Symptoms and Risk factors of children and adolescents with depression

Every sickness, whether it is mental or physical will always have symptoms and risk factors. Symptoms are “a physical or mental feature which is regarded as indicating a condition of disease, particularly such a feature that is apparent to the patient” and risk factors are “a variable associated with an increased risk of disease or infection”. Children and Adolescents may go through things and have symptoms for a disease or illness or even a disorder but they may not know it yet because they are still young and do not understand it just yet. Due to the fact that they are still young and don’t have many things going for them except for school and family so it is easy to spot the symptoms in children and adolescents. 

Many people have a sibling, child, or someone they know that may be depressed or have a mental illness but not know the symptoms or risk factors. It is indeed very sad to have a little child or adolescent depressed and really upset because as you grow older we always want to go back to when we were children where times were easy and there was no stress and all we did was have fun and enjoy life. We thought about it like that because we never really took into consideration the kids or adolescents with depression and hated every minute of their childhood and wished they grew up already or didn’t have to go through any of that. Symptoms can include from an article called ‘Teen Depression’ published by Mayo Clinic that states  “a change from the teenager’s previous attitude and behavior that can cause significant distress and problems at school or home, in social activities, or in other areas of life.

Depression symptoms can vary in severity, but changes in your teen’s emotions and behavior may include the examples below.” (Mayo Clinic, 2018). Children and teenagers also go through emotional and behavioral changes such as “Feelings of sadness which can include crying spells for no apparent reason, Frustration or feelings of anger, even over small matters,Feeling hopeless or empty,Irritable or annoyed mood,Loss of interest or pleasure in usual activities,Loss of interest in, or conflict with, family and friends,Low self-esteem,Feelings of worthlessness or guilt,Fixation on past failures or exaggerated self-blame or self-criticism,Extreme sensitivity to rejection or failure, and the need for excessive reassurance,Trouble thinking, concentrating, making decisions and remembering things,Ongoing sense that life and the future are grim and bleak,Frequent thoughts of death, dying or suicide”(Mayo Clinic, 2018). 

Furthermore, An article called ‘Depression in Children’ by Julian Charles and Mandana Fazeli speak about MDD which is Major depressive disorder and undertreated ir is in ages (5-12) years young.  “Major depressive disorder (MDD) in children (5-12 years of age) is a confronting and serious psychiatric illness. MDD has significant ramifications for the psychosocial development of the child, yet it remains under-recognised and undertreated” (Charles,Fazeli, 2017). MDD in children’s 5-12 years of age is very serious and it is very under-recognized and undertreated because they usually treat it when the kids get older and their MDD gets worse. “Children with MDD have the same core features as adolescents and adults, taking into account the child’s capacities for cognition and language, and developmental stage. Earlier onset of illness is associated with poorer outcomes and greater psychiatric morbidity persisting into adulthood. MDD is more common than anticipated, and should be considered for any child presenting with depressive symptoms and/or impaired psychosocial functioning. Despite limited evidence, numerous interventions exist that will, ideally, significantly affect the child’s developmental trajectory” (Charles,Fazeli, 2017). When children are diagnosed with MDD, it has the same features and symptoms as an adult. 

Finally, a main role/factor in depression is gender, depressive symptoms are more common in females than males. An article called ‘Gender Issues’ ‘ by Sophie Grigoriadis and Gail Erlick Robinson and talks about how and why women’s estrogen and menstruation cycle makes them more emotionally invested and care deeper and why they tend to have depressive symptoms. “The incidence, notably in girls, rises sharply after puberty and, by the end of adolescence, the 1 year prevalence rate exceeds 4%”(Thapar, Collishaw, Pine, Thapar, 2012). Females tend to be more emotionally invested and care deeper about any subject, especially by the end of adolescence. Another reason why depressive symptoms are more common in females is “ Women more often have a seasonal component, anxious and atypical depression. Explanations for the differences include psychological, neurochemical, anatomic, hormonal, genetic, and personality factors. Gender differences in antidepressant treatment response have not been found consistently. Hormonal status may be an important variable in addition to the effects of the menstrual cycle, pregnancy, perimenopause and menopause” (Grigoriadis, Robinson, 2007). It is explained why Women experience depressive symptoms because they are more emotional and go through more pain for example with their menstrual cycle and hormones.

