Depression in adolescents: new risk factors and signs to be alert

The case of the twelve-year-old Argentine twins who, weeks ago, fell from the third floor of a building in Barcelona – the investigators found two letters written by them and two chairs that they would have used to jump into the void – turned on the alarm

, put the focus on a global problem that, many times, is relegated to the privacy of homes.

In cases of impact, he once again confronts us –whether we are parents or not– with uncomfortable questions, perhaps necessary ones.

There are fictions that also

from which, in these times, it seems impossible to escape, in a world that often corners adolescents and young people.

Depression, anxiety and behavioral disorders, among the main causes of illness in adolescents.

Photo: Fernando de la Orden/Clarín Archive.

To the demands and lack of opportunities, many also add

, relationship or domestic tragedies, a combo that is sometimes lethal.

Euphoria

, to give an example, is a multi-award-winning television series that follows a group of high school students in their

, love, and friendship, while at the same time relating them to drugs, trauma, and sexuality.

Fiction hits the mark by fully dealing with the problems of age in its crudest state and portrays, without half measures, the

experienced by the characters, on their way to adulthood.

In some cases, this virulence becomes pathological and the characters

.

However, reality is almost always stranger than fiction.

We already know that there are numerous cases that are often reported on television, newspapers and social networks and it is known that many children and adolescents, for a host of reasons, never make it to the psychiatric consultation that could save

.

Serious and global problem

The World Health Organization (WHO) recognizes the seriousness of the problem.

According to recent figures – released in 2021 – young people are at risk.

It is recommended that children 12 years and older be screened annually for possible symptoms of depression and risk of suicide.

“Adolescence is a unique and formative stage, but the physical, emotional, and social changes that occur during this period, including exposure

, abuse, or violence, can make adolescents vulnerable to

”, warn specialists from this international organization.

They add that “depression, anxiety, and

are among the leading causes of illness and disability among adolescents.”

The pictures begin to be pathological if due to their duration and intensity they compromise or prevent daily functioning.

And they mention that "suicide is currently the fourth leading cause of death among young people between the ages of 15 and 29."

Not dealing with certain early disorders in adolescence can also lead to problems in adulthood: "These factors harm a person's physical and mental health and also restrict their chances of leading a full life in the future," they

from The OMS.

Depression: the Covid, predictably, worsened the panorama.. Photo illustration: Shutterstock.

The documents of this body indicated, already in the years prior to the pandemic,

and disability in adolescents.

A 2017 statistic indicated that one in five adolescents had suffered from a severe depressive disorder and that the number of cases had increased by 59 percent between 2007 and 2017.

For that reason—the apparent fact that one in five will experience depression at some point—the

(United States) recommends that all children ages 12 and older be screened for possible symptoms of depression and risk of depression. suicide at routine annual medical examinations.

Predictably, the pandemic made the outlook even worse:

around the world for obvious reasons.

An investigation carried out by a team of Israeli scientists on more than 200,000 adolescents between the ages of 12 and 17 showed an increase of 68 percent in depression, 67 percent in eating disorders and 42 percent in anxiety in diagnoses related to the Covid-19 period. 19, rates significantly higher than those observed in young people in the pre-pandemic.

At this point it is possible to deduce that if the 20th century was called "the century of anguish",

: it affects more and more young people and adults in the world and it is then a question of a global phenomenon.

Vital and relevant crisis

Is adolescence a stage of existential crisis?

Yes, and not only that:

because it represents, above all, the end of an inevitable stage.

The child must "say goodbye" to his childhood and transition his evolution towards an adulthood that still appears to him as an unknown.

This configures, on the one hand, a grieving process and, on the other, the need to face changes that force the adolescent to

, modify their behaviors and tolerate greater emotional instability, which involves sudden mood declines and oscillations in the humor.

In any case, and although it is expected in this phase of life, each case will have

depending on the way in which each young person assimilates these transformations, and also depending on how he "sees" himself, how he perceives his "new version".

It is essential –contrary to what many adults tend to think– to know that

, but that complex and unique problems of that maturational moment tend to arise.

In today's Western society,

, while the entry into adulthood –in terms of autonomy– tends to be located progressively later.

In our country, it is estimated that almost half of young people up to 30 years of age continue to live at home with their parents and -beyond the fact that this usually

, many of them seem not to have fully assumed the responsibilities that this entails. adult life.

It is a period phenomenon.

For this reason, it is common to hear that they are going through an "eternal adolescence."

The “first times” in life

As they grow, puberty and adolescents begin to experience new experiences: body changes, the production of hormones, the beginning of their first sexual relations, unprecedented love frustrations, their debut in hitherto unknown areas and, in many

, the first consumption of tobacco and alcohol.

“There are not only bodily, maturational changes, but also neurobiological ones.

From the subjective and psychic there is a search for who I am but also a self-affirmation and a belonging,

”, they explain from the Department of Pediatrics of the Hospital de Clínicas of the University of Buenos Aires.

Depression: bullying and excessive use of social networks, two of its risk factors.

Photo illustration: Shutterstock.

The question that arises, at this point, is why or how this impact can lead to some form of depression or

, if this occurs.

And also

, which may alert us to the need for specific accompaniment and help.

Why is adolescent depression increasing?

Are there new factors that in addition to genetics, brain chemistry, personality, and

are now considered variables that deepen distress?

Yes, and among those at the top of the ranking are high pressures and social expectations to achieve economic success;

the fact of

or that is frightening and threatening (violence, robberies, murders, shootings in schools, among others);

and the influence of social networks, which can

and the way the adolescent sees the world.

The emotional changes that accompany growth are partly "normal" and inevitable:

that allow the construction of identity are articulated with these moments of instability, an expression of the critical readjustments necessary to achieve a new mental balance.

