particularly in the United States. Awareness of teenage depression and suicide trends amidst community is important because “too many people resist treatment because they believe depression isn't serious, that they can treat it themselves or that it is a personal weakness rather than a serious medical illness.” (Mental Health America, Depression.)

Depression and suicide are taking too many of America’s potential generation and are undoubtedly a cause of concern. The future of the country depends on both the inheritance that these youth receive and the impact their generation creates. However, a generation devoid of an inherently and emotionally understanding environment is dragged more and more towards a sad extinction. The death of so many adolescents is not a sign of a blooming future for the country. Even depressed teens cannot perform to the fullest and cannot carry on the legacy of their past generations. Dealing with their emotional issues is vital to enabling a successful future for this generation of the youth. Supporting them in such times is essential to ensure we can continue to promote humanity’s greatest potential.

Therefore, it is imperative to conduct a fulfilling study recognizing the causes of both depression and suicide, suggesting measures to prevent these instances as well as help teens recover from these conditions and finally, understand what barriers stand in between the patient and the treatment so as to ensure that individuals in need receive the help they deserve regardless of social, racial, economic, ethnic, and other differences.

 

Challenges

 Suicide ideation and depression have become greater problems today than ever. Modern lifestyle, increased stress and pressure, social media, unrealistic expectations, financial difficulties are only few reasons promoting an ascent in these trends. Ethnic, racial, economic and gender differences also contribute to variation in these trends. A large amount of research suggests that racial and ethnic differences ought to be addressed while crafting policies to reduce teenage suicide rates so as to serve a diverse population.

 Attempts to reduce adolescent suicide are underway but not achieving substantial results. Remedial measures as well as preventive strategies are in place yet there are certain factors that inhibit complete recovery of individuals in need of these regimens. One of the greatest challenges to adolescents struggling with depression and suicidal ideation is receiving the right kind of treatment. Peers and parents often encourage depressed adolescents to remain positive but these teens may require medical intervention and treatment to improve their condition. According to data by NIMH, “approximately 60.1% of adolescents with a major depressive episode did not receive treatment.” (NIMH, Major Depression). It is therefore necessary to investigate why the right care is not reaching depressed individuals. Lack of awareness of approapriate treatment methods, stigma and social rejection associated with meeting therapists, psychologists, psychiatrists and the like, and fear of invasion of privacy for teens are only some of the reasons depressed teens are unable to reach out to the right care for their issues.

            Even teens who receive treatment face a number of other challenges. These teens are often unsure whether their peers and parents will support their treatment. Lack of qualified therapists and supportive environment at established therapy centers is another trouble faced by adolescents who reach out for help. Teens receiving treatment may also be clinically prescribed certain drugs or antidepressants. However, in September 2004, the Food and Drug Administration rose a concern about these drugs and “issued a warning that antidepressants may cause children and teenagers to become suicidal” (Stanford Child Health, Understanding Teenage Depression). Thus, even the medication given to solve these issues is facing debatable controversies in terms of its safety. 

 

How can we solve it?

Although depression affects such a large number of adolescents every year, the good news is that it is curable. With the right diagnosis and care, depression is treatable and suicide is avoidable. From recognizing warning signs and symptoms at individualistic levels to generating strategies to enable treatment reaching the masses – a lot can be done to solve this rising concern.

 One important facet that needs to be addressed is the stigma concerning depression and suicide. There is a need to generate greater awareness about this topic by speaking about it more openly. These are public health issues that need to be discussed rather than allowing these individuals to face their tragedies alone. Communal support is necessary to reduce the rising trends and the first step in creating a supportive environment for teens begins with talking to them about their feelings, asking teens facing anxiety and sadness if they have considered suicide as an option. Research has time and again shown that talking about suicide only lowers the chances of an individual’s risk to embarking on this act and this logic also applies to teens. Talking and generating a public responsiveness is a crucial step in solving this issue.

 Another significant step in radically eradicating this problem is the improvement of treatment regimens. Teens need to be aware of the facilities available to them as well as feel safe to approach them. Advocating for mental health insurance plans, organizing screening programs in schools, colleges and community centers, educating teens about their options and help available through workshops in academia are just a few ways to help teens reach the help they need and the help they deserve.

 Thus, a coherent understanding and evaluation of all these aspects is necessary to work up an appropriate strategy to reduce the numbers. Different factors such as racial and ethnic backgrounds, parental support, peer influence, social media as well as age and gender differences are contributing to depression or suicide. It is necessary to discuss possible recommendations for prevention strategies and possible methods to increase awareness in the community. More efforts must be taken to chance our understanding of teenage suicide and depression and enabling the current generation to improve the lives of our budding and promising youth.

 

 

 

References

 

American Academy of Child and Adolescent Psychiatry. (June 2018). Suicide in Children and Teens. Retrieved from: https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Teen-Suicide-010.aspx

Jaycox, L. H., Stein, B. D., Paddock, S., Miles, J. N., Chandra, A., Meredith, L. S., . . . Burnam, M. A. (2009). Impact of Teen Depression on Academic, Social, and Physical Functioning. Pediatrics, 124(4). doi:10.1542/peds.2008-3348. Retrieved from: https://pediatrics.aappublications.org/content/124/4/e596/tab-figures-data

Mental Health America, (n.d.) Depression. Retrieved from: https://www.mhanational.org/conditions/depression

National Institute of Mental Health.  (April 2019) Suicide. Retrieved from: https://www.nimh.nih.gov/health/statistics/suicide.shtml

National Institute of Mental Health. (n.d.) Teenage Depression. Retrieved from: https://www.nimh.nih.gov/health/publications/teen-depression/index.shtml#pub6

National Institute of Mental Health.  (n.d.) Major Depression. Retrieved from: https://nimh.nih.gov/health/statistics/major-depression.shtml

Pena, J., Matthieu, M., Zayas, L., Masyn, K., & Caine, E. (2012). Co-occurring risk behaviors among White, Black, and Hispanic US high school adolescents with suicide attempts requiring medical attention, 1999-2007: Implications for future prevention initiatives. Social Psychiatry & Psychiatric Epidemiology, 47(1), 29–42. https://doi.org/10.1007/s00127-010-0322-z

Stanford Children’s Health. Understanding Teenage Depression. Retrieved from: https://www.stanfordchildrens.org/en/topic/default?id=understanding-teenage-depression-1-2220

 

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