Over the years, depression has been under-recognized and under-treated in America adolescents, with approximately 75 percent of depressed adolescents not receiving treatment. The untreated depression, particularly in adolescence is associated with different severe adult outcomes such as poor physical health and low educational attainment. Apart from the suffering and the impaired functioning that depressed adolescents encounter, the reality is that some affected adolescents commit suicide which increases the need for a proactive examination and treatment.
The major features of depression in adolescents are irritability, sadness, and loss of pleasure or interest in activities. The extent of depression ranges from mild to severe. In severe cases, a wide constellation of features such as a decline in school achievement, disturbances in sleep and appetite, social isolation as well as nonspecific physical symptoms which combine to cause major distress as well as a wide functional impairment. As a result of depression, some adolescents may encounter psychotic symptoms such as paranoid delusions and hallucinations. Numerous adolescents with depression may experience a decline in physical health that is associated with poor self-care behaviors. Depression can also result in increased risk behaviors such as substance abuse and sexual risk behaviors that may compound with other difficulties as adolescents try to deal with the suffering. Other adolescents may develop overt suicidal behaviors and thoughts.
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As opined by Kroning and Kroning (2016), depression among teens in the United States is rampant, affecting about 10 percent of all adolescents. This study further reveals that approximately 30 percent of all high school students are depressed attributing to a suicide rate of approximately 17 percent. The prevalence of depression is absurd because teen years are greatly confusing yet fundamental in the growth and development process of adolescents. Most teens experience psychological, social, and physical changes during adolescence. As a result of this stage of development, most of them end up depressed, leading to heightened suicide cases. This paper, therefore, seeks to explain the role of depression in teen suicide and further recommend interventions to prevent such occurrences. Psychotherapy is a great measure that ought to be initiated to safeguard teenagers from suicide that result from depression.
Justification
Suicide is a severe public health issue among all age groups. Among adolescents, it exerts a huge toll because of significant years of potential life lost. As indicated by Wilkinson et al. (), suicide remains the third-largest contributor of death cases among adolescents in the United States and the second-largest contributor in the European Union. What has heightened suicide death cases in adolescents is the general assumption that children cannot suffer from depression. However, the evidence from recent studies reveals that clinical depression is among teens. The research carried out by the National Youth Risk Behavior Surveillance Survey (YRBSS) indicates that three out of every ten high school students suffer from depression (CDC, 2019). The data also show that female students and Hispanic teens that feel sad consider suicide as a solution as compared to blacks and white teens. The strong evidence provided by YRBSS shows that depression, as well as suicidal thinking, is common among youths.
Adolescent depression has become a profound issue in the United States. According to the National Comorbidity Survey-Adolescent Supplement done by Van Heeringen et al. (2011), it was found that about 10 percent of teens suffer major depressive disorder by the age of 18 years. More recently, the United States National Institute of Mental Health also found that approximately 2.7 million teens between 12 and 17 years suffered major depressive episodes in 2013 (Kim, 2014). Therefore, if depression cannot be treated, it will result in an intense feeling of hopelessness, frustration, sadness, and anger that can last for weeks, months, and years.
Risk factors
Adolescence makes teens vulnerable to suicide because it is a period of transition from childhood to adulthood that is characterized by freedom of movement and changes. In this stage, teens are obligated to make significant decisions that shape their lives. These decisions range from what they choose, the educational institution they attend to the personality they embrace. As they develop, the identity of these teens is expected to address the challenges they experience in the new environment. The pressure of high expectations that come from their peers, family and other parties destruct their self-esteem.
Various risk factors cause teen suicides. One of the risk factors that cause suicide is a mental disorder, particularly depression. Approximately 90 percent of individuals that commit suicide have suffered from a mental disorder. Mental disorder contributes between 47 and 74 percent of suicide risk and depression is found to contribute between 50 and 65 percent of suicide cases. The depression case is more in females as compared to males (Amitai & Apter, 2012). Even though the majority of individuals that have depression do not die by suicide, major depression heightens suicide risk more than individuals without depression. This indicates that the risk of death by suicide may be associated with depression severity.
Current studies on depression suggest that about 2 percent of individuals treated for depression in an outpatient setting can die by suicide and the rate of suicide of those patients treated for depression in an inpatient hospital setting is twice higher as compared to those treated for depression in an outpatient setting. According to Buchman-Schmitt et al. (2014), patients treated for depression as inpatients following suicide attempts or ideation are three times likely to die by suicide as compared to those only treated as outpatients. There are also significant differences in the sustainable risk of suicide in depression.
However, teenagers reveal depression indicators that are different from adults. Depressed teens are characterized by sulking, getting in trouble at school, acting out, feeling misunderstood and expressing negativity. Studies carried by Nock et al. (2018) suggest that more than six students in a classroom struggle with depression at any given time. During adolescence, many teens struggle with family, school, grades, their identity, and friends. The most common problem that results in depression is bullying. Bullying can be done on school property, electronically by chat rooms, email, and instant messages.
Family members, school personnel, and friends may not recognize teens that are distressed, lonely, or sad because these signs are invisible or these particular teens hide them. In 2013, it was reported that over 19 percent of US high school students were bullied on school property while over 14 percent electronically bullied through chat rooms, mail, and text. If depressed adolescents are not properly diagnosed, their conditions may worsen which may eventually lead to suicidal ideation or suicidal attempts. In general, depression comorbidity substantially heightens the suicide risk of teens.
