Introduction
Depression is one of the most common mental health problems among adolescents in the United States. According to a survey by Royuela-Colomer and Calvete (2016), at this important developmental stage in one’s life, a person requires close support from family and friends to understand how to deal with different biological and social changes. Unfortunately, parents rarely have time to engage these adolescents and understand their concerns. Edlund et al. (2015) observe that in most of the cases, both parents spend their time in the workplace, struggling to earn a living. They leave in the morning and come back late in the evening, which means that they do not get adequate time to understand the challenges that their adolescent children go through. Curry (2014) laments that parenting as responsibility has been handed over to teachers in American society. People are busy pursuing their careers, and they that believe taking their children to some of the best schools in the country solves all parenting problems. Given that teachers handle several students, they cannot provide personalized attention that these children need to overcome various challenges they need.
In the past, studies suggested that adolescents tend to be rebellious as they struggle with the need to make independent decisions. However, Curry (2014) suggests that such forms of rebellion are often caused by depression. Parents and teachers may view an adolescent going through depression as being rebellious while the truth is that the child has psychological problems. It means that such problems are ignored, making it difficult to find a solution at the right time. Given their age and inexperience, these children may not even realize that they have depression. They know they are troubled but cannot explain specific causes of such mental disturbances. When the condition is not accurately diagnosed and the stress agents are still present, the condition may become worse (Edlund et al., 2015). Some of these teenagers may develop suicidal thoughts when they realize that society does not care about their condition and is not doing anything concrete to help. Some may turn to drugs as a way of coping with their condition while others may join criminal gangs as a way of getting the support group they need to overcome social, mental, and biological challenges they face.
A recent report by Royuela-Colomer and Calvete (2016) showed that depression among adolescents in the United States grew by more than 7.6% from 2009 to 2012. The condition is expected to get worse because society has not yet realized that depression is a major mental health problem among adolescent. Most parents believe that providing the material support to their families is their primary responsibility and that the social support needed by these children can be obtained from the school. However, Curry (2014) argues that material support is just as important as the emotional support that these children need. When it is determined that an adolescent is mentally troubled, immediate medical attention and continued family support may help to overcome the problem. In this study, the researcher seeks to investigate whether psychotherapy treatment reduces the risk of relapse after discontinuity, in comparison to other medication used in treating depression among adolescents.
Problem Statement
Depression among adolescent is becoming increasingly common in the United States. Studies suggest that the problem affects both the rich and the poor in equal measures. The main challenge when dealing with this problem is the inability to diagnose the problem in time so that medical actions can be taken to address it (Mojtabai, Olfson, & Han, 2016). Adolescents who are going through depression do not even know what the condition is, and as such do not seek help within the right time. Parents who are expected to identify some of the signs and symptoms in their children rarely spend time with them hence cannot know when they start behaving normally. Those who identify symptoms such as withdrawal and lack of concern among these adolescents associate it with the rebellious nature of the adolescents. These factors have made it difficult for society to deal with the problem effectively. Parents, guardians, and teachers are yet to be adequately sensitized on how to deal with the problem.
Purpose Statement
The purpose of this study is to investigate whether psychotherapy treatment reduces the risk of relapse after discontinuity, in comparison to other medications used in treating depression among adolescents. Society needs to acknowledge that depression is a major medical problem among adolescents in the United States and measures need to be taken to address it. A study by Devenish, Berk, and Lewis (2016) found out that drug abuse among people of this age is mainly caused by depression. Adolescents highly value affection among peers and people close to them. When they fail to get the affection from parents and family members, they will gravitate towards those who can show them the same at school or in the neighborhood. They can easily join wrong groups that can mislead them into a life of crime. Knowing how to deal with this problem will not only help in addressing juvenile delinquency but also halt the trend where an increasing number of adolescents consider taking their own lives as a way of addressing challenges they face in life.
Project Question (PICO)
According to Curry (2014), a clinical question should be relevant to a specific patient or a given problem to facilitate a search for a solution. PICO allows a researcher to articulate the problem or affected population, the intervention that is needed, comparison with other alternatives, and the outcome if the proposed solution is implemented. It offers a complete picture of the problem, how to solve it, and the benefit of the solution. The following is the PICO question that guided the research.
Among adolescents with depression (P), does psychotherapy treatment (I) reduce relapse after discontinuity (O) compared with other medications (C)?
Definition and Terms
The following terms were used in the study:
- Depression– a feeling of severe dejection and despondency (Curry, 2014).
- Adolescence– a developmental stage after the onset of puberty as one transition from childhood to adulthood (Mojtabai et al., 2016).
- Relapse– a state if deterioration after a period of improvement (Devenish et al., 2016).
- Psychotherapy– the use of psychological as opposed to medical means when treating a mental disorder (Curry, 2014).
