Depression among Adolescents

The Social Issue
Depression is a significant social issue of interest to me as I have seen it affect numerous people in my own life and have even struggled with it at times myself. Depression has caused people to take their lives: Chester Bennington, lead singer of the group Linkin Park took his life following the suicide of his friend, and numerous other people who are less famous end up in similar situations—lost, without hope, unable to break a cycle of depression that has them gripped as though in a vice. Depression is an issue that can be treated, however, but in order for the right intervention to be applied, awareness about depression has to be raised so that the stigma and taboo of depression can be alleviated, allowing those who suffer from it to come forward. In recent years, major public figures, especially athletes, have come into the light to talk about depression. NBA basketball stars Kevin Love and DeMar DeRozan have talked about their struggles with mental health, which helped to increase awareness about the issue. Teens especially need to hear this subject discussed because they are one of the most vulnerable populations when it comes to depression.
Questions to Guide My Examination of This Issue
The questions that will guide my examination of this issue are:
1. Why are adolescents affected by depression?
2. What are the effects of depression among adolescents?
3. What are the ways depression can best be treated among adolescents?
High-Risk Population
Adolescents struggle with depression for a number of reasons. First, they are transitioning from a state of childhood to a state of adulthood: their bodies and minds are undergoing rapid, major changes and their roles and responsibilities are changing as well. They face many new pressures and stressors. Second, adolescents are impacted by peers, groups and media and the messages
Why Adolescents are at High Risk Compared to Other Groups
Adolescents are at a high risk for depression compared to other groups because they are going through very difficult changes during that time. Their bodies are changing, their minds are developing, and they are being faced with new peer pressures that they may not understand. Other groups such as adults or children are not as at such a great risk according to the statistics from the National Institute of Mental Health (2019), which found that “the prevalence of adults with a major depressive episode was highest among individuals aged 18-25 (13.1%).” Only 7% of adults suffer from depression, and children under the age of 12 are not likely to suffer from as it is very rare for them to experience prolonged periods of sadness or hopelessness. For teens, however, it is a different story. They are trying to figure out their place in life and they are transforming in so many different ways while that process is happening. Plus, they are inundated with a variety of stressors that adults and children do not face.
Contributing Factors
There are myriad causes and effects of depression in adolescents. Today’s adolescents live in a highly pressure-filled environment, where they are impacted by peers, groups and media to think, act, and feel a certain way (Bandura, 2018). It sets them up for conflict, both internal and external, and teens who are unable to cope with the conflict can succumb to negative impulses, such as depressed thoughts and feelings. According to Erikson’s model of human development, the adolescent stage of development is the fifth stage of development, as is typified by the Identity vs. Role Confusion conflict, which commonly lasts from ages 12-18—i.e., the teenage years (Shriner & Shriner, 2014). It is during this stage of development that teens struggle to understand who they are and what they should do with their lives, their talents, their desires, passions and so on. If they do not have a sense of talent, self-worth, value, passion, interest, or guidance, they can become depressed and withdrawn, failing to resolve the important conflict that people face at this stage of their lives. This is why guidance and support for teens is so important. Other pressures come in the form of drugs, sex, school, work, and family—and balancing all of these while also trying to find time for personal recreation can cause teens to have negative, depressed thoughts. In short, anything in one’s environment or within one’s own biological makeup can be a potential cause for depression.
However, as the Mayo Clinic (2019) points out, there is no known etiology of depression. A range of factors may play a part in why some teens become depressed and others do not. Brain chemistry, hormones, inherited traits, early childhood trauma, learned patterns of negative thinking—all of these can be causes of depression for teens (Mayo Clinic, 2019). If one’s neurotransmitters are not functioning normally, nerve receptors and systems change, which can trigger depression. This is usually a situation where pharmacological intervention is required. Hormones are something every teen experiences, as the body is changing and developing at a rapid pace and in a new way for teens. Depression can also be an inherited trait that teens acquire from a blood relative, such as a mother or father, a grandparent and so on. Trauma suffered at an early age can lead to later onset of depression in adolescence: sexual or emotional abuse, the loss of a pillar in one’s support system—such as a mother or father; abandonment—all of these are experiences that might cause trauma that leads to depression. Teens can also learn to be depressed by being around others who demonstrate helplessness and an inability to overcome challenges.
