Abstract
In the recent years, a very strong correlation between depression, perfectionism and rumination has been established among the adolescent populations. Both genders have a tendency to get affected by these; however, the girls exhibit this tendency to a higher degree. The perfectionist attitude usually takes form of physical control over eating habits and body shape, and the development of various eating disorders can take place. Suicide ideation in such children has led to a higher number of suicides committed each year. Rumination has become one of the chief contributors to this problem. The correct identification of the problem is essential to prevent suicidal incidences in these children.
Introduction
It is a sad fact that depression is becoming a prevalent problem in younger age groups. This rise in the incidence is leading to new strategies being implemented for the treatment of depression afflicted individuals and identifying the various factors that may be contributing towards such trends. Depression among adolescents is all the more concerning due to the various physical manifestations that it can take form of. Children may develop personality disorders, eating disorders, or self harm tendencies. Addiction and alcoholism are also increasing especially in the UK. These and many of such findings point to the importance of understanding the underlying reasons which may be affecting the minds of children and adolescents, and how these can be tackled with.
Depression
Depression in the psychological sense displays the overall depression of the normal behavior of a person, and a depression in the ability of that person to respond normally to various circumstances in one’s life. This inability to socialize and carry out daily activities on normal basis may isolate such individuals, and the person may feel inferior, scared, isolated, misunderstood, and may even be avoided by his or her peers. (BPS, 2005) There are many manifestations and representations of depression, however, all of these represent the presence of sadness which is beyond the normal time frames of a normal sadness process. Depression and its manifestations may be different according to the age and sex of the person, therefore, men and women may show different methods of depression expression.
Children may display very different sets of behave when they suffer from depression. Such children are more likely to feel physically unwell too, and they may be a common presentation in the medical clinics with symptom less illnesses and aches. (BPS, 2005)
From a child’s perspective, there are two main environments that determine and even predict the likeliness of depression. These are the home and the school and peer environments. Children with problems at home, or who are exposed to substance abuse and violence in family or siblings are most likely to suffer from depression. Similarly, children who are unable to perform well in the academics, or are not able to make social relationships with their peers are very likely to become depressed. Academically challenged children such as those with learning disabilities are also likely to undergo depression. Correct and early diagnosis of children with such problems is essential in treating them and in preventing the progression of the depression in to adulthood. (BPS, 2005)
The recent increase of attention on the issue of depression is because of the increased rates of suicide that are being reported all around the world among the adolescents. Among the children between the ages 15 and 19, suicide has become the lead killer, leaving behind even cancer and heart conditions. (McClean, 2003) This increase has been attributed to the increase in depression among young adults, which is reaching the average of 16 per 100, 000. (McClean, 2003)
Adolescence for many teenagers is a very significant time due to the many changes that are taking place physically, mentally, and emotionally. Among other changes are included “separation and individuation from family, identity formation and cultural socialization” (McCauley, 2000) When combined with other changes that may be taking place in the person’s life, the child may feel more confused about his or her identity. Depending on the gender, the self esteem may increase or decrease considerably. This is probably the reason why girls feel more depressed or vulnerable compared to boys when entering this phase. The physical changes and the changes in the neuroendocrine system may also be a significant contributor in the development of depression in girls, but the role of changing cognitive function is also a factor to be taken into consideration. (McCauley, nd) Issues such as self worth, environmental changes, changing personal relationships with parents, family and friends, and lack of understanding about the changes taking place within self may also increase tendencies towards depression. The time of adolescence therefore is a very significant event in a child’s life, and may hold important bearings on the future outcomes. (McCauley, 2000)
Perfectionism
Many definitions of perfectionism have been stated to define a condition where a person is interested in achieving perfection in every aspect of life, and is constantly unhappy with any achievement or any aspect of life. Perfectionism is therefore a person’s perception of achieving the highest state in any area of life. While this attitude may be promoted in many areas of life, a personal obsession with it can be very demanding on the person’s life, his or her expectations and happiness, and consequently the content level with life. It is therefore a negative trait and in combination with other conditions such depression or obsessive behavior may become highly damaging to the person. (Kobori, 2005)