Conceptual Framework
The concept of depression as a medical condition has been in existence for a long time, and Curry (2014) argues that although it may not be possible to credit a single person for the discovery of the condition, a number of ancient great thinkers focused on it. In Mesopotamian, Roman, Greek, Egyptian, and Babylonian Empires, scholars talked about this condition, its possible causes, and how it can be managed. In this conceptual framework, the researcher will focus on Carper’s fundamental ways of knowing to help in the classification of knowledge sources when discussing depression among adolescents (Stevens, 2018). Figure 1 below identifies six sources of knowing used in this study.
Personal knowledge gained from personal understanding, empathy, and experience can help in understanding possible causes of adolescent depression and the approach that can be taken to deal with the condition. From personal experience, it is known that issues such as financial constraints, rejection among peers, and underwhelming academic performance can cause depression among adolescents. Empirical knowledge, especially from peer-reviewed scientific journals, also forms an important source of information. Ethical knowledge and attitudes such as the expectations that society has of adolescents may cause stress or depression among them.
Aesthetic knowledge refers to awareness of the immediate situation/environment of the patient and the manner in which it causes a given problem, which in this case is depression (Stevens, 2018). Socio-political factors may also help in understanding depression among adolescents. The recent decision of the political class and some education experts in the United States to introduce Common Core State Standards (CCSS) may put academic pressure on students (Stevens, 2018). If the situation is not managed effectively, it can degenerate into depression. Unknowing knowledge, as explained in Caper’s ways of knowing, refers to a condition of openness, which is essential to intersubjectivity and leads to change.
Literature Review
The problem of depression in adolescents has been the focus of health practitioners’ attention for quite long due to the complexity of the disorder and the necessity to address multiple factors contributing to the emergence thereof. According to Mojtabai et al. (2016), the nature of depression represents a combined influence of genetic and environmental issues that define a patient’s perception of life. For instance, drug abuse may cause the development of depression (Devenish et al., 2016). Among the risks that adolescent depression entails, one should list the concerns associated with mental health issues that range from comorbid disorders to suicidal ideations (Curry, 2014). Therefore, it is critical to improve the current strategy for managing and preventing adolescent depression.
When considering some of the most problematic aspects of managing depression in adolescents, one should address the fact that the specified concern is rather difficult to identify and diagnose. Consequently, in a range of cases, the process of treatment for adolescents with depression begins at the stage when the disorder has progressed extensively (Carrellas, Biederman, & Uchida, 2017; Mojtabai et al., 2016). The low levels of prevalence in sub-threshold manifestations of depression in the specified population increase the risk of its negative effects magnifying. The problem of suicidal ideation in adolescents with depression should be seen as the issue of the greatest concern. In the target demographic, suicidal thoughts need to be addressed with the help of a family-based therapy, during which patients are provided with extensive support from their family members. In a range of cases, the management of depression in adolescents is complicated by the presence of comorbid mental health concerns, ASD being one of these conditions.
The management of depression in adolescents typically involves the consumption of medications along with the integration of psychotherapeutic measures. However, it is believed that the application of psychotherapy after discontinuity is likely to yield better results than the current framework. Studies indicate that, when deployed after discontinuity, psychotherapy allows patients to redefine their priorities, exploring the nature of their depression and realizing how they can shape their perception of reality. Therefore, the integration of psychotherapeutic measures after the medical treatment is discontinued should be regarded as one of the critical stages of managing depression in adolescents.
Royuela-Colomer and Calvete (2016) also insist that the inclusion of psychotherapeutic elements into the process of managing depression in adolescents is critical to the effective treatment of the issue. To be more accurate, the authors propose the integration of rumination as one of the measures aimed toward handling the development of depression in adolescents (Santomauro, Sheffield, & Sofronoff, 2016). The authors warn that the abuse of medication and forceful therapy, in general, is likely to have a detrimental effect on the health of an adolescent with depression, which means that psychotherapeutic tools have to be integrated into the process of depression management after the medication-based stage is discontinued in the target population.
Therefore, there is the necessity to address the problem of depression in adolescents from a new perspective that involves the active application of patient-centered psychotherapy. Stevens (2018) suggests using the principles of knowing and unknowing, as well as the approach geared toward increasing patients’ confidence and change, in general. The identified technique is expected to lead to more effective management of the problem of depression in adolescents due to the opportunity to establish a patient-centered approach and handle the core factors that define the development of depressive thoughts in patients (Edlund et al., 2015).
Annotated Bibliography
Mojtabai, R., Olfson, M., & Han, B. (2016). National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics, 138(6), 1-10. Web.