External factors may be that teens are hyper-connected, with digital devices over-stimulating them and giving them the means to engage in unhealthy social comparison, as they constantly monitor their social media pages and compares themselves to others. This can result in major depression. Lack of real community and real family support may be contributing factors as well (Lohmann, 2019).
Statistics
According to the World Health Organization (2019), depression is one of the leading causes of mental health problems for adolescents all over the world and for teens aged 15 to 19, suicide is the third leading cause of death. Obviously depression is a major issue that teens face. As the World Health Organization (2019) points out, protecting adolescents and making sure they have the physical, social, emotional and even spiritual support to maintain a positive state of mind is critical.
The trend shows that depression among teens is on the rise: 3.2 million 12- to 17-year-olds have experienced at least one major depressive episode within the past year.  That number is up by one million from 2017. That represents a 4% increase among the total population of adolescents suffering from depression. Today, 13.3% of the adolescent population is depressed (National Institute of Mental Health, 2019).
Other important statistics to consider are:
· The prevalence of major depressive episode was higher among adolescent females (20.0%) compared to males (6.8%).
· The prevalence of major depressive episode was highest among adolescents reporting two or more races (16.9%)
· 60% of teens suffering from depression do not receive any treatment (National Institute of Mental Health, 2019).
Twenge, Cooper, Joiner, Duffy and Binau (2019) show that over the past decade, the number of adolescents who are depressed has more than doubled. This coincides with the rise of social media and the social media usage among adolescents, according to the Pew Research Center, which finds that 95% of teens have access to a smart phone and 45% of teens say they are online “all the time” (Anderson & Jiang, 2018).

Reasons for the Escalation of This Issue
One of the big reasons for the escalation in this issue is that more and more adolescents are turning to the virtual world for support instead of to the real-world where they might have friends and families. On the virtual world, they are spending all their time on social media, comparing themselves to others and wondering why other people have more friends and followers than they do. They become depressed as a result because their self-esteem suffers. Their entire sense of self-worth is determined by the strength or popularity of their social media page (Lohmann, 2019). Many teens today want to be YouTubers and have a career being Influencers. They spend more and more time online focusing on building their own brand. Teens can become addicted to the Internet as a result and can develop self-esteem issues if they are not getting the following they want for themselves on their social media page. The pressure to outperform other YouTube sensations can be overwhelming, and teens can suffer from stress and anxiety, become depressed, and become so attached to their social media profile that they lose touch with the real world.
But, on the other hand, as Chester and Montgomery (2008) show along with Lim, Radzol, Cheah and Wong (2017), when it comes to social media, teens cannot get enough of it. Social media is so powerful because teens can see themselves in it, it is interactive, and it allows them to dream and use their imaginations to think about how they could achieve fame and status via social media. They turn to other social media users and Influencers for information because they trust their opinions and feel their peers are giving an honest review. They want to be like the Influencers they see, too. They want to have an income stream from being their own boss by having a YouTube channel. They no longer want to be Rock Hudson and Brad Pitt. Today they want to be PewDiePie or some other famous YouTuber. And if they cannot achieve that level of success, they can feel depressed or humiliated. And in the meantime they will buy the brands peddled to them by other Influencers. They will even get online and try to peddle the brands of companies they like, doing the work of advertising for companies for free, hoping that in the future they get something out of it while they work on developing their own following and becoming a social media star. It can thus be surmised that social media is thus playing a major role in the rising depression rate of adolescents.
How This Situation Compares to Countries Outside the U.S.
In China, adolescents are even more depressed than they are in the U.S. As Zhou, Zhang, Rozelle, Kenny and Xue (2018) show, 14% of teens in urban regions are depressed and 23% of teens in rural regions in China are depressed. Zhou et al. (2018) contend that the reason for the elevated levels of depression among adolescents in China is mainly economic: ethnic minorities are afforded fewer opportunities to rise up in the world in China, and many of those teens who are depressed come from poor families and have parents who are also depressed—so to some extent it is a learned behavior.
In India, teens also suffer from depression but the rate is about comparable to what it is in the U.S., with roughly 13% of teens in India experiencing depression (Grover, Raju, Sharma & Shah, 2019). The same rising trend is seen in India that is seen in the U.S. and with the global rise of social media being prevalent in India just as much as in the U.S., it is likely that this is a factor there too.
