Depression is becoming more common among teenagers around the world. Teenager depression has no single definitive cause, instead, several factors exist that increase the risk of developing the condition. About 20 percent of all teens suffer from depression by the time they reach adulthood. With the risks and dangers associated with the condition, the American Academy of Pediatrics updated the guidelines for teen depression that include yearly screening examinations.

Teen Depression

Teenagers are subject to emotional changes every now and then because of the hormones that run in their system. Sometimes, they may feel angry or irritated, anxious or agitated, and blue or sad. These are a part of the physical, emotional, and psychological changes that happen during adolescence. However, strong external factors can lead teens to depression, such as:

- Overwhelming expectations for the family.

- Unrealistic academic and social expectations.

- A sense of rejection from family or peers.

- Deep disappointment.

- Mistreatment or neglect by caregivers.

- Learning disabilities including ADHD.

- Physical disabilities.

- Personality traits like low self-esteem.

Clinical symptoms of depression include poor academic performance, social isolation or withdrawal, feeling sad or hopeless, lack of energy or enthusiasm, guilt or shame, and thoughts of self-destruction which last for more than two weeks.

Teenagers affected by depression exhibit emotional changes, such as anger or frustrations, extreme sensitivity to failure or rejection, difficulty in concentrating, and crying spells due to extreme sadness. They also exhibit behavioral changes including insomnia, loss of appetite, slow thinking, neglect of physical appearance, and risky behaviors.

Updated Guidelines

The American Academy of Pediatrics noted that the clinical practice guidelines have been updated to help primary care clinicians in the management of adolescent depression. The changes were derived from two informed phases – currently published and unpublished scientific evidence, and draft revision and iteration from the steering committee that includes clinicians, experts, youth, and families.

The new guidelines include the following recommendations:

1. Preparation of the PC practice for the improved care of youth with depression.

2. Yearly screening of youth who are at risk of developing depression.

3. Identification of youth who show signs or who are at risk of depression.

4. Assessment processes that use reliable methods and sources, including depression scales, and patient and caregiver interviews.

5. Evidence-based therapeutic intervention through psychoeducation among the youth and families.

6. Installation of related links in the community.

7. Creation of a safety plan.

"There are a lot of warning signs that sometimes if you're not looking for it, or you sort of dismiss it, can be really problematic especially for the teen who's silently suffering. If these kids go undetected they can go on to have a lot of the negative sequela, and the most troublesome is whether or not they feel so down and depressed and hopeless that they consider harming themselves or thoughts of suicide," said Dr. Nerissa Bauer, an associate professor of pediatrics at Riley Hospital for Children.

The coverage of the updated guidelines includes youth aged 10 to 21 years, and those who correspond to early phases of adolescent depression management.

A safety plan has been initiated by the guidelines that help to prevent dangers from occurring among the youth with depression and to help create the best ways on how to deal with related dangers. According to the 2018 Indiana Kids Count Data Book, certain environmental settings in Indiana can increase the risk of depression. These settings resulted in some of the following depression cases in the area:

- Youth vulnerability of 7.8 percent in a family with deployed parents to the military.

- Depression has been diagnosed in 5.3 percent of children, while 9.7 percent for anxiety.

- About 30.8 percent of high school students reported feeling sad or hopeless in 2017.

"If you can invest a minute and find out that 10 percent of your pediatric population in clinics has depression or anxiety, then it's a good investment to make," said Jagdish Khubchandani, an associate professor at Ball State University. Khubchandani developed a four-question test can successfully detect anxiety and depression in 81 percent of individuals who have the issues. The test includes two questions per screening category and the categories are anxiety and depression. Individuals who take the screening test are given choices to rate how often they experience feelings related to anxiety and depression.

Depression is a complex mental disorder that can slowly impair the person's ability to communicate and trust others and prevent them from enjoying the better things in life due to negative thoughts and emotions clouding the mind. The National Institute of Mental Health advises people who feel the signs of depression to be good to themselves by taking care of their health, seeking aid from professionals, spending more time with family and friends, and learning to express their feelings to people they can trust.

[메디컬리포트=Ralph Chen 기자]

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