Title: Depression in Adolescents
Date and time: 20th September 2020, 2:00pm
Speaker: Consultant psychologist, Ms. Lee Li Li

Although feeling low for consecutive two weeks or more is one of the symptoms of depression, however, if the feelings are caused by stressful life events such as being bullied, broken up with partner, or gotten bad grades and etc., then it is normal for people to experience such feelings for a long period of time, whereas people with depressive symptoms have overwhelmingly depressive feelings and excessive rumination on negative thoughts. People who are feeling low are able to brighten up their mood by occupying themselves with work and events.

On the contrary, people with depressive symptoms take an avoidance approach in life, such as engaging in malingering in order to avoid academic stress. Although both of them exhibit guilt and self-blaming, however, the former will eventually regain their confidence in life but the later will fall into the cycle of negative emotions, subsequently affecting their social relationships. For example, people with depressive symptoms will isolate themselves from friends and family by locking themselves inside their room for a long period of time. If teen exhibits these behaviors mentioned above, parents should pay more attention to him/her and observe whether he/she is merely feeling low or having depressive symptoms.

Emotions / Feelings	Frustration, sadness, hopelessness, emptiness
Psychological motivation	Loss of interest in things once pleasurable
Physical	*Changes in appetite or body weight; *Changes in sleep schedule; *Changes in physical strengths
Cognition	*Low self-esteem; *Overwhelming negative thoughts; *Self-harm; *Persistent thoughts of death
Behaviour	*Trouble concentrating; *Irritability or slacking

Source: Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5)

Depressive symptoms include changes in appetite / body weight, insomnia / excessive sleepiness, chronic fatigue (lying on bed all day long, can't even bring themselves to get shower or having a meal) etc. In terms of cognition, teens often experience low self-esteem (having negative self-talk, such as "I'm useless"), negative thinking, self-harm, and having death thoughts. In some cases, teens would hide their pain behind a smile and cover their self-harm scars by wearing long sleeves shirts. They intentionally hurt themselves to distract themselves from the emotional pain that they could not express, and even developed suicidal intentions. In terms of behaviours, they have trouble concentrating, mood changes or impulsive behaviours (such as irritability, having conflict with others, noncompliance and other deviant behaviours). According to the diagnostic criteria of Major Depressive Disorder, or in general, we called it as depression here, a person may have depression if they have at least one symptom mentioned in the "Emotions/Feelings" and "Psychological motivation" rows above, in addition to at least four of the symptoms with the asterisks "*" sign. If so, the teen needs psychological intervention by professionals if he or she experienced the symptoms above.

In many cases, teens tend to express their sadness by avoidance or deviant behaviours and it often be mistaken as discipline problems or seen as rebellious. Besides, some children may have subtle learning difficulties at his/her young age and the problems gradually accumulate throughout the teenage stage, subsequently becoming triggers of depression.

Depression can be caused by single or a series of factors, including genetic inheritance, early life experiences, major life events (such as long-term stress, physical illness, sense of loss), life education and environments (friends and social media) etc. Besides, teens who have depression usually have one thing in common before they have been diagnosed, which they have no one to talk to and their friends usually encounter similar situations too. As time changes, teens' emotional needs have also increased. Teens would experience emptiness if their emotional needs have been deprived.

In the case which the teen has been diagnosed with depression, parents need to have a clear understanding regarding depression in order to help their teen in a better way. Family of the teen should also avoid using some phrases such as "you are the only one who can help yourself", "don't overthink", "you should figure out the solution to get out of it" etc. These phrases may trigger them and cause them to retreat from the current challenges. Other than that, parents are suggested to not compare their own teen to others, or criticize them in front of others. Instead, parents should give encouragement and compliment with care to the teen, express feelings and reasonable expectations in order to reduce their stress.

If teen has started their medication treatment for depression, be sure not to stop their medication without the psychiatrist's advice even if they seem to have improvement on their conditions. Medication treatment needs a certain period of time to ensure effectiveness, there is risk of relapse if the cycle is disrupted. Some parents may worry about the side effects of medication, but doctors will usually start with the minimal dose of medication, which the main purpose is to increase the patient's sleeping quality. The effectiveness of psychotherapy would be maximized if the sleeping quality of patients has improved. If the teen does not have sleeping or eating problems, capable of self-control, and willing to cooperate, parents can let the teen to start their journey of recovery by psychotherapy.

Kindly click the following icons to watch the full sharing.


Note: The above content is adopted from ZOOM live sharing session held by DreamicEdu, titled "Depression in Adolescents" on 20th September 2020. Kindly contact our office if you would like to learn more or seek consultation. Thank you.