Adolescent Depression: Causes, Trends, and Treatment

Introduction: Depression as a Social Issue

Depression is a significant social issue that affects numerous people across all walks of life. It has caused people to take their own lives: Chester Bennington, lead singer of Linkin Park, took his life following the suicide of his close friend, and countless less-famous individuals end up in similar situations—lost, without hope, unable to break a cycle of depression that grips them like a vice. Depression can be treated, however, and in order for the right intervention to be applied, awareness must be raised so that the stigma and taboo surrounding depression can be alleviated, allowing those who suffer from it to come forward.

In recent years, major public figures—especially athletes—have spoken openly about depression. NBA stars Kevin Love and DeMar DeRozan have talked about their struggles with mental health, which helped to increase public awareness about the issue. Teenagers especially need to hear this subject discussed, because they are one of the most vulnerable populations when it comes to depression.

The questions that guide this examination of the issue are:

1. Why are adolescents affected by depression?
2. What are the effects of depression among adolescents?
3. What are the best ways to treat depression among adolescents?

Why Adolescents Are at High Risk

Adolescents struggle with depression for a number of reasons. First, they are transitioning from childhood to adulthood: their bodies and minds are undergoing rapid, major changes, and their roles and responsibilities are shifting as well. They face many new pressures and stressors. Second, adolescents are heavily influenced by peers, social groups, and media—all of which send powerful messages about identity, appearance, and worth.

Adolescents are at a higher risk for depression compared to other age groups because of the profound developmental changes occurring during that period. Other groups—such as adults or young children—are not at the same level of risk. According to statistics from the National Institute of Mental Health (2019), "the prevalence of adults with a major depressive episode was highest among individuals aged 18–25 (13.1%)." Only about 7% of older adults suffer from depression, and children under the age of 12 are unlikely to suffer from it, as prolonged periods of sadness or hopelessness are rare in that age group. For teenagers, however, the story is very different. They are trying to figure out their place in the world while simultaneously undergoing profound physical, emotional, and social transformations—and they face a variety of stressors that neither adults nor young children typically encounter.

Contributing Factors and Causes

There are myriad causes of depression in adolescents. Today's teenagers live in a highly pressurized environment in which peers, social groups, and media push them to think, act, and feel in particular ways (Bandura, 2018). This sets them up for internal and external conflict, and teens who are unable to cope may succumb to negative impulses such as depressed thoughts and feelings.

According to Erikson's model of psychosocial development, the adolescent stage is the fifth stage, characterized by the Identity vs. Role Confusion conflict, which typically spans ages 12 to 18 (Shriner & Shriner, 2014). During this stage, teens struggle to understand who they are and what they should do with their lives, their talents, their desires, and their passions. If they lack a sense of self-worth, value, passion, or guidance, they can become depressed and withdrawn, failing to resolve the central conflict of this developmental stage. This is why guidance and support for teenagers is so important. Other pressures—drugs, sex, school, work, and family—compound the difficulty, and balancing all of these demands while also finding time for personal recreation can trigger negative, depressed thinking. In short, virtually anything in one's environment or biological makeup can be a potential cause of depression.

As the Mayo Clinic (2019) points out, however, there is no single known etiology of depression. A range of factors may explain why some teens become depressed while others do not. Brain chemistry, hormones, inherited traits, early childhood trauma, and learned patterns of negative thinking can all contribute (Mayo Clinic, 2019). When neurotransmitters do not function normally, nerve receptors and systems change in ways that can trigger depression—a situation in which pharmacological intervention is often required. Hormonal changes are universal among adolescents, as the body develops rapidly during the teenage years. Depression can also be an inherited trait passed down from a parent or grandparent. Trauma experienced early in life—such as sexual or emotional abuse, the loss of a primary caregiver, or abandonment—can lead to depression that emerges during adolescence. Teens can also learn depressive patterns by being surrounded by others who model helplessness and an inability to overcome challenges.

External factors include the reality that today's teens are hyper-connected. Digital devices over-stimulate them and provide the means for unhealthy social comparison, as teens constantly monitor social media and measure themselves against curated images of others. This can result in major depression. A lack of genuine community and meaningful family support may be contributing factors as well (Lohmann, 2019).

Statistics and Escalating Trends

According to the World Health Organization (2019), depression is one of the leading causes of mental health problems for adolescents worldwide, and for teens aged 15 to 19, suicide is the third leading cause of death. Depression is therefore a critical issue that teens face. As the WHO (2019) emphasizes, protecting adolescents and ensuring they have physical, social, emotional, and even spiritual support to maintain a positive state of mind is essential.

The trend shows that depression among teens is rising: 3.2 million 12- to 17-year-olds have experienced at least one major depressive episode within the past year—an increase of approximately one million from 2017, representing a 4% increase among the total adolescent population. Today, 13.3% of adolescents are experiencing depression (National Institute of Mental Health, 2019).

Other important statistics include:

• The prevalence of major depressive episodes was higher among adolescent females (20.0%) than males (6.8%).
• The prevalence was highest among adolescents reporting two or more racial identities (16.9%).
• Approximately 60% of teens suffering from depression receive no treatment whatsoever (National Institute of Mental Health, 2019).

Twenge, Cooper, Joiner, Duffy, and Binau (2019) demonstrate that over the past decade, the number of depressed adolescents has more than doubled. This coincides with the rise of social media use among teenagers. According to the Pew Research Center, 95% of teens have access to a smartphone and 45% report being online "almost constantly" (Anderson & Jiang, 2018).

One of the primary reasons for this escalation is that more and more adolescents are turning to the virtual world for connection rather than to the real world of friends and family. On social media, they spend significant time comparing themselves to others and questioning why other people have more followers. Their self-esteem suffers as a result, and their sense of self-worth becomes tied to the popularity of their social media presence (Lohmann, 2019). Many teens today aspire to careers as YouTubers or social media Influencers, spending increasing amounts of time online building their personal brand. Teens can become addicted to the Internet and develop serious self-esteem issues if they fail to gain the following they desire. The pressure to outperform established YouTube personalities can be overwhelming, leading to stress, anxiety, and depression.

At the same time, as Chester and Montgomery (2008) show, along with Lim, Radzol, Cheah, and Wong (2017), teens are deeply drawn to social media because it is interactive, allows self-expression, and enables them to envision paths to fame and status. They look to Influencers for information and trust their opinions, seeing them as more authentic than traditional advertising. They aspire to earn income through their own channels and to build an independent audience. When that level of success proves unattainable, feelings of depression and humiliation can follow. Social media can thus be identified as a major driver of the rising depression rate among adolescents.

In China, adolescents experience even higher rates of depression than in the United States. Zhou, Zhang, Rozelle, Kenny, and Xue (2018) found that 14% of urban teens and 23% of rural teens in China are depressed. The authors contend that elevated depression levels in China are largely economic in nature: ethnic minorities face fewer opportunities for advancement, many depressed teens come from low-income families, and parental depression appears to be a learned influence as well.

In India, the rate of teen depression is roughly comparable to that of the United States, with approximately 13% of adolescents experiencing depression (Grover, Raju, Sharma, & Shah, 2019). The same rising trend is observed, and the global spread of social media—as prevalent in India as in the United States—is likely a contributing factor there as well.

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 (teen 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., & Shriner, M. (2014). Essentials of lifespan development: A topical perspective. Bridgepoint Education.

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.

World Health Organization. (2019). Adolescent mental health. Retrieved from https://www.who.int/news-room/fact-sheets/detail/adolescent-mental-health

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.