Depression In Adolescents

According to the National Institute of Mental Health, about 11 percent of adolescents have a depressive disorder by age 18. Depression can be a chronic illness or a short term reaction to a life stressor.

Military lifestyle involves more than just deployments. Stress on the family and adolescent can come as a result of many moves, changing schools, leaving friends and community connections, constant training, and separation of the active duty service member. Deployments are not the only stressful part of being in a military family. For adolescents, fitting in with peers in a new duty station may be difficult, therefore possibly increasing the chance of their acting out or decreasing their motivation to make friends or performing well academically.

According to the National Institute of Mental Health, about 11 percent of adolescents have a depressive disorder by age 18. Depression can be a chronic illness or a short term reaction to a life stressor. Sometimes, with the stresses of everyday life, the mood of an adolescent from a military family can be seen as typical teenage behavior, without taking into account the experience of additional risk factors.

Risk factors that may contribute to symptoms of depression:
• Upcoming deployment or homecoming of a parent or sibling
• Frequent separations of active duty service member, including field training or detachments lasting days, weeks, or months
• Health issues (physical, emotional, or mental) for themselves or a family member
• Changes in the role at home (increase in chores or care of sibling)
• Moving due to parent orders to new duty station
• Friends moving, adolescent being “left behind”
• Changing schools (either due to moving, or transition to middle or high school)
• Being a victim of bullying at school or in the neighborhood
• Academic struggles
• Hormones/Puberty
• Changes in the family structure (divorce, re-marriage, new baby)
• Death of a family member or friend
• Trauma (car accident, witness to violence)
• Abuse (physical, emotional, sexual)

Protective factors that increase resilience from experiencing depression:
• Family involvement, which includes providing limits, rules, structure, and monitoring
• Healthy modeling of coping with stress, asking for help, communication, eating, and sleeping by primary caregiver
• Ability to identify and describe emotions
• Effective clinical care for mental, physical and substance use disorders
• Easy access to a variety of clinical interventions
• Support for seeking help
• Strong connections to family
• Community support
• Financial stability of family
• Support through ongoing medical and mental health care relationships
• Skills in problem-solving, conflict resolution and nonviolent handling of disputes
• Participation in extracurricular activities in two or more of the following contexts: school, with peers, in athletics, employment, religion, culture

When monitoring changes in an adolescent’s behavior, it is important to note that not every adolescent will display the same symptoms. These are some of the symptoms to be aware of that may indicate depression:
• Changes in appetite, either eating more or less than usual. Significant weight loss or weight gain. Binge eating, eating unhealthy food or loss of appetite with limited food intake.
• Changes in sleep patterns; sleeping more or less than usual. This could be expressed as sleeping during the day, staying up most of the night, or difficulty getting up in the morning for school or activities.
• Changes in motor activity. Look for slower movements, including increased time getting dressed, or restless energy such as increased fidgeting.
• Fatigue, lack of energy, or being bored. Look for lack of motivation, including not attending previously enjoyed activities or isolating from family or peers.
• Feelings of worthlessness or guilt. Adolescents might express thoughts of not being good enough or guilty for not appreciating what they have. They may take the blame or responsibility for negative events or outcomes.
• Persistent sad or irritable mood. Look for crying more than usual, changes in appearance or clothing choice, or increase in hostility with parents or teachers.
•Frequent vague, non-specific physical complaints. Some adolescents experience frequent stomach aches, headaches, or muscle aches related to depression.
• Frequent absences from school or poor performance in school. This can indicate decrease in motivation and energy or may include behavior problems with teachers or peers.
• Reckless behavior and/or alcohol or substance abuse. Adolescents may use substances to deal with feelings of sadness to numb or forget about their stresses. They may engage in activities that put their physical health at risk due to feelings of guilt or worthlessness.
• Decreased concentration or indecisiveness. This may be expressed as an “I don’t care” attitude by the adolescent in decisions that they usually had an opinion.
• Recurrent thoughts or attempts at self-harm or suicide. Always take this seriously when an adolescent mentions death or self-harm and contact a mental health professional as soon as possible.

If you recognize these symptoms in your adolescent, sometimes knowing what to do next can be a challenge. Try to:
• Open a discussion with the adolescent about changes you have noticed and express your concern. Ask the adolescent what may be contributing to them.
• Contact a primary care physician or insurance for a referral to mental health professionals who specialize in adolescents and understanding of the current military lifestyle.
• Explore multiple treatment interventions including individual or group psychotherapy and/or medication assessments.
• Continue to provide support to the adolescents by listening to their concerns and following up with mental health appointments. Intervention programs available for military families include education and skill development for handling situations unique to military life:

Families Overcoming Under Stress (F.O.C.U.S.) is a family centered approach that is developed from evidenced based research to increase resiliency and decrease risk in military families. The overall purpose of F.O.C.U.S. is to increase the resiliency of the family during a stressful time. Identifying and regulating emotions (anger, sadness, fear, guilt), finding the deployment triggers that increase emotions, communication within the family, problem-solving, and goal-setting are points that need to be focused on during sessions.

The purpose of Operation Purple Camp is to provide connection and social support for children and adolescents in military families. It is designed as a one week camp to promote healthy coping strategies to utilize during deployments.•

Jennifer Woodworth graduated from The Chicago School of Professional Psychology – Irvine Campus – in August 2013 with a doctorate in Applied Clinical Psychology. She is currently a post doctoral fellow at Aurora Behavioral Health Care – San Diego and has worked in the mental health field for six years. She is also a Marine Corps wife of 12 years and mother to three children ages five, seven, and nine.

American Academy of Child and Adolescent Psychiatry – Military Family Resource Center
American Academy of Pediatrics – A Teen’s Personalized Guide for Managing Stress
National Institute of Mental Health
National Military Family Association – 10 Things Military Teens Want You To Know
National Military Family Association – Operation Purple
F.O.C.U.S. Project
Military Mental Health Online Screenings
National Suicide Prevention Hotline
1-800-273-TALK (1-800-273-8255) or TTY: 1-800-799-4889. This hotline is a 24-hour, toll-free suicide prevention service available to anyone in suicidal crisis. You will be routed to the closest possible crisis center in your area. Your call is free and confidential.

Source Exceptional Parent Magazine

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