Such people are in the habit of setting extremely high standards in life, which may be impossible for them as well as others to fill. The inability of others to come up to such expectations may be very disappointing to such people, with the result that the person may feel depressed and isolated. Again the inability to meet one’s own standards may be a very traumatic incident for the person, and he or she may then display various forms of behavior that are not in accordance with a normal personality behavior. (Kobori, 2005)
A child or a teenager with a perfectionist attitude is more likely to be aggressive in his or her outlook, and have a higher tendency towards impulsive and rash behavior. The problem with this trait is that it is made by the self or may be implied by an external source. In children and adolescents, this perfectionism is usually the reflection of the parent’s wishes for perfection. Such children may require too much from themselves, and may not recognize their own achievements. Anxiety to perform the best may plague them constantly, and such children may not be able to enjoy even the simple things such as games with friends etc. (Krain, 2004)
Such children may only live to please others or to win the approval of others or themselves. In this regard, they may not appreciate their own positive traits, and may constantly be engaged in criticizing themselves over issues that may not be in their own hands. (Krain, 2004)
The lack of understanding that the parents themselves may be motivating the children to become depressed or have suicidal tendencies is very difficult to explain. The parents consider their simple wish for the child to perform the best as in the best interest of the child, but the child may be feeling constantly pressurized into delivering something that he or she may not be able to. Such children therefore feel constantly threatened of failure, and negativity can continue to increase with time. (Krain, 2004)
It is not difficult to understand the relation between perfectionism and food disorders in children. When teenagers feel loss of control in other areas of their life, they are more likely to try to gain that control by controlling their eating habits, and by losing weight. (Harris et al, 2004)
The figure ideation becomes the most common method to vent out the perfectionist attitude developing in such children. Along side depression, the result is the presence of perfectionist attitude, which in order to attain itself resorts the mind to various food eating disorders, and thereby increases the depressive tendencies in the child. This becomes a vicious cycle, whose end may lead to suicide in such children. (Harris et al, 2004)
A distorted body image leads to dislike for cold, irregularities in the menstrual periods, various forms of malnutrition due to lack of diet, and constant skipping of meals to avoid gaining weight. Girls are more likely to take up smoking in order to reduce their weight. (Harris et al, 2004) so long as the ideation for a perfect figure remains, the child, especially the girls will continue to have depression and suicide ideation among other problems.
Rumination
In the psychological terms, rumination means the constant meditation of a person over one particular thought. This is akin to re-chewing of a mental food again and again which can emphasize certain negative factors in the thinking patterns. This in turn can lead to increase in the negative behavior. In the depressed person, this may lead to exaggeration and increase in the depressive symptoms. There are many problems that such patients can face due to their condition. For example, the decision making capacity can be severely impaired, and the person may find it very difficult to take a decision in due course of time. With delayed decision making power, the person may feel lack of confidence regarding his or her decision making power, thus increasing the depressive state. Simply put, rumination is thinking too much about various simple things in life. (HealthPsyche, 2006)
The link of rumination in depression is significant because such patients are very likely to develop depression than those who do not ruminate. The tendency can be as high as four times as non ruminators, which is therefore very diagnostic for depressive patients or those with tendency towards depression. The cycle of rumination starts to take place very commonly among those who have had previous history of traumatic experiences, are stressed or perceive that they are stressed, or suffer from other psychological conditions such as perfectionism or neuroticism etc. (Law, 2005) Other symptoms and problems include “negative inferential or attributional styles, dysfunctional attitudes, hopelessness, pessimism, self-criticism, low mastery, dependency, sociotropy and neediness. (Hoeksema and Wisco, nd, pp 3)
Rumination helps in propagation of depression as it causes increased focus towards the negative events and factors instead of looking for ways to distract the mind and thereby cope with such situations. Dysphoria is also a very common feature found in people who ruminate. (Richmond et al, 2001) Other cognitive abnormalities found in patients with rumination include “maladaptive cognitive styles, including negative inferential or attributional styles, dysfunctional attitudes, hopelessness, pessimism, self criticism, low mastery, dependency, sociotropy, neediness, and neuroticism” (Hoeksema and Wisco, nd) Revenge and spiteful behavior is likely to develop, and thereby the adolescent may start considering various forms of physical damages to self. Binge drinking, alcoholism and other addictive behaviors are very likely to take place in such children, and the level of severity is very likely to predict the level of depression that the child may be feeling. Worry and anxiety are not unusual traits found in such children. (Hoeksema and Wisco, nd)
