Abstract
People in different stages of development have diverse physical, cognitive, psychological, and behavioral experiences that act as risk factors for depression. Therefore, any policy for dealing with depression requires one to consider the risks for particular groups. Depressants may change with time. Consistent with this concern, this paper proposes research on depression in teenagers with the objective of determining whether young adults suffer from higher rates of depression now than they did 10 or 20 years ago.
Such research is critical in helping to set the necessary policy directions for managing depression among young adults by putting in place appropriate changes in the current programs in a manner that they can meet the emerging challenges. Despite the lack of sufficient data on the variation of depression among young adults over the last 10 to 20 years in the US, from the literature review, the research identifies an increasing trend of adolescent depression. The issue of fewer adolescents accessing treatment after a positive diagnosis for the disorder explains this variation. It suggests that if risk factors such as familial, physical, and psychological elements for adolescent depression are modified, severe consequences of depression, including young adults’ suicide, may be reduced significantly.
Background
Depression among young adults constitutes a serious health challenge. Bennet (2014) reckons that nearly 6.7% (14.8 million) of all United States adults suffer from Major Depressive Disorder (MDD). A survey conducted in 2012 by Harris Interactive on behalf of the American Psychological Association showed that millennials (18-33 years) are more likely to suffer from depression when compared to other age groups. The survey indicated that 19% of millennials are likely to be informed by their doctors that they have depression or an anxiety disorder compared to 14% for the case of individuals whose age lie between 34-47 years, 12% for 48-66-year-olds, and 11% for 67- year-olds, and above (Bennet 2014). Irrespective of its causes, the condition needs medical attention due to its negative effects on the psychological health of an individual including suicidal ideation among young adults.
Introduction
Many social work scholars contend that the majority of young people who are put under their care have psychological challenges that are associated with depression. For instance, Bennet (2014) asserts that depression encompasses one of the key reasons why young adults go for treatments. Depression is also a risk factor that makes adolescents resort to drug abuse and excessive consumption of alcohol as perceived mechanisms for enabling them to manage the stress that is associated with experiences such as family conflicts. Therefore, managing depression among young adults or teenagers implies that it is also possible to manage its associated severe consequences such as contemplation of plans and thoughts to commit suicide.
There is no singly agreed standard definition of depression. Indeed, attempts to define it are mainly based on its description of what one feels in case he or she suffers from it. For example, Bennet (2014) defines depression as a repugnance to activities that shape people’s behaviors, their judgment, and physical conditions due to low mood. Hence, this finding suggests an inadequate description of depression in many peer-reviewed academic articles. Although depressed moods may be an indication of psychiatric problems such as Major Depressive Disorder (MDD), it may arise as a response to bodily changes or even due to medical treatments’ side effects.
Ontology and Epistemology of Depression
Depression constitutes major a disorder that influences young adults. What is it exactly? The manual for Mental Disorders (MD) only gives the criteria for major depressive episodes but does not define depression in its ontological terms (Huang & Fang 2015). The criterion is on how one can recognize that he or she suffers from depression. Therefore, Diagnostics and Statistical Manual of Mental Disorders (DSM-1V) only describes depression while not offering reasons for the combinations of causes or even reasons for the collective symptoms that comprise depressive episodes. This gap underlines the importance of questioning the ontology and epistemology of depression.
Ontology means ‘being’ in Greek. Thus, in the context of this paper, it means the metaphysical questioning of the constituents of depression. DSM-IV claims that depression encompasses a kind of malfunction. It exists materially inside an individual in the form of this dysfunction. Nonetheless, no single objective tests can be conducted in diagnosing it. Depression is only diagnosed through clinical interviews following the criteria set out by DSM-VI coupled with professional judgments (Huang & Fang 2015). Can clinicians then socially construct the ailment during the interviews or is it inexistent? The argument here is that depression lacks a precise and clear ontological explanation.
Epistemology means knowledge limits and studies of nature. It is derived from the Greek words ‘episteme’ and ‘logos’. Logos denotes ‘knowledge of’. Epistemology is about developing criteria for any knowledge to determine what is achievable. In the case of depression and proceeding from DSM-IV, the knowledge on depression has limits to the extent that it is not known about the constituents that exist in material nature that can account for its causes. Knowledge exists for the symptoms and/or how the disorder can be identified but not its material components that can be used to substantiate the symptoms for depression.