The point is that sometimes the balance is not reached.

The pictures begin to be pathological to the extent that, due to their

, they compromise or prevent daily functioning or imply risk situations.

The symptoms

Depression is a heterogeneous illness, with

.

Thus, on an emotional level, it usually manifests with irritability, sometimes shocking mood swings, lack of interest, anhedonia (not feeling pleasure),

, inappropriate guilt, or even suicidal ideation.

While, on a physical level, it is usually expressed with the appearance of varied and diffuse body pains, without a justifiable cause, headaches, digestive disorders, psychomotor restlessness, sleep disturbances (hypersomnia insomnia), changes in diet with an increase or decrease

(can lead to obesity or anorexia), easy tiredness, decreased libido.

And at the cognitive level, it manifests itself with poor concentration, difficulty memorizing, impaired thinking ability or indecisiveness.

All these symptoms can sometimes appear and evolve in a "deceptive" and gradual way (for example, through a

or a change in eating behavior), but very frequently they manifest themselves critically and unexpectedly, with intense oscillations. and abrupt.

In these cases, these are changes in behavior that should never be underestimated, either because of the potential suffering and malfunctioning that they usually hide, or because of the risk that they lead to self-destructive behaviors or risky behaviors (consumption of harmful substances or

for danger).

What to do in those cases?

Be vigilant, and also know that

: irritability, anger and agitation are usually the most prominent symptoms at this age.

Most frequent causes

Depression has a multifactorial causality.

The genetic or family components that result in a

in young people triple if their parents or relatives have suffered from this disorder.

However, not every young person with a family history is "doomed" to suffer from it.

And, in turn, others may become depressed even if they don't have such a family history.

Environmental factors –such as family crises, poverty,

, lack of social support or poor communication with the environment– can precipitate the onset of depression.

Biographical experiences are always relevant, especially the loss of a parent,

, sexual abuse or mistreatment at an early age.

Nor should the influence of hormones be underestimated since, even in small amounts, they produce

in the same way as the action with brain neurotransmitters (serotonin, dopamine, among others), which are studied in depressed people.

However, the usual is the combination of biological, environmental and psychological factors.

warning signs

Specialists agree that sudden changes in behavior, sadness and

, being "always in a bad mood", easy anger or frequent crying are behaviors that reveal this problem.

Depressive illness is distinguished from sadness because the latter

and is not as intense or persistent over time.

In one case it is an emotional situation, in the other a pathology that can lead to a serious problem.

When something "is wrong" from the mental point of view,

: behaviors that involve the destruction of objects, attacks on other people or oneself, the fact of "putting oneself at risk" (getting involved in fights or driving at high speed , For example).

The presence of alterations in biological patterns, such as

(by increase or decrease) also warn of a possible potential severity.

And neither should verbalizations of negative thoughts or thoughts related to death go unnoticed.

The fact that these are expressed in a repetitive manner should always be considered as

.

By causing a decrease in physical and mental energy, together with concentration and memory difficulties, depression usually also brings with it lower school performance, so that school becomes a privileged setting to observe if there is poor

at class or a drop in grades in a formerly “good and responsible” student.

In the same way, it is common for boys to show

, abandon participation in social or sporting events or withdraw from family and friends, and state that nothing is "so fun" anymore.

Anthony Jurich, a professor of family studies and human services at the University of Kansas, notes that "adolescents believe they are invincible, so when they experience

, they are more likely to be overwhelmed with hopelessness and the belief of their worthlessness."

And he calls these feelings of hopelessness and helplessness "the Molotov cocktail that can trigger teen suicide."

When social networks can increase discomfort Social networks can, in turn, make the landscape with which young people interact more complex.

On the one hand, they can offer them

, as they interact with their peers.

Although they can also expose them to

, to the spread of rumors, negative opinions about their life or their physical appearance, and to the indirect –and sometimes cruel– pressures exerted by groups.

Various investigations established that there is a connection between adolescent depression and

,

One of the reasons that often leads to excessive use of the networks is the

adolescent's

Among the consequences that spending a lot of time online can lead to, the

is usually identified , both in terms of physical appearance and life experiences.

Both situations can damage self-esteem, and more to those who already have it diminished.

In addition, spending a lot of time "connected" generates

that has a negative effect on mental health and, even more so, if this routine interferes with physiological nighttime sleep,

.

It was also shown that adolescents who spend a lot of time online have

(between 13% and 66%) than those who use less time (these studies show a correlation, not a causation).

Social networks have generally been demonized for their addictive potential, generating

such as self-harm, inducing techniques to favor anorexia nervosa or explicit methods for suicide.

But it is worth mentioning that they also show enormous potential to combat and compensate for these effects and an example of this are

who have stimulated consultations with psychologists and psychiatrists in an open and extremely useful way.

It is always possible to ask for help

While for the WHO suicide is defined as "the deliberate act of taking one's own life", the suicide attempt is considered "as any

to generate potentially lethal damage, but without actually causing death".

According to global statistics, while a suicide is completed, there are between 20 to 40 attempts that fail.

The most frequent risk factors to take into account are: self-demand and parental demand, failures in the face of expected achievements, socioeconomic and cultural factors, the total lack

, conflicts and aggressions in intrafamily life, as well as abuse. sexual harassment, bullying or

, the recent loss of a loved one, and conflicts with one's own sexual identity within a family or social context that does not provide support.

Suicide threats

and a call for help that should always be taken very seriously.

Especially considering that cases of suicide in adolescence have tripled in the last 30 years and are already the second cause of death, as mentioned, between 12 and 19 years of age.

Lastly, in the face of a multi-causal disease such as depression, it is important that the treatment is approached in

, that is, including jointly the biological, psychological and social factors. 

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