If you are a teenager and your mood is down or if you know of a teenager who may be suffering from depression, you need to read on. With double the incidence of depression in teens compared to adults, research¹ further shows that anxiety disorders and depression are particularly high in South African teens.
Although depression can occur at any time of life, 20% of high school teens are depressed (double the incidence of depression among South African adults). The teen years are a time of great personal change. It is a time to make decisions that may affect the rest of your life. It is a time of hormonal fluctuations and identity crises. There is a large workload to get through as well. If you suffer from depression during this time, it may negatively impact on academic choices, interpersonal relationships and long term life choices.
WHAT IS DEPRESSION?
It is a common, but serious, mental illness typically marked by sad or anxious feelings, which interferes with daily activities. Common symptoms may include one or more of the following:
- Irritability, restlessness or disruptive behaviour
- Lack of energy
- Loss of interest in pleasurable activities
- Difficulties with concentration, memory or decision making
- Problems falling asleep or sleeping too much
- Loss of appetite or excessive comfort eating
- Thoughts of suicide or suicide attempts or self-harm activities
- Physical symptoms such as body pains, headaches or abdominal cramps.
WHAT CAUSES DEPRESSION?
Any stressful situation may trigger depression, especially when you feel powerless to change the situation. This is called negative stress, as opposed to positive stress, which is the driving force that enables one to achieve great things. Some teens may inherit genes which increase their likelihood of developing depression.
Schoolwork accounts for 80% of the stress experienced by teens, followed closely by uncertainty about the future or future plans (78%). Social media are fast becoming a cause for concern. A recent study2 showed that the more a teen used Facebook over a two-week period, the lower his/her life satisfaction level declined. Victimisation, gossip, emotional blackmail, feelings of unpopularity or rejection because one does not have as many ‘friends’ as others, can all cause depression and even lead to suicide. If you allow social websites to determine how good you feel about yourself, the statistics show you will end up with negative feelings about who you are. Many teens do not realise how savagely they can wreck another’s life by sending out the wrong words or photos.
Vitamin D deficiency has also been noted in recent studies to cause anxiety and depression. The lower the vitamin D level, the more likely that person would be depressed. Although we live in a sunny country, the majority of South Africans tested have low blood levels of Vitamin D. This is probably due to many people avoiding the sun, or applying sun- screen, or covering up with hats and clothes. You need to expose naked skin to the sun for at least 10 minutes daily (without burning) to manufacture enough Vitamin D for good physical and emotional health.
Low levels of omega-3 fatty acids (found in good quality fish oils) in the diet, have also been shown to cause depression, mainly in women.
DIFFERENT TYPES OF DEPRESSION
- Major depression: the symptoms are disabling and interfere with studying, eating and sleeping.
- Dysthymia or mild, chronic depression: although less severe it can still interfere with everyday activities. It may last several years.
- Minor depression: milder symptoms, but may develop into a major depressive disorder.
- Psychotic depression: severe depression associated with delusions or hallucinations.
- Seasonal Affective Disorder (SAD): associated with cold, dark days of winter and usually improves in summer.
WAYS OF COPING WITH DEPRESSION
Many teens with one or more symptoms of depression are too ashamed or embarrassed to ask for help. They are fearful of what others may think of their weakness. One study1 found that 28% of high school learners resorted to taking a substance to help them cope (11% took alcohol, 10% smoked cigarettes and 4% took cannabis).
The same study found that the most commonly used strategy for coping with stress was confiding in someone whose opinion they valued e.g. a friend or a parent. Socialising with friends is also commonly used. Only 3.5% of teens consulted a psychologist.
Engaging in exercise is an effective way to cope with stress, as endorphins (feel-good hormones) are produced during exercise, which help to elevate mood.
The Goldberg Depression Questionnaire, a Screening Test for Depression
This 18-question self-test by pioneering researcher Dr Ivan K Goldberg highlights signs and symptoms associated with depression.
To complete the questionnaire, please tick the box next to the selection which best reflects how each statement applies to you. Be sure to choose the statement that applies to how you have felt and behaved during the past week.
About Scoring this Psychological Questionnaire
- 0 points Not at all
- 1 point Just a little
- 2 points Somewhat
- 3 points Moderately
- 4 points Quite a lot
- 5 points Very much
Screening test scoring ranges:
- 0-9 No Depression Likely
- 10-17 Possibly Mildly Depressed
- 18-21 Borderline Depression
- 22-35 Mild-Moderate Depression
- 36-53 Moderate-Severe Depression
- 54 and up Severely Depressed
- Source: Dr Ivan Goldberg, psychiatrist.
TREATMENT OF DEPRESSION
The first step should be to talk to a friend or a respected adult. A consultation with a doctor or a counsellor should be the next step. The health care professional will take a careful history to enable him/her to make a diagnosis, and to propose a treatment plan.
A treatment plan may include one or more of the following:
- Antidepressant drugs or tranquillisers
- Natural antidepressants, such as herbal medicines
- Homeopathic treatment
- Correction of any deficiencies such as Vitamin D and Omega-3 fats.
- Psychotherapy involves talking with a mental health care professional. Two types of therapy have been shown to be effective in treating depression:
– Cognitive Behavioural Therapy, which helps one change negative thought patterns and negative behaviours into positive ones.
– Interpersonal Therapy, which helps one understand and improve troubled personal relationships.
Depending on the severity of the depression, one may have to engage in weekly consultations for a short or a long term. Antidepressants come in many shapes and sizes. Pharmaceutical drugs such as Prozac may be prescribed by a doctor for three months or longer. They usually take about four weeks before one feels any improvement.
Herbal products such as St John’s wort and Sceletium tortuosum are as effective as many of the drugs, and may also take about four weeks before one feels improvement. The side effect profile is much better than that of the drugs, but note that herbs, such as St John’s wort, are not completely free of side effects.
5-HTP (5-Hydroxytryptophan) is another natural antidepressant, which is effective, and safe to use. It also helps to improve sleep so is usually taken at night.
The Bach flower remedies are one of my favourites, as they work so quickly to balance the emotions. Individual flower essences are chosen to balance each emotion that is troubled, for example gentian for depression, aspen for anxiety, Star-of-Bethlehem for grief, elm for being over-whelmed, etc. The chosen essences are put together in a treatment bottle and four drops are taken regularly throughout the day. The return to a state of calm and positivity happens quickly and without any unwanted effects.
Homeopathic treatment is best undertaken with a registered homeopath. Self-prescribed homeopathic medicines seldom work as effectively as a well prescribed homeopathic constitutional remedy.
There is an NGO in RSA called The South African Depression and Anxiety Group (SADAG) which provides free counselling and comprehensive mental health information. Depending on funding, they run awareness programmes at schools called ‘Suicide shouldn’t be a secret’. They can be contacted for counselling on 0800 12 13 14 or suicide counselling on 0800 56 75 67.
It is important for you to recognise the early signs of depression in yourself or your friends. It is just as important to take the next step to get help. Suicides should never happen, especially if remedial action can be taken in the early stages of depression.
- Strydom MMA., et al. Depression and anxiety among grade 11 and 12 learners attending schools in central Bloemfontein. South African Journal of Psychiatry. 2012; 18(3):84-8.
- Kross E et al. Facebook use predicts decline in subjective well-being in young adults. PLoS ONE 8(8):e69841. doi:10.1371/journal. pone.0069841 (2013)