¶ … depressive disorder (MDD) is a condition distinguished by the presence of at least one major depressive episode (American Psychiatric Association [APA], 2000). MDD occurs in adolescents with an estimated annual prevalence of four to eight percent and with a lifetime prevalence of 20% by age 18 (APA, 2000). In addition, the data indicates that the prevalence of depression rates among adolescents is increasing with the greatest surge in rates of depression occurring in adolescents between the ages of 15-18 years-old (Costello, Erkanli, & Angold, 2006). Previous research has suggested that when MDD occurs in adolescents and children an untreated episode can last from seven to nine months (Sadock & Sadock, 2007). Adolescent depression shares many clinical features similar to depression in adults. Depressed adolescents are sad, they can lose interest in activities that used to be of importance to them, and they are very critical of themselves and believe that others also criticize them (Walkup, 2010). Depressed adolescents also feel unloved, pessimistic, and hopeless about their future; like adults they may think that their lives are not worth living and often can entertain thoughts of suicide (APA, 2000). Depressed adolescents often appear irritable and this irritability can lead to aggression or may lead to acting out in aggressive ways towards others (Walkup, 2010). It is not uncommon for adolescents with MDD to be indecisive, experience difficulties concentrating, lack energy or motivation, and even may neglect their personal appearance and hygiene (Walkup, 2010). In MDD normal sleep patterns are often disturbed as well (APA, 2000).

Yet despite the general similarities in the presentation...

First, psychotic features do not occur as often in depressed adolescents as they do in adults and when psychotic depression does occur in adolescents auditory hallucinations are more common than delusions (Sadock & Sadock, 2007). Second, concurrent anxiety symptoms such as fears of separation or social phobic-type behaviors such as an unwillingness to meet with other people occur more often in adolescent depression (Walkup, 2010). Third, somatic symptoms including overall body aches and pains, stomachaches, and headache are more common in adolescents than in adults with depression (Costello, Erkanli, & Angold, 2006). Depression occurring in adolescents is often related to social factors such as popularity issues, issues with friends, fitting in, etc. (Costello, Erkanli, & Angold, 2006). There is at least a 2:1 ratio of the prevalence of depression in adolescent girls to boys (APA, 2000; Sadock & Sadock, 2007). One reason for this is that girls tend to be more socially oriented, feel as if they are dependent on social relationships to a greater extent than do boys, and find losses or changes in social relationships to be more traumatic than are boys (Costello, Erkanli, & Angold, 2006). And of course physical changes such as puberty can lead to identity confusion, hormonal imbalances, and other changes that can increase the probability of an adolescent experiencing a depressive episode (Giedd et al., 2006).
Much of the research on adolescent depression comes from adolescents in treatment and this group may experience more serious symptoms and reoccurrence than those that…