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Depression in America's Teens
Teenage Depression. Everywhere you look these two words appear together as one, in newspapers and magazines, as well as in scholarly reports. Teenage depression is one of today's "hot topics" this among other teenage mental health problems, has been brought to the forefront of public consciousness in recent years after several incidents involving school shootings (CQ 595). The environment that teens grow up in today is less supportive and more demanding than it was twenty years ago. Not only are the numbers of depressed teens rising, but children are also being diagnosed at younger and younger ages. Studies have found that, "There is an estimated 1.5-3 million American children and adolescents who suffer from depression, a condition unrecognized in children until about 20 years ago" (CQR 595). This increase in depression is due to social factors that teenagers have to deal with everyday. A recent study found that, "About five percent of teenagers have major depression at any one time. Depression can be very impairing, not only for the affected teen, but also for his or her family-and too often, if not addressed, depression can lead to substance abuse or more tragic events" (NAMI.org). Gender roles and other societal factors including the pressures on girls to look and act a certain way, the pressures on boys to suppress their emotions and put on a tough front and the pressures on both sexes to do well in school and succeed, all contribute to depression in teens today. Depression is a growing problem which crosses gender lines and one that needs to be dealt with with more than just medication.
Clinical depression goes beyond sadness or having a bad day. It is a form of mental illness that affects the way one feels, thinks, and acts. Depression in children can lead to failure in school, alcohol or other drug abuse and even suicide. The warning signs of depression fall into four different categories: emotional signs, cognitive signs (those involving thinking), physical complaints, and behavioral changes. Depending upon the degree of depression, a child may experience a few symptoms or many. Also, the severity of each symptom may vary. According to the CQ Researcher, "School
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Clearly neither the boys nor the girls are having their needs met and many argue that it is America's youth as a whole that is being neglected. Some mental health professionals say depression is increasing among children because modern life is more toxic and stressful than in decades before. In A Tribe Apart, author Patricia Hersch refers to a 1989 Girl Scouts survey of 5,000 kids, "It was found that by a huge margin the youth problems of the headlines-peer pressure, drugs, alcohol, sex, gangs-were not the "crisis issues" for kids. Their major concerns were "the social expectations of the adult world which all have to do with pressure: the pressure to obey parents and teachers (80%), to get good grades in school (78%), to prepare for the future (69%), and to earn money (62%)" (Hersch101). The survey overwhelmingly shows the biggest pressure for teens comes from the need to succeed in both academics and in life.
Judy Mann, author of the book The Difference: Growing up Female in America writes about how society teaches boys to repress their emotions while encouraging and allowing girls to express themselves. Mann writes, "While we encourage sensitivity and emotion in girls, we limit and confine it when it shows up in boys...While I felt free to encourage my infant daughter and indeed probably gave her a vocabulary to express her feelings with, we do not as a culture encourage similar behavior in little boys. When we discourage the little boy from weeping too much when he falls off a bike, or from weeping with separation anxiety when we take him for the first day of preschool, we are silencing his emotions, and depriving him of any way to express what he is feeling. He has no chance to practice the language of emotions. And there are serious consequences, 'We see men use violence when they can't communicate' (Mann 25).
Social factors begin affecting children as soon as they enter kindergarten. In the June 18th issue of CQ Researcher Psychologist Michael Thompson role-plays to show how differently boys and girls at a young age are reprimanded in schools. Thompson kneels besides two females who he says have misbehaved in class.
In a wheedling, almost pleading tone of voice, he asks one of them, "Why did you do that to her? How do you think that made her feel?" the two girls were actually the mother of boys. Thompson then goes over to a father and towering above him, "Cut it out young man!" he says, his voice changing to a brusque command. "I don't want to see that in my classroom."
This simple situation shows how we instill gender differences at such a young age. Society tends to treat boys more rigidly, while showing its more compassionate side to girls.