Aims and Objectives
Depression has negative effects on individuals, young or old. It influences how people feel about themselves, causes low interest in people’s hobbies, leads to poor work performance and difficulties in falling asleep, and may make some people be easily annoyed and even have poor attitudes towards things that otherwise used to be interesting among other effects. For teenagers, its implications on socialization processes may deter their development. Considering this negative implication of depression, it is necessary to reconsider policy decisions on depression management initiatives and treatment approaches.
This paper aims at determining whether depression among young adults has reduced or increased over the last 20 years to the level that families can gauge their initiatives on how they manage depression among their young adults. The objective involves laying a framework through which teenagers can investigate the causes of increasing depression in a manner that they can put efforts to distance themselves from depressants. This strategy is necessary for such people to live longer, healthy, and productive lives.
Hypothesis
The changing political and socio-economic landscape transforms conditions under which people live and/or interact. This change can cause variations in incidents of depressed young adults. The US has established elaborate mechanisms for addressing young adults’ problems, including treatment of disorders such as MDD. Such mechanisms should have effects on depression rates in the US. A common argument among clinical scholars has been that when the depressive disorders among young adults are treated, risks such as the desperate activities coupled with suicidal ideation would also disappear. Based on this anticipation, this research hypothesizes:
- Depression rate among young adults in the US has decreased over the last 10 to 20 years due to the improved diagnosis of depression and its treatment
- Risks such as suicidal ideation and the actual suicide among young adults have gone down due to decreased depression among young adults over the last 10 to 20 years.
The above two hypotheses lead to the research question, ‘Do teenagers in the US suffer from higher rates of depression now than 10 or 20 years ago?’
Methodology
Research methodology describes the processes through which researchers acquire data on a given topic. It also shows the tools used in the analysis of the results in addition to the mechanisms for interpreting the results of studies that investigate health and social care practice. Research methods have diverse characteristics. The selection of an appropriate methodology depends on the available resources, objectives, and goals of the research.
The selected methods need to fulfill certain requirements to arrive at valid results and recommendations that can lead to solutions to the problem under scrutiny. Scott (2011) identifies such characteristics as integrity, consistency, the deployment of rigorous methods and verifications, lucidity, and rationality. Research can be designed as either qualitative or quantitative. It can also deploy mixed methods, or take the form of participatory or advocacy research design. Although some reviewed articles have quantitative data on young adults’ depression in the US, the fact that this research reviews the articles makes it qualitative.
Assessment of various researches to establish theoretical paradigms that may help to explain changes in depression among young adults in the last 10 to 20 years ago implies that the data used in the research is secondary. Hence, the methodology used introduces challenges of reliability and validity of the inferences made. However, this challenge is countered by the use of a wide range of scholarly researches sourced from credible websites such as EBSCOhost and PUBMED to guarantee the reliability, which is a major concern about the approaches used to investigate health and social care practices.
Qualitative and quantitative approaches are good and not good for particular research. Quantitative research is associated with the paradigms of post-positivists or positivist. The method is good where it is necessary to collect data and then convert it into numerical form to permit the making of statistical computations that are necessary for drawing conclusions. The process of accomplishing this research begins with laying out a hypothesis.
A methodology is then devised to garner the information utilized in justifying the hypothesis. To arrive at the conclusions, statistical analysis is required to reveal the differences, relationships, and associations between the variables utilized in a study. In approaches used to investigate health and social care practice, the research methodology is good where frequent updating of data is necessary and/or where the research involves asking open-ended questions or surveys. Nevertheless, since it requires consistent updating, it is not good for researches that take a long time to be completed after the data has been collected.
Qualitative research revolves around recording, analyzing, and unveiling the actual meaning and relevance of certain deeply ingrained human experiences and behaviors. It is ‘usually associated with the social constructivist paradigm, which emphasizes the socially constructed nature of reality’ (Rocco, Hatcher, & Creswell 2011, p.109). The method is good where the researcher wants to acquire a complex understanding of different people’s experiences.
The approach also finds good applications in approaches that are used to investigate health and social care practice where focus entails coming up with theories and/or looking out for meaning and patterns associated with the generated data in the research. Indeed, the current research focuses on this method. Qualitative research approaches are not good at gaining information that requires generalization for it to apply to a large group of people apart from the sample. The goal of the current research is to explain changes in depression prevalence levels among young US adults/teenagers over the last 10 to 20 years. The study does not encourage data generalization.
Inclusion and Exclusion Criteria
Various universities and organizations maintain databases. These databases are utilized in the current research to acquire various documented papers of past researches. These databases contain books and journal articles. They include EBSCOhost, EMERALD, and PROQUEST. Research is also conducted using internet search engines, but with care to identify peer-reviewed journal articles together with organizations that have reliable sources of data such as the Centre for Disease Control and Prevention (CDC). Not all books and journal articles pass the validity and reliability test.