The article focuses on the prevalence and treatment strategies used to manage depression among adolescents and young adults in the United States. The scholars found out that adolescents and young adults are increasingly suffering from depression because of numerous factors. The environment and genetic factors were identified as the primary stressors that may cause depression if corrective measures are not taken within the right time. Unrealistic family expectation was identified as a common social factor that is linked to depression. The desire of parents to have their children pursuing careers considered prestigious such as medicine and law may cause pressure among adolescents to register impressive academic performance. The scholars argue that in some cases the desire of the child may be to become a musician or comedian. Ignoring the desires of the child may cause stress that can degenerate into depression. The quality of this article, based on the methodology used to collect and analyses data, meets the expectation for this study. The article will be useful in identifying the potential causes of depression among adolescents and young adults.
Carrellas, N.W., Biederman, J., & Uchida, M. (2017). How prevalent and morbid are sub-threshold manifestations of major depression in adolescents? A literature review. Journal of Affective Disorders, 210(1), 166-173.
This article investigates the prevalence of sub-threshold manifestation of depression among adolescents. The authors argue that in many cases, depression among adolescents is often diagnosed when it has reached advanced stages. When an adolescent develops suicidal tendencies, lack of motivation, and rage even when faced with minor challenges, it is a sign that they are having severe depression. The problem, as identified in this study, is that the problem is often diagnosed at this advanced stage when parents, teachers, and colleagues realize that an adolescent is behaving in an abnormal manner. Managing the problem at this advanced stage may be challenging, especially when the adolescent becomes addicted to drugs and alcohol as a way of overcoming their condition. Their findings show that sub-threshold manifestation of depression among adolescents is more common than the national statistics because they are rarely reported as mental health problems. The journal conducted primary data collection from a large number of participants, which makes its quality good for this project. It will be useful in understanding how this problem can be identified at the earliest stage possible.
Devenish, B., Berk. L., & Lewis, A.J. (2016). The treatment of suicidality in adolescents by psychosocial interventions for depression: A systematic literature review. Australian & New Zealand Journal of Psychiatry, 50(8) 726–740. Web.
The study focuses on suicide as one of the common approaches that adolescents use to address the problem of depression. People suffering from depression require urgent medical help and support from their families. However, the study shows that most of the adolescents do not even realize that they have a medical problem that may require some form of medication. When they fail to get help from their immediate support system, they tend to view their lives as having little or no meaning. Suicide becomes the only option of addressing their problem. The scholars argue that most of them use suicide because they believe that they will be punishing their loved ones for failing to give them the needed support. They hope that their death through suicide would be a reminder to those in authority that adolescents need their attention and care. The quality of the article meets the desired threshold and that is why it was considered an appropriate source for the research. The journal will help in analyzing suicidal trends in the country and the manner in which they can be managed.
Royuela-Colomer, E., & Calvete, E. (2016). Mindfulness facets and depression in adolescents: Rumination as a mediator. The Analysis of Vernal Behavior, 7(5), 1092-1102.
The article looks at ways of managing stress among adolescents. The authors argue that the perception of parents, teachers, and adults in general about adolescents’ rebellion should change. For a long time, adults have been interpreting a change of behavior of teenagers as a form of rebellion and a stage of development that they can easily overcome with time. However, the truth is that some of these children have to deal with serious depression that often gets worse with time. The authors believe that ignoring the condition or responding with force as a way of making them do what is expected may only worsen the condition. Instead, it may be necessary for adults to be mindful of these adolescents and understand that they need support. Their behavioral change may be a manifestation of a serious psychological problem that cannot be addressed using force. The methodology used in this study demonstrates that it is of the right quality for this research. The article will be useful in this study because it explains how children who might be battling this condition should be managed.
Santomauro, D., Sheffield, J., & Sofronoff, K. (2016). Depression in adolescents with ASD: A pilot RCT of a group intervention. Journal of Autism and Developmental Disorders, 46(2), 572-58.
In this article, the focus was to assess depression among adolescents with an autism spectrum disorder. The condition makes children have a problem with communication, social interaction, and interest in things popular among their peers. The authors argue that it is uniquely difficult to deal with depression among these adolescents because parents and teachers would easily assume that their change is behavior is caused by the disorder. They suggest that adolescents with ASD require close attention and care to help detect signs of depression early enough to facilitate medication. The article’s quality is satisfactory because it used a randomized controlled trial that seeks to reduce bias. The information from this article will help in explaining how adolescents with ASD can be helped to overcome depression.
References
Curry, J. F. (2014). Future directions in research on psychotherapy for adolescent depression. Journal of Clinical Child & Adolescent Psychology, 43(3), 510-526. Web.
Edlund, M.J., Forman-Hoffman, V.F., Winder, C.R., Heller, D.C., Kroutil, L.A., Lipari, R.N., … Colpe, L.J. (2015). Opioid abuse and depression in adolescents: Results from the national survey on drug use and health. Drug and Alcohol Dependence, 152(1), 131-138.
Stevens, S. (2018). Ways of knowing and unknowing in psychotherapy and clinical practice. Journal of Trauma Treatment, 7(1), 418-410. Web.