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Depression is a disease that afflicts the human psyche in such a way that the afflicted tends to
act and react abnormally toward others and themselves. Therefore it comes to no surprise to
discover that adolescent depression is strongly linked to teen suicide. Adolescent suicide is now
responsible for more deaths in youths aged 15 to 19 than cardiovascular disease or cancer
(Blackman, 1995). Despite this increased suicide rate, depression in this age group is greatly
under diagnosed and leads to serious difficulties in school, work and personal adjustment which
may often continue into adulthood.
How prevalent are mood disorders in children and when should an adolescent with changes in
mood be considered clinically depressed? Brown (1996) has said the reason why depression is
often over looked in children and adolescents is because "children are not always able to express
how they feel." Sometimes the symptoms of mood disorders take on different forms in children
than in adults. Adolescence is a time of emotional turmoil, mood swings, gloomy thoughts, and
heightened sensitivity. It is a time of rebellion and experimentation.
Blackman (1996) observed that the "challenge is to identify depressive symptomatology which
may be superimposed on the backdrop of a more transient, but expected, developmental storm."
Therefore, diagnosis should not lay only in the physician's hands but be associated with parents,
teachers and anyone who interacts with the patient on a daily basis.
Unlike adult depression, symptoms of youth depression are often masked. Instead of
expressing sadness, teenagers may express boredom and irritability, or may choose to engage in
risky behaviors (Oster & Montgomery, 1996). Mood disorders are often accompanied by other
psychological problems such as anxiety (Oster & Montgomery, 1996), eating disorders (Lasko et
al., 1996), hyperactivity (Blackman, 1995), substance abuse (Blackman, 1995; Brown, 1996;
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Lasko et al., 1996) and suicide (Blackman, 1995; Brown, 1996; Lasko et al., 1996; Oster &
Montgomery include marked changes in mood and associated behaviors that range from sadness,
withdrawal, and decreased energy to intense feelings of hopelessness and suicidal thoughts.
Depression is often described as an exaggeration of the duration and intensity of "normal"
mood changes (Brown 1996). Key indicators of adolescent depression include a drastic change in
eating and sleeping patterns, significant loss of interest in previous activity interests (Blackman,
1995; Oster & Montgomery, 1996), constant boredom (Blackman, 1995), disruptive behavior,
peer problems, increased irritability and aggression (Brown, 1996). Blackman (1995) proposed
that "formal psychologic testing may be helpful in complicated presentations that do not lend
themselves easily to diagnosis."
For many teens, symptoms of depression are directly related to low self esteem stemming from
increased emphasis on peer popularity. For other teens, depression arises from poor family
relations which could include decreased family support and perceived rejection by parents (Lasko
et al., 1996). Oster & Montgomery (1996) stated that "when parents are struggling over marital
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