Differences between expectations of boys and girls continue to come about and grow as children advance from elementary school, to middle school and then high school. One noticeable situation is calling out in class. If a boy calls out he is usually recognized and allowed to speak, but if a girl calls out she is usually ignored and told to raise her hand if she wants to speak. Boys are generally taught to speak up and voice their opinion while girls are taught to politely wait their turn. Therefore, until recently, many argued it was girls who were being short changed in schools; however, after the recent school shootings the focus seems to have switched to boys. Experts believe that with all the focus on the girls, the boys began to be neglected. The opening paragraph on the front page of the June 18, 1999 issue of CQ Researcher reads, "The carnage committed in April by two boys in Littleton, Co., has forced the nation to reexamine the nature of boyhood in America. Some psychologists contend that societal pressures on boys force them to suppress their most vulnerable emotions in service to a rigid idea of manhood. They say the result is a nation of boys depressed, failing in school and occasionally exploding with murderous rage. The new concern about boys follows a decade in which adolescent girls were thought to be suffering in loss of self esteem and academic achievement, in part because teachers gave them less attention than boys. But now it is the boys who are falling behind and more likely to be in remedial classes, to be suspended and drop out of school." This statement agrees with the one made earlier by Mann, suggesting that boys are being emotionally deprived.
One of the biggest issues for teens is fitting in. They want to be accepted and there is a fear of being alone and not being wanted. Popularity is a huge social factor for any teen, especially in High School. Everyone wants to be part of the "in crowd" and if you cannot be a part of them, you want to dress like them or act like them. Pressures like this do tend to be worse for girls. Girls feel the need to please others and seek approval while boys learn that it is ok to be themselves and do their own thing. Boys tend to be able to deal better with these social issues then girls do. They are able to put events behind them, and not depend upon others for reassuring them of their self worth. Mann concluded that, "Girls still measure self-esteem by popularity and their ability to please boys, not by their grades and their prospects for living self sufficiently (Mann 14)." Girls tend to be more open and talk about their feelings and emotions. When dealing with friendships or matters of the heart, girls are more socially responsive than boys are and seem to dwell more on relationships. It has been found that, "Teenage girls report being depressed not only more frequently than boys, but for longer periods of time. Given the fact that adult women are three times more likely to be depressed than men, it appears the pattern begins in adolescence. Why this is remains open to debate, but one theory is that the different coping mechanisms girls and boys have may contribute to girl's greater rates of depression. Adolescent boy and girls are equally interested in each other, but boys seem to be able to cope with love's losses better than girls do. They put it behind them and move on, while girls focus on the breakup and keep talking about it, stirring the emotional pot" (Mann 263).
In addition to relationships with their peers, many teens seem to have a lack of strong stable relationships with adults. When children are younger, they tend to come home from school to either a parent or babysitter waiting for them. They come home from school, share the details of their day over a snack, possibly do homework and then off they go to play with friends again. As children get older, they tend to become more independent and less talkative to adults. Many teenagers come home to an empty house, go up to their rooms and then come out only when its time for dinner. A picture of this isolation is clearly painted in Hersch's A Tribe Apart. "Around 3:00 in the afternoon in Reston, the middle and high school buses return, and at streets with inviting suburban names like Ambleside Court, Deep Run Lane, and Steeplechase, approximately three thousand adolescents hop off, fling their backpacks over their shoulders, and meander towards home, sometimes alone, sometimes with friends. Keys in hand, they open doors all over the community. Then the doors shut. It's their world now. With the exception of a few lone outposts where adults await their return, nobody's home but the kids" (11 Hersch).
This isolation brings up many questions. Of course teens want their space, and don't want to be bothered, but what happens when this need to be alone turns out to be something more serious? In recent years there has been a sharp increase in the numbers of adolescents who are being treated for depression, and many experts are worried about what this might mean. In a study done on the number of prescriptions written for the six leading antidepressants (Prozac, Zoloff, Paxil, Serzone, Effexor and Luvox) it was found that: primary-care physicians and pediatricians wrote nearly twice as many antidepressant prescriptions for children 18 and under in 1998 than in 1996. In 1998, physicians and pediatricians wrote 543,000 prescriptions compared to the 274,000 written in 1996. By contrast, the number of antidepressant prescriptions written by psychiatrists only increased 18 % during the same period. In 1996, they wrote 1 million antidepressant prescriptions and by 1998 the number had only risen to 1.2 million. Many psychiatrists worry that non-specialists may be administering the drugs without referring the children for psychotherapy, which they say should be an integral part of drug therapy (IMS Health/CQR 596).
