Depression In Teenagers
Depression in adolescence often originates from dysfunctional family life, early trauma, physical abuse, self-or other inflicted emotional, or sexual abuse. Half of all trauma victims recover naturally without treatment. The other half suffer from disrupted and altered perceptions of the traumatic event leading to a failure to recover. It damages emotional attachments, self-esteem, raises anxiety and feelings of guilt and shame. The adolescent grows up feeling damaged, angry and alone. Their hopelessness and sense of defeat causes interpersonal conflict. They blame themselves for feeling unloved. They feel empty and hostile. Depending on the temperament of their personality, they either internalize (blame themselves) or externalize (act-out) their inner turmoil.
Internalizers blame themselves. They have low self-esteem, a poor body image, lack self-confidence, are withdrawn, and have few friends. They may self-mutilate, develop eating disorders (bulimia or anorexia). Externalizers blame others, often present with severe impulsiveness, inattention, and distractibility. They may be thrill seekers and act recklessly, numbing themselves out seeking greater and greater levels of stimulation to feel anything at all. They are often underachievers, deaden their pain by sexing, drinking or drugging. They are often hostile towards authority acting oppositional and defiant and are in open conflict with their parents.
Treatment for Depression in Adolescence
The first phase of treatment involves a psychological evaluation to determine the severity of the symptoms and to assess whether there is underlying trauma. This includes an assessment of suicidality. At the conclusion of the assessment, the correct treatment setting is identified. When corollary symptoms are severe, hospitalization may be the first treatment setting. When suicidality, substance abuse or eating disorder is not moderate or severe, outpatient treatment would be recommended.
The second phase of treatment is psycho-education. Clients are taught why they have been failing to recover. They learn to identify their “stuck points” caused by faulty self-perceptions or perceptions of traumatic events in their lives which distort beliefs and amplify the intensify of their mood, preventing them from recovery.
The next phase of treatment, clients are introduced to Cognitive Behavior Therapy (CBT). They learn the connection between their beliefs and the stressful or traumatic events they’ve experienced. Using structured approaches to analyze the logic of their beliefs, clients are able to make a shift in their thinking towards more effective and factually supported beliefs.
As clients become comfortable using the tools of CBT they enter the next phase of therapy in which they can process the emotions associated with their stressors. As they process their emotions, memories, sensations and beliefs (or cognitions), the intensity and amplitude of the emotion begins to decrease allowing the teenager to recovery to full functioning.
The final phase of treatment involves relapse prevention. Clients learn the steps along the path to relapse so that they can recognize them and prevent themselves from returning to regressive levels of functioning.