Social and Economic Costs of This Issue to Society
The economic cost of depression in the U.S. is $210 billion per year (Greenberg, 2015). This results from trips to the hospital, lost work and production hours, and the toll placed on others who must provide care. The social cost of depression is that teens suffer from bullying, unrealistic views, and peer pressure. Adolescents can become withdrawn and isolated and fear being part of groups that are not online. They can fail to learn basic interaction techniques or how to talk to people face to face. This makes it harder for them to get a job as they are unable to engage in direct conversation with people. It thus limits their chances of employment as well as their future development.
The social effects of depression can be seen in many ways: tiredness, loss of energy, inability to sleep or getting too much sleep, changes in one’s appetite (weight gain or weight loss), abusing drugs or alcohol, constant state of agitation or nervousness, slowness in movements, constant complaints of headaches, isolation, poor academic performance, self-harm, fits of anger, risky behavior, suicidal ideation, feelings of sadness that do not go away and come on for seemingly no reason, frustration over small matters, hopelessness, feeling of emptiness, irritability, loss of interest in past pleasures and in family or friends, no self-esteem, sense of worthlessness or guilt, fixation on self-criticism, inability to focus thoughts or concentrate for long, bleak view of one’s life or future (Mayo Clinic, 2019).
How Society Has Dealt with It in the Past
Society has dealt with the issue of depression in the past by using drug therapy and cognitive therapy. Teens who suffer from depression can get help. Therapy and counseling, from cognitive behavioral therapy to family therapy to animal-assisted therapy can all be ways to help teens cope with depression. Once the signs of depression become evident, therapy should be sought.
Therapy has been provided to teens in the past in a number of ways, starting with drug therapy, though this has not always been shown to be an effective approach to therapy. Drug therapy can lead to over-prescription and to a drug dependency that causes harm to the teen over the years. The teen lives in a somnolent state and never goes through the resolution process of solving the crisis that is at the heart of his issues. The drug therapy process can help the teen to be more stabilized in terms of mood, but it does not address the underlying issues or allow the teen to find a way to heal and grow and move forward. It is more like a short-term band-aid on the problem, which is why many researchers have pushed for alternative treatment options like cognitive behavioral therapy and animal therapy. Animal therapy for instance has been shown to be especially helpful, as it gives individuals an opportunity to develop themselves in ways that were not open to them in the past (Korry, 2015). For instance, animal therapy gives the teen something to care about outside of himself. As Korry (2015) shows, one teen suffering from depression and who was being treated with drug therapy throughout his adolescence found it impossible to focus on anything. When he started animal therapy with a horse, he got to see what it was like to have care for another being. He felt the animal was sensitive to his feelings and understood him and his confidence and self-esteem grew as the animal did not judge him but accepted him for who he was. This put him in a positive place and got him connected to nature and the real world and eventually he was able to get off the drugs entirely and obtain a full-time job and go to school (Korry, 2015). This type of therapy is usually recommended with cognitive behavioral therapy, which allows a person to identify behavioral goals to pursue and to identify negative thoughts that can trigger a regression into depression. Sometimes pharmacological therapy, cognitive therapy and animal therapy can all be used depending on the teen’s situation and the severity of the depression.
What Has Changed to Make the Situation Worse
One of the problems that has occurred to make the situation worse for teens is the rise in opioid addiction (too many people getting hooked on prescription drugs and synthetic street drugs) and becoming unable to function. Their depression leads them into addiction as they attempt to self-medicate and they are unable to contribute to society.
Another problem that has made it worse is the increased access to digital technology—mobile phones, computers, laptops, and so on—all of it has made disappearing into the virtual world so much easier for teens. They are becoming addicted to the Internet and to social media and this is further exacerbating their depression. They are spending too much time on social media and are negatively comparing themselves to paid Influencers who do social media for a living, or to friends who have more followers; or they are exposing themselves to online bullying and teasing, which is hurting their self-esteem.
The combination of increased peer pressure to do drugs as marijuana becomes legalized in more and more states, and the prevalence of opioids adds to the risk, adolescents come under added pressures to conform and do things they would not do if they were alone. Peer pressure is increasingly making it harder for teens to avoid these traps and social media is not helping.