Nevertheless, peer-reviewed journals are reliable sources of information that can be utilized in any research. By peer-reviewed, it means that a body of scholars has evaluated the journals or any other research documents for validity and reliability in terms of the methodologies used, the reliability of the sample and sampling techniques used, and the analysis of the findings to measure up to the hypothesis being tested. For the current research, the inclusion and exclusion strategy is that the articles used must be peer-reviewed journals published between 2010 and 2016 and in the English language.
Literature Review
Adopting good habits for mental health such as coping skills, resilience, and making good judgments are critical to achieving good health that is free from psychological disorders in adulthood. Despite mood swings occurring normally during the adolescent age, Johnson, Cohen, and Kasen (2010) assert that about 1 in 5 young people have mental disorders such as depression that can be diagnosed. However, in 2014, only less than 50% of adolescents who exhibited symptoms for mental health disorders received treatment (Huang & Fang 2015).
This finding suggests that the cumulative number of adolescents failing to receive treatment in a given year may explain the higher rate of depression among teenagers in subsequent years. Indeed, through the World Mental Health Survey, the WHO found that people living with mental illnesses first experienced depressive episodes at 14 years (Huang & Fang 2015).
Quoting data from Psychology Today, Gallerani, Garber, and Martin (2010) assert that high school and college young adults have 5-8 times the likelihood of suffering from depression compared to teenagers who lived 5 to 6 decades ago. This finding suggests an increased rate of depression among adolescents of today. The rate may escalate further if an appropriate policy intervention is not developed. The risks for a depressive disorder vary with demographic factors.
For example, the 2011 data from the Substance Abuse and Mental Health Services Administration showed that girls aged 15 years are 3 times more likely to suffer from depression than those aged 12 years (Huang & Fang 2015). According to the same organization, in 2011, 1.4 million girls in the 12-17 age bracket in the US reported having experienced depressive episodes. Lesser boys reported having experienced such an episode. Major risk factors for young adults’ depression are chronic illness, contact with distress in childhood, family past depression conditions, and/or nervousness. Although Gallerani, Garber, and Martin (2010) reveal that the US has been experiencing increasing adolescent depressions, the article fails to provide comparative data, which is necessary for determining the trend of changes over the last one or two decades.
Suicidal cases associated with depression among adolescents may demonstrate variations in depression among adolescents. Scholars find many of the suicides that are successful as having been instigated by multiple factors, including psychological, family, biological, social, and cognitive elements. This situation also constitutes the risk factors for depression as identified by Gallerani, Garber, and Martin (2010). The prevalence of adolescent suicides also appears as largely unbalanced on the gender and age demographic factors in the US. For instance, the Centre for Disease Control and Prevention (2012, Para. 10) posits, ‘of the reported suicides in the 10 to 24 age group, 81% of the deaths are males while 19% are females’.
However, the same source observes that girls are more likely to attempt suicide compared to boys. Suicide-associated fatalities are also more prevalent among Native American youths (Centre for Disease Control and Prevention 2012). Similar to the high prevalence levels of depression among girls, its associated severe consequences of suicidal attempts also have a high prevalence level among girls. However, from the Centre for Disease Control and Prevention (2012) data, fewer girls than boys actually commit suicide.
Scholarly attempts have been to explain the high rates of depression among adolescents. For example, Eszter and Balazs (2013) together with Abela and Hankin (2011) claim that teenagers may experience inadequacies in their school performance or changes in their sexual orientations as they grow up. Peer social status may also undergo consistent changes. This situation may cause changes in the way teens to see themselves, hence leading to depression. The literature on teenage depression shows an increasing rate over the last 5 decades. Such an increase is founded on identified depressive disorders based on the DSM-IV criteria. Eszter and Balazs (2013) amplify this situation by claiming that symptoms of depression among adolescents have been increasing over the years with many adolescents having them, but not meeting thresholds of the DSM-IV.
Eszter and Balazs (2013) review literature from 27 studies on sub-threshold depression (SD) in adolescents. The article mainly focuses on sD occurrence, the eminence of life, the threat of suffering from Major Depressive Episode (MDE), and the programs that target adolescents with sD. In the research, ‘A systematic literature search is done from the year of the introduction of Diagnostic and Statistic Manual for Mental Disorders Fourth Edition (DSM-IV) until 2012 (18 years) with a special focus on adolescent sD’ (Eszter & Balazs 2013, p.590). The study finds a high prevalence level of sD among teenagers. The indication is that sD acts as a major risk factor for developing MDE. The researchers also note that MDE leads to low-quality lives among young adults.