A very interesting finding about rumination and depression has been that girls are more likely to suffer from depression when discussing previous negative experiences with their friends when compared to boys. (Schwyzeron, 2007) While both sexes may develop strengthening of the relationships and thereby improve in their social skills, young girls are more likely to ruminate and therefore feel pessimistic and sad about the various events that take place during this time. The recent trend of focusing on boys and their emotional health shifted somewhat the focus on the need of the girls in this regard. This may have led to closed up and isolated feelings in the girls, which may be a factor contributing to the increased rumination activity in teenage children. These behaviors can lead to various outward forms of expression such as eating problems which are very common in girls, and self hurting activities. (Schwyzeron, 2007)
The above mentioned patterns very clearly show how rumination can lead to depressive states. Alongside negative thinking and losing decision making ability, such people lose social support, which may aggravate depressive symptoms. The person may then show various forms of behavior, and may even resort to various destructive behaviors. The façade that they may present may negate the presence of such symptoms; however a closer inspection may be very helpful in outlining the problems that such people may be suffering from. (Hoeksema and Wisco, nd) The issue in this regard is that the rumination process of thinking may not completely go away in persons with such tendencies, despite changes in the levels of depression. This means that this condition can in the future lead to relapse of depressive states among susceptible patients. While the efforts of correction of the patients with rumination problems may be intense, the inability to identify their problem and how to tackle it in the proper way may be the reason for failure. Rumination feature is most likely to be found in women, however, the number of men suffering from it is also significant. Escapist behaviors in the form of food and eating disorders are a very common pattern. (Hoeksema and Wisco, nd)
The effects of this problem can extend to physical manifestations, and the patients may display various forms and types of pain, which may even lead to physical debilitation. Depending upon the age, the effect of rumination may lead to very serious consequences. In children and adolescents the most common outcome can be self harm and suicide attempts. In elderly people, there is definite association with abnormalities in the body’s immune system. Therefore, it can be assumed that rumination can affect the health of those whose bodies are vulnerable in some way. The strong physical effect on the health of the patient makes it a very important issue to deal with. (Thomsen et al, 2004)
Conclusions
The therapy individuals with multiple psychological conditions such as depression, perfectionism and rumination, must be taken simultaneously as well as individually under consideration when designing a treatment plan. (Law, 2005)
Since there are many contributing factors that cause depression among adolescents, the treatment is primarily based on the identification of those factors. For some, the cause of depression may be only biological, such as genetic vulnerability or the hypersecretion of cortisol and growth hormone. For others, the role of psychosocial stressors may be the more important factor. Therefore the correct identification and rectification accordingly can ensure success in the long term for the adolescent. (McClean, 2003) Rumination is one of the most significant factors seen to contribute towards depression. Other important factors such as perfectionism are also very important in the development of depressive symptoms. (McClean, 2003)
Studies regarding treatment of rumination have shown that such individuals benefit most from various distraction techniques. The main objective in the whole process is to break the cycle of rumination, which can be done by giving people small tasks of decision making. (Law, 2005)
The role of antidepressant drug therapy in the past for adolescent patients was frowned upon. However, there is now increased literature which supports the need for drug therapy in these patients. A combination of psychological therapy maneuvers and anti depressants is more likely to result in success than any of the components alone. (Mayor, 2005)
It is not very hard to understand the role of perfectionism and rumination in the development of depression among young adults and adolescents. With lack of experience in handling and understanding their emotions, and with the new set of changes that take place as the child enter adolescence, many children feel unable to keep up, and therefore may resort to extreme behaviors. The role of family, parents and the various community members in contact with children is important in early identification and rectification of the condition. With the increase in the rates of suicide worldwide, it is a policy that must be advocated in all parts of the globe. It is a very important requirement if we wish to see a healthy and happy future for the youth of today.
References
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