What should a teacher know?
Adolescence is the process of transition between childhood and adulthood. Adolescence might also be seen as a crossroads, where the construction of identity, the search for autonomy, and experiencing novelties can bring about new risks and losses. Given the context of brain maturation and social challenges, most mental disorders start to appear in adolescence, including depression. Depression is notable by virtue of its frequency, severity and risk for suicidal acts.
School is an important arena for identifying and preventing mental health problems. It is common for a teacher to suspect something is wrong when a student's behaviour and academic results change over time. Unfortunately, such changes might be attributed to other causes and a valuable opportunity to intervene may be missed.
Depression in adolescence
The burden of depression is huge: it affects approximately one in four women and one in eight men during their lifetime. According to World Health Organisation, 6.2% of children and adolescents between 9 and 17 years of age suffer from depression, which is more common in females.
Compared with earlier childhood, adolescents often experience an increase in the challenges they are faced with. Such challenges can increase vulnerability to depression, namely parental loss or rejection, social alienation, poverty, academic pressures and parental demands, romantic concerns, fear about one's personal future, social mistreatment and bullying by peers.
Compared with adulthood, adolescents have fewer coping strategies at their disposal. Adolescents are relatively inexperienced in coping with these stressors, and may engage in less adaptive coping strategies.
Depression is not only "feeling unwell"
Depression is more than just temporarily feeling unwell or blue due to a specific cause. It is a medical disorder that needs professional help and it can be treated. Sometimes it is not easy to differentiate between feelings of sadness anyone experiences from time to time and a depressive disorder. The important distinctive features are the personal suffering and the negative impact in social, interpersonal and work life, lasting for more than 2 weeks. Doctors and psychologists will refer to a list of symptoms to assess if a patient meets diagnostic criteria.
If the following features are present, it is likely that some will be depressive symptoms and that the person concerned is suffering from depression:
- Loss of interest and pleasure in previously engaging and preferred activities like getting out with friends, seeing a football match;
- Complaining of chronically being fatigued or without vitality;
- Deteriorating school performance;
- Not managing to focus attention and concentrate in studies;
- Expressions of hopelessness, helplessness and global pessimism;
- Loss of appetite, loss of weight, insomnia or sleeping too much, and loss of interest in sex;
- Experimenting with drugs or abusing them more often than expected;
- Fixating on death and sometimes self-harming behaviours.
These symptoms usually affect several areas. The number of symptoms, as well as their severity, can vary from person to person and over time.
The most important pillars of the treatment for depression are antidepressant medication and psychotherapy. There are other options for specific types of depression or cases that are resistant to regular treatment as well as additional options from different areas (sport, creative activities, diet etc.). Often the best solution will be a combination of several therapy options.