Young et al. (2012) suggest that high prevalence levels of depression among young people may not necessarily indicate that adolescents are the most depressed groups of people. Young people admit having encountered depressive episodes more frequently than other groups of people. Such people grow in an environment that can be associated with this high expectation on them. Therefore, individual failures are a worry to young people, especially when there are a set of anticipations for them to achieve to prove their importance to families and peer groups attached to them. Young et al. (2012) quote a survey by Harris Interactive that was done on behalf of the American Psychological Association.
The 2012 study involved 2020 respondents. It indicated decreasing depression levels among young adults in the US by 4% compared to 2010 when it was 24%. The researchers also indicate decreasing unhealthy ways of coping with depression and anxieties from 2008 to 2012. According to the researcher, 34% of young adults took meals to eliminate depression in 2010 compared to 25% in 2012 while 18% drunk alcohol to lessen depression in 2010 compared to 13% in 2012 (Young et al. 2012).
About one in every four to five youths experiences mental disorders by the age of 18 years. This finding indicates serious health impairments (Merikangas et al. 2010). Using a sample of young adults drawn from 13-18 years, the researcher found that 1 in 3 adolescents suffered from anxiety disorders while 14% reported depressive episodes. Suldo, Thalji, and Ferron (2011) confirm that mental health disorders, including depression, relate to underachievement in education, early parenthood, risky sexual behaviors, suicide attempts, and poor familial associations. Indeed, Centres for Disease Control (2014) reports suicide as the most serious effect of depression, taking third place in the list of leading causes of deaths among 10-24-year-old young adults.
Young and Dietrich (2015) conducted research with the objective of examining mechanisms that predict depression and anxiety symptoms with the aim of identifying risk factors that can be modified to promote health among teenagers. The research drew its sample from 11-15-year-old adolescents. After making adjustments for various baseline values, issues such as raising stress increased worry, and rumination predicted depressive symptoms. Young and Dietrich (2015) recommended the creation of programs for addressing these factors to manage depression among young adults.
Considering the seriousness of the problem of depression among adolescents, the question of how successful depression management among young adults can be achieved has been a major concern for healthcare providers. One of the solutions to this query rests on the CBT. Spirito, Wolf, and Uhl (2011, p. 191) assert, ‘cognitive-Behavioural Therapy (CBT) has been the most widely researched psychotherapy approach to treating depression in adolescents’. The CBT intervention for depression among adolescents emphasizes two approaches, namely behavioral and cognitive facets of care.
Spirito, Wolf, and Uhl (2011) assert that the behavioral element of depression management emphasizes several strategies that can boost the situation. The strategies include survival tactics, interpersonal associations, communal problem resolution mechanisms, and contribution in enjoyable deeds. The cognitive facet focuses on the process of identifying and challenging the teenager’s schemas, cognitive deformation, and processes of involuntary judgment.
Ethical Considerations
Ethics prescribes certain ways of doing things. In any research, ethics involves the evaluation of standards that need to be observed in the study process. Scientific research leads to the development of theories that can inform practice to yield evidence-based approaches to mitigating certain societal problems. Thus, it is unethical to modify data to meet the needs of a researcher. Consideration of ethical issues in the current research can be demonstrated by the use of reliable sources of data such as the CDC and peer-reviewed journal articles. Such materials are not based on personal opinions and affiliations of their authors. Therefore, the sources can be used to help a researcher in the identification of the missing gaps in a given body of knowledge to inform future research. The goal is to derive an evidence-based approach to handling a given problem such as depression that influences different population segments.
Conclusion
Teenagers experience various physical, psychological, and even social changes in the process of their development. High pressures from peer groups and their families may accompany this condition, especially if the underlying forces push the teenagers towards meeting certain life expectations, including educational attainment. Poor performance in these expectations may lead to mood swings, which result in depression. Through the literature review of data from CDC and peer-reviewed articles, the paper finds limited data on the variation of depression among teenagers over the last 10 to 30 years.
The limited data indicate increasing cases of depression among adolescents in many samples used by many of the researchers. This finding nullified the first hypothesis. The second hypothesis could not be confirmed due to a lack of sufficient data on the relationship between depression and the severe consequences of young adults’ suicide over 10 to 20 years ago. Therefore, a research opportunity exists in relating these variables, considering that suicide takes the third position in the list of leading causes of young adults’ deaths in the US.
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