Apart from depression, teen suicide is also associated with impulsivity. As much as people know that the process of suicide can take several days to build up, the tragic shift from suicidal attempts and ideation to a completed suicide occurs suddenly, particularly in adolescents (Yip et al., 2012). The difficulties experienced by teens in dealing with different mixed emotions as well as mood fluctuations accompanied by new and ever-changing challenges confrontation in the various domain is another risk factor that contribute to teen suicide.
Teenagers that commit suicide tend to have poor problem-solving skills as compared to other peers. Their behaviors have a rather passive attitude and always wait for another individual to provide a solution for their interpersonal problems. Their inability to regulate mood and solve problems causes insecurity, low self-esteem, and self-efficacy, anger, emotional crisis, aggressive and suicidal crisis. These problems can trigger depression in these teenagers which eventually makes them prone to suicidal attempts or ideation.
Additionally, family factors are linked with suicide behaviors in many ways. Romero (2013) estimates that in 50 percent of cases of youth suicide, family factors are significantly involved. One significant issue of a family factor is a mental disorder history among family members such as substance abuse and depression. However, it is not clear whether mental disorder such as depression directly affect child suicidal behavior or does so indirectly through these disorders evoked in the child because of the family context. Studies have also found that the augmented presence of depression that causes family members to commit suicide may evoke youths to commit suicide. As much as there is no viable mechanism behind these findings, teens tend to imitate certain behavior from some family members. Poor communication within a family is another factor that may result in suicide cases in teens. The direct conflict of parents has a significant impact on child development. Violence at home found in the background history of the family may cause the child to be depressed and if suitable ways are not established to deal with the problem, it may result in the child committing suicide (Im et al., 2017). As much as parental divorce is slightly associated with teens involved, this relationship can be attributed to practical, socio-economic and financial consequences. Risk factors that are directly connected with particular important life events are dynamic but stressors are related with suicide in some youths as compared to others. Therefore, impulsivity and family factors are some of the risk factors that increase the chances of depression in teens which eventually contribute to suicide.
Intervention and Recommendations
The high case of teen suicide can be averted through a strategic approach that considers developmental stages. The first step that can be undertaken to prevent teen suicide is to recognize, diagnose and treat depression. Effective early intervention can assist people to minimize the disability and burden of depression. A combination of mood-elevating medications, proactive support as well as psychotherapy is significant in treating teen depression that can result in suicide. Some of the suicide critical protective factors include support from friends, families as well as school or faith community. Various interventions can be utilized to address depression that causes teen suicide.
One of the interventions that can be used to prevent teen suicide caused by depression is creating awareness. In this intervention, teens or adolescents should be sensitized on the symptoms and consequences of depression. Trained personnel such as psychiatrists and psychologists ought to be contracted to educational institutions and communities to diagnose as well as treat mental health issues. These psychologists and psychiatrists should assess depressed teens on how they respond to life, particularly in stressful circumstances and further replace their negative thinking behaviors and patterns with effective coping strategies such as motivating them to transform in behavior, developing their self-esteem as well as helping them deal with relationship problems. According to Wilkinson et al. (2012), schools with easily accessible mental health services, and practitioners have reported a decrease in teen depression and suicidal cases. Assisting teens to notice that there are individuals that want to assist them will encourage teens to receive the care they need. Apart from helping them through this situation, teens should be assisted to know the warning signs and risk factors of depression.
Another strategy that can be used to prevent teen suicide caused by depression is developing a national suicide strategy. This strategy entails national strategy coordination by stakeholders such as educational institutions, the government, and non-profit organizations. National strategy implementation to prevent suicide is critical in averting this crisis. The issue of teens can be addressed through public dialogue and support from stakeholders (Apter & Gvion, 2016). Measures ought to be established to prevent shame, depression, and prejudice. The government should also initiate stringent policies that condemn suicide which is essential in preventing incidences of teen suicide. Apart from introducing stringent policies, the national strategy must also amalgamate public health and behavioral health to use clinical knowledge in addressing suicide.
Another intervention that can be used to prevent teen suicide is the incorporation of social networks. Relevant stakeholders and agencies should create a social strategy to identify teens contemplating suicide and connect with trained professionals such as psychologists and psychiatrists. Social media platforms will provide an alternative for users to report suicidal comments from other users. For instance, the National Suicide Prevention Lifeline offers a helpline that links a person to a crisis worker.
Likewise, depression and suicide can be prevented if the society takes into consideration the development level of an individual, determining high-risk groups as well as researching evidence-based interventions to reach a large group of people. Nurses can also play a unique role to prevent teen depression and suicide. They can provide education and support to families, schools, and patients to facilitate protective mechanisms for depression. Nurses can also advocate for establishment of policies that address evaluation and treatment crisis intervention and further confer teachers and counselors.
In summary, depression is a social crisis that is difficult to diagnose through observation and therefore this paper acknowledges that increased awareness and mental health programs and psychological outreach introduction, teen suicide cases can be prevented. Social media platforms will also help stakeholders to reach teens that might be quietly suffering. Finally, collaborations between government agencies, educational institutions, and family members can save lives and prevent teen suicide crisis.
References
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