Introduction

Depression as defined by the Mental Health Foundation (n.d.) is a common mental health problem that causes low moods, feelings of low self-esteem and guilt, loss of pleasure/interest, loss of appetite and poor concentration among other issues. When long lasting with severe or moderate intensity, depression can become a serious health condition. It can lead to an affected person losing interest in school or work and at its worst can lead to depression. Suicide is the second leading cause of death among people aged 15 to 29 years globally. Depression is thus a serious mental health issues which when not addressed can be disastrous. For teenagers, depression can lead to other developmental problems thus affecting their overall state of life. It is thus paramount that depression is addressed soonest possible to ensure that the long-term effects of this condition do not manifest and affect teenagers in their adulthood. This paper will look at teen depression by evaluating its causes, prevalence, impact on development, concerns for future wellbeing if not addressed and comprehensive discussion of contemporary approaches for support.

Depression in teenagers is caused by several factors. In the modern world, there are many risk factors for teenage depression. A major risk factor for teen depression is bullying. Bullying can take several forms from verbal to relational and physical. A Victorian Adolescent and Wellbeing survey in 2015 showed that 31% of adolescents faced verbal bullying, 14% social exclusion, 11% physical and 18% had rumours spread about them (Ford et al., 2017). Research has shown that teenagers face bullying and the condition is worse with the rise of social media where bullying can occur without anyone noticing. With more than 80% of teenagers having access to social media in the developed countries, cyberbullying has become a major concern and there have been countless cases of suicides (Grand Canyon University, 2018).

Another external stressor that can cause teen depression is a family crisis such as divorce or death. Experiencing life changing events such as divorce or death of loved one can have long term and short-term effects. Research has shown that children from divorced families have more psychological issues than their counterparts in intact families. The anxiety and lack of life satisfaction that follows events such as divorce can lead to teen depression (Pálmarsdóttir, 2015). Domestic violence is also a major contributor to teen depression. Teens commonly experience domestic violence as a traumatic event and experts have concluded that for teens, witnessing violence at home has the same effects as experiencing it (Avanci et al., 2012). The fact that domestic violence commonly is a recurring event lead to teens experiencing a recurring traumatic event. The high level of anxiety and stress associated with such occurrences develop to depression for teenagers.

Another cause of teen depression is emotional, physical or emotional abuse. Children experience any form of abuse as traumatic and since different forms of abuse co-occur in children can easily lead to depression. Childhood emotional abuse is more strongly associated with depression not only for teenagers but also in adulthood (Christ et al., 2019). Childhood physical and sexual abuse which remain major problems globally also contribute to depression in teens. When children are abused by their caregivers, they experience isolation in that they lack the necessary support system and thus develop depression. There are other stressors such as school, poverty as well as other living conditions.

In the U.K, 25% of the teenage girls are hit by depressions at age 14. A cohort study which followed 19,000 children born in 2000 and 2001 found that at age 14, parents reported 18% of the girls and 12% of the boys as having emotional problems. However, when questioned bout their mental health, only 9% of the boys and 24% of the girls reported symptoms of depression (Patalay & Fitzsimons, 2017). The Wold Health Organisation (2019) estimate that teen depression affects one in six teens aged 10 to 19 years. Globally, depression remains a major cause of disability and illness among the young people. Suicide which is common associated with depression is the third leading cause of death in the age group 15 to 19 years.

Depression is more prevalent in women that men. Women are twice likely to develop depression than men in their lifetime. Teenage women are specifically susceptible to the effects of hormones released during puberty. When the effects of these hormones interact with gendered interpersonal factors, there is generation of stress which greatly leads to more teenage women acquiring depression as compared to teenage boys (Kuehner, 2017). In addition, women are more exposed to issues such as gender violence, inequality and sexual abuse which exposes them to depression. Women are also mor exposed to everyday stressors when compared to women and apply different coping strategies. This has been attributed to social disparities such as income inequalities forcing women to work more than women for the same pay while still taking care of the family (Wong, 2018).

At age 15, depression can have different effects on one’s development. Physiologically, it can lead to weight loss or gain. Depression results to appetite changes which in turn lead to unintended weight loss or gain. Excessive weight loss is associated with other conditions such as heart disease, diabetes and obesity. Depressed teenagers can also experience insomnia leading to lack of sleep. Lack of enough sleep is associated with feelings of exhaustion and anxiety and this can increase depression or other mental issues. Depression also increases the level of stress hormones in the body increasing the risk of other diseases. It also weakens the immune system making the body weak.

