Adolescents

The transition period between childhood and adulthood – a time when personal identity and social understanding accompanies physical and emotional changes that are so rapid they are aptly called ‘growing pains’. The last time a similar phase of development occurred was in toddlerhood, when their brain developed sufficiently to distinguish themselves as an individual independent from their parent. The toddler tantrum is not unlike adolescent demands; while toddlers focus on “I want” as a way of evidencing their individuality, the adolescent catch cry is “Why not!?”. These words usher in a period of uncertainty, challenge and erratic behaviour.

But there is no one path for adolescent development – every individual changes at their own pace and time and in their own context.

At a time when developmental, social and personal challenges are at their greatest, it is no wonder so many teenagers succumb to the stresses. Adolescents are often hypersensitive observers of the physical and social development of themselves and their peers. The impact of these comparisons on their own self-image and identity will heavily influence the satisfaction they feel in their daily life, compounding into adulthood.

The physiological changes (such as changes in appearance and hormonal changes) as well as the emotional rollercoaster and the development of morals and abstract thinking capabilities drive the adolescent to reconstruct relationships in new and meaningful ways. The pressure on adolescents to manage this period well is only magnified by the media’s simplified, romanticised and skewed portrayal of “successful” adolescents and adults. Parents find themselves dealing with a shift from the inquisitive ‘why?’ of childhood years to the demanding ‘why not?’ in adolescence.

Identity clarification – especially sexual identity – is the paramount psychological task for adolescents. The first task of adolescence is the discovery of ‘self’ – I am a person with my own mind, my own heart, my own personality. Then there is the discovery of freedom and the responsibilities that come with it – I am autonomous, free to take my life in the direction I want to. Finally there is the establishment of values and beliefs that will take them throughout their life. Professor David Isaacs proposed that until adolescents effectively develop these commitments they do not leave this phase of life.

While the doors to the wider social world are opening, and the adolescent has a glimpse, their egocentricity and limited experience make the transition a challenge not only for themselves, but also for those who love and care for them. It is also at this point that many biologically-influenced psychological issues begin to be identified. These include depression.

Sadness, discouragement, pessimism, and a sense of hopelessness are emotions experienced by all people at one point or another. In children and adolescents, depression often appears more as irritability and a diffuse anger, rather than the sadness we normally think of when we hear about ‘depression’. For most adolescents and adults alike, the experience is short-lived. Research shows that normal mild depression lasts long enough to ‘adapt’ to new situations (e.g. after the death of a loved one). This capacity to experience depression is beneficial. However, when the experience persists, invading daily life and impacting on the capacity to continue functioning as well as usual, then it is time to act. The need to seek help is even more important in adolescents, as depression left untreated during this intense period of growth can hinder the acquisition of skills and development in areas that pave the way for sustained, healthy adult functioning.

Mood disorders (of which depression is one) are complex, invasive variations of our regular mood patterns. The complexity usually varies on three dimensions – severity, type (up or down), and duration. The common thread is extremes of emotion.

Major Depressive Disorder (Depression)

Major Depressive Disorder (Depression) is a Mood Disorder experienced by approximately 10% of the general population at some stage. While 39% of boys and 55.6% of girls between the ages of 12 and 16yrs report experiences of depressive symptoms including negative feelings about the future, bouts of sadness or anger, changes in sleep and eating patterns, and negativity about themselves.

An episode is characterized by at least two week of loss of interest or pleasure in most activities. The mood may be irritable rather than sad and is accompanied by changes in appetite or weight, sleep, activity levels, as well as decreased energy, fatigue, feelings of worthlessness or guilt, difficulties thinking or concentrating, or recurrent thoughts of death or suicide.

It is important to attend to these symptoms and not to put them down to “hormonal adolescence”. While each of these characteristics may be present at any one time in regular development, a combined pattern is a sign of more pressing issues.

Other mood disorders

  • Depressive & Bipolar Disorders

  • Eating disorders – anorexia and bulimia

  • Disruptive behaviour disorders

  • Anxiety disorders

  • Substance related disorders

  • Attention Deficit Disorders

  • Phobias

Psychological conditions reflected through physical symptoms

  • Somatoform Disorders

  • Personality Disorders

One person’s experience

Maddie has had a comparatively settled life. Her parents owned a small business which has provided well for the family, until her father found the pressure too much and was hospitalised following a ‘break down’ when she was 13. Since then he has returned to work for someone else and the family has settled into a new routine.

Maddie wants to do well, her parents think a good education is important and have encouraged and supported her desires to go on to tertiary studies.

But lately Maddie has felt that it doesn’t matter what she does she can’t get the grades. She can’t write the way the teachers want, she can’t figure it out, she can’t think straight, she feels dumb. She’s been feeling tired and lethargic which she puts down to studying late at night.

Her mother has noticed that she often withdraws to her room to listen to music that ‘makes her sad’, but when she tries to talk to her about it, through her tears Maddie tells her mother she’s OK.

At other times Maddie gets as angry as hell over things – like the time her parents wouldn’t let her go to town to meet her friends on Friday night. She fumed over that for months and every chance she got she let her parents know she felt they didn’t trust her, before she burst into tears and ran off.

Her boyfriend also wants to go on to tertiary study, and he’ll get there for sure. Maddie worries about this because she thinks that he will meet someone better than her and she’ll be alone.

She’s tried to talk to her teachers but they tell her she’ll be all right and to get more rest. Her friends are getting sick of her being ‘down’ and told her to get a grip. Even her boyfriend is starting to wonder about their relationship. Maddie feels like nothing can make it better.

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