Some argue that depression may be showing up in younger and younger kids because children today reach puberty earlier, and depressive symptoms often show up at adolescence. However, there are some who argue that the apparent increase in depression may be the result of the availability of a new generation of safer antidepressants. As one researcher noted, "The increase may be real, and the disease may be spreading, or we may just be more sensitive to identifying depressed children" (Koch 596). This seems to be a double-edged sword. On the one hand, we want to be sensitive and identify depression in teens and children, but on the other hand, we have to make sure that we are not too quick to diagnose someone and put them on medication. The study that was done on the number of prescriptions that have been written for antidepressants shows how much more depression is being diagnosed. Prozac is even available now in a child friendly, peppermint flavored liquid form. Experts are quick to warn that simply identifying and putting a patient on drugs is of no use if the patient is not also asked to see a counselor or therapist of some sort. There needs to be a combined treatment of medication and guidance. Some experts believe, "Medication alone is never an appropriate treatment. It should only be used as part of a comprehensive treatment plan, which includes individual therapy and perhaps family counseling" (Koch 597).
The key is being able to recognize depression and effectively treat it. A research study concluded that, "The current outlook for depressed teens isn't bright. The results indicate that by their early 20's, about half of these young people have again experienced depression's trademark blend of melancholy, despair, and apathy. Adolescents destined for recurrences of depression had earlier exhibited severe symptoms of the disorder, had parents and siblings who had suffered from depression and felt an overwhelming desire for the support and approval of others" (Bower 244).
While speaking about why he thinks depression is increasing and showing up in younger and younger children, child psychiatrist and co-author of the book 'Help me, I'm sad' David Fassler says, "Yes, it's more likely to be identified, but kids are under an awful lot more stress these days, and they seem to have less stability in their lives." This statement concurs that two major factors that affect teens today are stress and lack of stability. Martin Gassler, a child and adolescent psychiatrist and spokesperson for the American Association of Child and Adolescent Psychiatrists (AACAP), believes that, "There aren't many support systems for kids, and the rules for what is acceptable behavior have been blown away. Kids function best with boundaries and there aren't many today" (Koch 596). Teens are affected in countless ways by even the smallest things. Lack of stability or boundaries allows today's teens to get away with a lot. Many people will miss or ignore warning signs because they think of it as typical teenage behavior. For example they might say, "It's just a phase" and the situation will be left at that and ignored. However, depression is a serious issue, because if left unnoticed and untreated, it can lead to suicide. "Suicide is the end stage of depression that hasn't been effectively treated" (Koch 600). A recent study in the journal of the American Medical Association found that adolescents diagnosed with depression as youths are 14 times more likely than their healthy peers to commit or attempt suicide during their lifetime. In 1996, suicide was the third leading cause of death among Americans ages 15-24 and the fourth leading cause of death among those 10-14. Many argue that the escalating suicide rates prove that more kids are depressed today than at any time in history, and thus the skyrocketing rate of antidepressant prescriptions for kids is justified (Koch 601.) Suicide is a cry for help that has gone unanswered and every attempt should be made in order to try and prevent it at all costs.
Before reaching this end stage of depression, there are many signs that can be found in a depressed individual. Once someone has been found to be depressed, it is important that they be treated properly with a combination of both medication and psychotherapy. Teens are prone to depression more than any other age group, especially girls. The way children have been brought up reflects how they handle situations. Boys are brought up to be tough and hold back their emotions, which as we have seen can have terrible consequences, while girls are taught to be sensitive and talk about how they feel. It's no surprise then that girls tend to report depression more than boys do. On the whole girls experience depression more than boys. After age 12-13 girls are twice as likely as boys to get depressed. This is due to the fact that societal pressures as well as gender roles make girls feel more insecure than boys. Girls tend to worry about their problems more and since they are more sensitive to these pressures, there is a greater impact on them. Society needs to become more aware of depression and not be afraid to talk about it and address the issues that are affecting America's youth.