Depression also impairs memory and attention thus affecting the ability to concentrate. A 15 years old is still developing cognitively acquiring increased mind processing in preparation for adulthood. However, depression affects information processing as well as decision making and thus impairs judgement. Depression lowers the ability to adapt goals to strategies and for 15 years old who is developing to adulthood, the ability to adapt as situations change is very significant. Depressed teenagers show functional impairment in various social and cognitive domains. In school, performance is affected by depression. Prolonged difficulties with concentration can affect the academic and intellectual performance. Attention problems commonly associated with depression affect the processing of mastering new complex problem soling skills. Furthermore, reduced motivation as a result of mood swings can result in one having difficulties engaging in tasks that require processing. Thus, teen depression can affect the cognitive development of teenagers especially when it is severe.

Sociologically, depression contributes to isolation. Human beings are a product of their society and social interactions not only affect behaviour but also development of brain structure. Depressed teenagers commonly isolate themselves and avoid engagement that involve friends and family. This leads to depressed teens lacking social interactions that reinforce the necessary age appropriate social skills necessary for continued management of interpersonal situations. Much of behaviour and problem-solving skills are learned from the social interactions people have. Teens learn how to interact appropriately while adapting to changing social situations. This is learnt by interacting with the social elements. At age 15, a teen is rapidly acquiring new information and improved problem-solving skills. Depression however disrupts the interaction with the environment that facilitate learning.

Teens at 15 years have a strong desire to be independent. They are struggling with the dependency on parents as well as the physical and emotional changes around them. Ait is at this age that teenagers asserts their individuality by learning how to deal with emotions. Depression however affect the emotional development of teens in that it interferes with self-esteem and confidence. Depressed teens isolate themselves and avid talking to others. They are thus not able to ger the necessary emotional support from friends and family in understanding their feelings. During adolescent, the physical and psychological changes coupled with depression leads to lack of resiliency. Such teens are unable to acquire the emotional awareness to cope with difficult emotional situations. With low self-esteem, the feelings of unworthiness may develop and the lack of emotional intelligence result in suicide. The fact that teen depression is a leading cause of suicide expounds on the lack of emotional intelligence that comes with depression.

Concerns for the Client’s Future Well-Being if Depression is Not Addressed

Untreated depression at teenage years can have behavioural, emotional and health problems in the future. On a national scale, depression leads to human suffering, lost productivity, increased cost of healthcare and employment issues. For individuals, untreated depression can lead to deteriorated wellbeing as a result of behavioural changes. There are several issues that can emanate from untreated depression that can affect the well-being of individuals. From low social economic status to social problems and suicide, untreated depression is a menace to individuals in the long term.

One of the common results of untreated depression is alcohol and drug use. When untreated depression interferes with the life of an individual and lifestyle. Depression for example can affect workplace and social relationships. When untreated, individuals seek solutions to their problem and alcohol and drug use is a common easy solution to depression. Drug abuse temporality reduces the emotional paid associated with depression in the short term and individuals have to keep taking drugs and alcohol as they try to forget their problems. The end result is that such individuals are addicted to drugs and alcohol. Once the body becomes dependent on the drugs and alcohol, the symptoms of depression will exacerbate and cause other health problems such as reduced brain functionality (Mackie, Conrod & Brady, 2012). Furthermore, as the body get used to specify drugs, individuals seek out more stronger drugs to have the effect they desire. The continued use of drugs combined with the increasing depression becomes a health menace. Drug abuse leads to reduced immune system which increases the risk of other infections and illnesses. The strain on the liver also puts one at risk of liver damage. drug use and alcohol abuse also lead to reduced functionality and limits employability thus affecting the financial productivity of individuals.

Another possible effect of untreated teenage depression is excessive weight gain or loss. Research has shown that depression affect appetite and thus while some people result to eating much others result to not eating. In that depression is associated with social isolation and lack of physical activities such as exercising, people who result to heavy eating accumulate a lot of weight. The increased weight can result in obesity. Obesity remains a major health issue in the world today. Research has shown that both obesity and depression are cause and effect and there is no concession on which comes first. When untreated however, depression can cause obesity and the obesity exacerbate the depression (Sutin & Zonderman, 2012).  For teenagers, excessive weight loss or gain can increase the social pressure and when combined with hormonal changes and other life pressures such as education can result to severe symptoms of depression. At the worst case, severely depressed teenagers can result to suicide or other personal harms. Severe depression is also associated with other mental problems such as psychosis associated with a break from reality. It can also lead to sleep problems, intellectual impairment, hallucinations and delusions. For individuals who experience weight loss, they can get malnourished or even severely underweight leading to other health problems.