More risk factors of depression in young children and adolescence but mostly adolescents include the association of cannabis.  There are studies that question if cannabis is not only a risk to depression but also anxiety and suicidality. In this article called “Association of Cannabis Use in Adolescence and Risk of Depression, Anxiety, and Suicidality in Young Adulthood” by Gabriella Gobbi, M  and includes a study that 23,317 individuals participated in, adolescent cannabis use was related with increased risk of creating depression and suicidal conduct further down the road, even without a premorbid condition. This basically means that Preadolescents and adolescents should try not to consume/use cannabis as use of it is related with a huge increased danger of developing depression or suicidality in youths’ life. In the article it states that “Cannabis is the most commonly used drug of abuse by adolescents in the world. While the impact of adolescent cannabis use on the development of psychosis has been investigated in depth, little is known about the impact of cannabis use on mood and suicidality in young adulthood.”(Gabriella Gobbi, M.,2019). To further explain this quote it is saying that the drug that goes by “Cannabis” is very commonly used and abused by adolescents. These young kids use this substance because of many reasons, it can vary from peer pressure to stress, to even relief from mental condition and think it is harmless and do not know the true effects of it. Even though little is known about how cannabis has effects on mood and suicidality, The high commonness of adolescents consuming cannabis creates an enormous number of young kids who could develop depression and suicidality due to cannabis. To go further into the study of the Association of Cannabis use in adolescents, the study selection was assessing “cannabis use in adolescents younger than 18 years (at least 1 assessment point) and then ascertaining development of depression in young adulthood (age 18 to 32 years) were selected, and odds ratios (OR) adjusted for the presence of baseline depression and/or anxiety and/or suicidality were extracted”. FInally to conclude this study and although individual-level risk remains moderate to low and results from this study, There is still a high prevalence of adolescents who consume cannabis and still could develop depression and suicidality due to cannabis.  More studies showing the symptoms of depression in young children and adolescence, these studies mainly show and discuss what type of support is needed for this age group, by way of illustration is this article from Sage Journals “Social Support Seeking and Early Adolescent Depression and Anxiety Symptoms: The Moderating Role of Rumination” written by Clorinda E. Vélez, Elizabeth D. Krause, Allison McKinnon, Steven M. Brunwasser, Derek R. Freres, Rachel M. Abenavoli, and Jane E. Gillham, , studies the “social support seeking and rumination interacted to predict depression and anxiety symptoms 6 months later in early adolescents” (Vélez, et al, 2016). This article addresses the inconsistencies within previous “social support literature”(Vélez, et al, 2016) with addressing cognitive risk factors such as rumination and how different levels of rumination are associated with the level of success when seeking help. As they found that adolescents found more help when they were getting emotionally based help rather than problem based, to be specific the article stated “results were stronger for emotion-focused than problem-focused support seeking and for depression compared with anxiety symptoms” (Vélez, et al, 2016). This quote shows that emotionally focused help seeking is what is needed for adolescents when they are seeking help for their depression, which is not something mentioned within other “social support literature”(Vélez, et al, 2016). The article continues to state that “social support seeking predicted fewer symptoms of depression and anxiety at low rumination levels but was not associated with benefits as rumination increased” (Vélez, et al, 2016). This quote indicates that cognitive risk factors such as rumination is vital when it comes to adolescents when seeking help. As adolescents need a lower level of rumination to actually see benefits. Adolescents deserve to be listened to when it comes to what style of help they need, especially when it comes to their depression and anxiety. Not all individuals are the same but other articles need to be able to recognize the needs of young children and adolescents.

References 

Charles J, Fazeli M. Depression in children. Aust Fam Physician. 2017 Dec;46(12):901-907. PMID: 29464226.

Clorinda E. Vélez, E. (n.d.). Social Support Seeking and Early Adolescent Depression and Anxiety Symptoms: The Moderating Role of Rumination – Clorinda E. Vélez, Elizabeth D. Krause, Allison McKinnon, Steven M. Brunwasser, Derek R. Freres, Rachel M. Abenavoli, Jane E. Gillham, 2016. Retrieved November 03, 2020, from https://journals.sagepub.com/doi/abs/10.1177/0272431615594460

Gabriella Gobbi, M. (2019, April 01). Cannabis Use in Adolescence and Risk of Depression, Anxiety, and Suicidality in Young Adulthood. Retrieved November 03, 2020, from https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2723657

Grigoriadis S, Robinson GE. Gender issues in depression. Ann Clin Psychiatry. 2007 Oct-Dec;19(4):247-55. doi: 10.1080/10401230701653294. PMID: 18058282.

Teen depression. (2018, November 16). Retrieved October 28, 2020, from https://www.mayoclinic.org/diseases-conditions/teen-depression/symptoms-causes/syc-20350985

Thapar A, Collishaw S, Pine DS, Thapar AK. Depression in adolescence. Lancet. 2012 Mar 17;379(9820):1056-67. doi: 10.1016/S0140-6736(11)60871-4. Epub 2012 Feb 2. PMID: 22305766; PMCID: PMC3488279.

Wesselhoeft RT. Childhood depressive disorders. Dan Med J. 2016 Oct;63(10):B5290. PMID: 27697136.