Implications on Society and the Future Social Work Place if the Issue Persists
If this issue persists it could be devastating for society. As these adolescents grow up, if they continue to go untreated (and the majority of them do go untreated as the National Institute of Mental Health (2019) has shown), they will enter into adulthood with severe emotional and social problems. Their depression will likely have worsened and they will have likely turned to self-medication (i.e., drugs or alcohol) to help them deal with their depression. That will only worsen their condition. It will be hard for them to hold down jobs and get through school and they will end up not being big contributors to society.
The future social work place will suffer too if the problem persists. Too many teens today are lacking in social skills because they have spent all their time on social media and not on learning how to interact with real people in the real world. They do not know the basic norms of communication, how to use body language, how to read other people, or what it means to have social and emotional intelligence. Many of them have been taught and/or have come to believe that they are the center of the universe and thus they expect everyone to conform to their needs and allow them to create and carry with them their own personal safe space wherever they go. Those who suffer from depression will not even be able to retain jobs and so there will be less and less interaction in the workplace and more jobs will likely have to be outsourced. Jobs will end up becoming virtual positions too as that will be the only way people feel comfortable working—no one will want to go to a workplace.
Sunmmary: What I Have Learned in Terms of Issues That Generate Social Welfare Policies and Social Work Practice
This issue of depression has taught me that there is a need for society to address it and to help teens deal with the issues that are affecting them. Teens need a helping and supportive hand and if they do not receive it, they can become withdrawn and isolated. They can dwell on negative thoughts and emotions and become depressed for long periods of time. This might lead them to self-harm or to addiction. Awareness of addiction has to be increased so that teens do not feel like they have to be afraid to seek help.
Help should be provide in terms of social welfare policies like animal therapy being offered to teens to help them deal with their issues. This could be a public service, where teens could adopt an animal and take care of it to help them with their depression. Social workers could also be educated on how to help teens who are dealing with depression so that they can identify the symptoms and provide the assistance needed.
References
Anderson, M. & Jiang, J. (2018). Teens, Social Media & Technology 2018. Retrieved
from https://www.pewresearch.org/internet/2018/05/31/teens-social-media-technology-2018/
Bandura, A. (2018). Toward a psychology of human agency: Pathways and reflections. 
Perspectives on Psychological Science, 13(2), 130-136.
Chester, J., & Montgomery, K. (2008). No escape: Marketing to kids in the digital
age. Multinational Monitor, 29(1), 11.
Greenberg, P. (2015). The Growing Economic Burden of Depression in the U.S.
Retrieved from https://blogs.scientificamerican.com/mind-guest-blog/the-growing-economic-burden-of-depression-in-the-u-s/
Grover, S., Raju, V. V., Sharma, A., & Shah, R. (2019). Depression in children and
adolescents: a review of Indian studies. Indian journal of psychological medicine, 41(3), 216.
Korry, E. (2015). California Moves To Stop Misuse Of Psychiatric Meds In Foster Care.
Retrieved from https://www.npr.org/sections/health-shots/2015/09/02/436350334/california-moves-to-stop-misuse-of-psychiatric-meds-in-foster-care
Lim, X. J., Radzol, A. M., Cheah, J., & Wong, M. W. (2017). The impact of social media
influencers on purchase intention and the mediation effect of customer attitude. Asian Journal of Business Research, 7(2), 19-36.
Lohmann, R. (2019). What's Driving the Rise in Teen Depression? Retrieved from
https://health.usnews.com/wellness/for-parents/articles/2019-04-22/teen-depression-is-on-the-rise
Mayo Clinic. (2019). Depression. Retrieved from
https://www.mayoclinic.org/diseases-conditions/teen-depression/symptoms-causes/syc-20350985
National Institute of Mental Health. (2019). Major depression. Retrieved from
https://www.nimh.nih.gov/health/statistics/major-depression.shtml
Shriner, B & M. Shriner. (2014). Essentials of Lifespan Development: A Topical
Perspective. Bridgepoint Education: San Diego, CA.
World Health Organization. (2019). Adolescent mental health. Retrieved from
https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health
Twenge, J. M., Cooper, A. B., Joiner, T. E., Duffy, M. E., & Binau, S. G. (2019). Age,
period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005–2017. Journal of Abnormal Psychology, 128(3), 185–199.
Zhou, M., Zhang, G., Rozelle, S., Kenny, K., & Xue, H. (2018). Depressive symptoms of
Chinese children: prevalence and correlated factors among subgroups. International journal of environmental research and public health, 15(2), 283.