Social isolation is another result of untreated depression for teenagers. Depression is a major cause of social isolation and when treated individuals can increase their social connections. When untreated however, the long-term social isolation can have devastating life changing effects. As individuals grow, they acquire the necessary skills to establish independence from interacting with family, friends and the society at large. The adolescence stage sees increased exploration, risk taking and increased sensation. Individuals at this age commonly spend much time with their peers as opposed to family. Through this process, individuals develop the necessary strategies for adulthood (Walker et al., 2019). Prolonged social isolation is associated with heightened loneliness. Loneliness has been associated with health risks such as over smoking, drug abuse and alcohol use disorder. Furthermore, loneliness leads to a dissatisfaction with social life, family and community life. Social isolation contributes to individuals sliding into unhealthy behaviours. With no support due to the isolation, isolated individuals can result to all manner of behaviour changes. As argued by Matthews et al. (2016), lonely individuals are disposed to being less trusting, pessimistic and more anxious.

At the extreme, untreated depression affect the wellbeing of individuals to the extent of committing suicide. Untreated depression causes the depression disorder. Clinical depression which is a major depression affects one thought. People with severe depression can rarely organise their thoughts to put themselves together rather have unorganised thoughts. Suicide remains the third cause of death among adolescents. For pregnant mothers, untreated depression contributes to suicide more so during pregnancy or postnatal. The lack of social and problem-solving skills associated with social isolation leads to feelings of self-unworthiness. With no effective coping mechanisms to the depression, individuals can result to all forms of solutions such as drug abuse. However, when ineffective, individuals can result to a more permanent solution commonly suicide. People who commit suicide as a result of depression are not fixated on dying rather are just trying to escape the pain.

Untreated teen depression can also cause problems at school and at home. At adolescent, most teens are looking to get independent and hate being told what to do. This coupled with depression can result in relationship issues between teens and their families. Depression also leads to lack of concentration. This results to poor grades in school. With lack of treatment, the continued poor school performance lead to other problems such as academic disqualifications. Posting poor grade can also increase the problems at home with parents trying to seek answer as to the problem. In that teens are bad at sharing with parents coupled with isolation caused by depression, the situation can get worse resulting to serious results such as suicide. Posting poor results in school can also lead to low self-esteem thus exacerbating mental health.

Another major problem associated with untreated teen depression is poverty. At age 15, teens are developing their education backgrounds as they prepare to join higher education and careers. However, the onset of depression causes lack of concentration and the end result is poor results in education. When untreated, the poor concentration continues and the quality of life reduces. In most of the countries today, education is a major determinant of financial success.  Lack of education is associated with lack of employment. Coupled with other effects of depression such as drug abuse, continued depression can result to lack of housing and other social services leading to homelessness. Depression remains a major metal issue in the homeless population. The quality of life deteriorates resulting to other health problems.

Another major result of untreated depression is self-destructive behaviour or risky behaviour. Depressed individuals are on the lookout for temporally relief from the emotional pain and thus can adopt risky behaviours such as excess drinking, unsafe sex and inflicting self-injuries. Depression when untreated common unearth other problems that people are trying to hide or escape. untreated depression causes maniac depression which in turn cues a rush of emotions that limit effective decision making. As long as depression remains untreated, the affected decision-making leads to individuals adopting destructive behaviours as a way of coping. The destructive behaviour’s also lead to other life problems such as lack of employment which in turn affects the quality of living.

Most of the problems associated with untreated depression affect the wellbeing of individuals later in life. The fact is that with no planned intervention at such a young age, teens with depression result to unconventional ways to cope with the situation.  Such coping strategies such as drug abuse is a long-term issue and the fact that depression is untreated increase the chances of drug abuse addiction remaining untreated. Depressed teens fail to develop the necessary skills to cope with physical, emotional and psychological pain. Thus, when faced by depression for a prolonged period, the lack of coping mechanisms leads to short solutions such as alcohol abuse, drug addiction or suicide. Most of these issues go hand in hand in that social isolation can cause alcohol abuse and then graduate to drug abuse, lead to problems at school and at home and gradually result to suicide. The longer depression remains untreated, the more severe it becomes as one ages and the more destructive it becomes.

Contemporary Approach

To address teen depression, a contemporary approach is required to ensure that the wellbeing of clients is improved. In that failure to address teen depression can have devastating effects in future expounds on the need for effective diagnosis and treatment. Depression can be treated through antidepressants medication or through interpersonal therapy that seeks to addresses the cause of depression. In the case of teen depression, effective diagnosis and medication will help address depression. However, without addressing issues leading to the depression, it will be hard to avoid relapses. Thus, interpersonal therapy will address the causes of depression while Problem solving therapy ensures the client is able to solve problems in future.

Diagnosis and Medication

As a counsellor, I am not equipped to conduct diagnosis and prescribe medication. The first step will thus be to visit a doctor for a diagnosis.  There are several exams and tests that a doctor can use to test for depression. One of the tests is a physical exam. This involves the doctor physically examining the client and asking in-depth questions about the health of the teenager to try and identify the cause of the depression. It is common for depression to be associated with physical health problems such as prolonged pain on a specific body part. If the physical examination does not reveal anything, the doctor can go ahead and order a lab test. Lab tests can be used to check for specific hormones associated with depression or for anaemia, thyroid and at times vitamin D levels and calcium (Mayo Clinic, n.d.). Furthermore, the doctor or a mental health professional can conduct a psychological evaluation to identify behaviours, thoughts and feelings. A psychological evaluation will check for complication and pinpoint diagnosis.

Once the doctor diagnosis depression, it is also important to identify the type of depression. The symptoms od major depression vary from one person to the other and the doctor has to use specifiers to identify the type of depression facing the client. One of the specifiers is anxious distress which specifies depression with uncommon restlessness. Another specifier is Melancholic features which identifies a severe depression with lack of response to things that bring pleasure and is commonly associated with worsened mood and morning awakening. Another identifier is the atypical features and elaborates on depression where one is cheered by happy events in the short term, appetite increase, excess sleep and rejection sensitivity. There are other disorders that cause depression symptoms such as Bipolar disorder and disruptive mood dysregulation disorder.

After effective diagnosis, the right mixture of medication should be employed. Two common drugs have been approved by the American Food and Drug Administration including fluoxetine (Prozac) and escitalopram (Lexapro). The doctor should advise on the right medication based on the diagnosis. However, every individual is different and finding the right medication can take trial and error. Furthermore, it is important to monitor the use of medication by teens. The fact that such medication is being used to treat depression indicates that there is risk for overdose. In case of any side effects, it is important to talk to the doctor before stopping taking the drugs.

Interpersonal Therapy (IPT)

While antidepressants are effective in treating depressive episodes, they do not address the cause of depression. It is significant to thus combine medication with interpersonal therapy. IPT is short-term treatment for depression. While originally developed to treat adult depression, IPT is also effective for teenagers. IPT is based on the principle that depression occurs in an interpersonal context and affect both relationships and the roles of individuals in such relationships. By addressing any underlying interpersonal issues, IPT focuses on the connection between symptoms of depression and the family and peers’ relationships with the client (Goldberg, 2017). The short-term goal of IPT is to reduce the symptoms and improve social adjustment. The long-term aim is however to enable the client to make adjustments on their own to be able to cope with depressive symptoms.

IPT is a based-on manual which mean the therapist follows a predetermined process. The International Society for Interpersonal Therapy argues that depression has three components including symptom forming, social functioning and personality issues. typically, the sessions consist of hourly sessions where the therapist focus on problems that can be identified (Goldberg, 2017). IPT however does not address the symptoms of depression rather collaborate with the client to identify and address any problems or issues. the number of problems addressed is however limited to one or two deliberately to ensure that the client focuses on how to make adjustments in interpersonal situations. The types of problems addressed include interpersonal conflicts, role transitions, and interpersonal deficits.

Problem solving therapy

Problem solving therapy is an intervention that focus on improving the ability of the client to cope with stress in life. It is based on the assumption that psychopathology is a negative consequence of ineffective coping mechanism. The therapy thus aims to help individuals adopt an optimistic and realistic view of coping and understand the role emotions play more effectively (Van’t Hof et al., 2011). It then develops an action plan towards the reduction of the psychological distress and improve wellbeing. Once the client goes through the problem-solving orientation, he/she will be able to apply it in all areas of life. The fact is that while treating depression is significant, avoiding its reoccurrence is also important. This can only be achieved by ensuring the client is empowered to deal with problems in future. For teens, they are still learning on the aspects of problem solving and coping on their own and thus the problem- solving therapy will be effective in instilling the effective problem-solving skills

Conclusion

Teen depression is a common problem facing 15 years old in the modern world. Major causes of teen depression include bullying, family issues such as divorce, physical abuse and sexual abuse. Depression in general is more prevalence in women than men attributing to women facing more life stressors than men. Teen depression affects the cognitive, social, emotional and physiological development. If left untreated, teen depression can result in devastating results affecting the wellbeing of the affected individual in the future. From drug abuse to poverty, suicide, self-harm and social isolation, depression can be disastrous not only to the individuals but to the society. The recommended approach to treating teen depression for a 15 years old teen is medication combined with Interpersonal Therapy (IPT) and Problem-solving therapy. The combination will ensure the client not only reduces the symptoms but also acquires the skills to resolve problems in the future. This contemporary approach seeks to treat and prevent further occurrence of depression to improve the wellbeing of the client.

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