The adolescent population is at risk for depression at any time. Factors that may increase their risk are family history of depression, history of an anxiety or learning disorder, history of a recent loss, or a history of depression. For most adolescents these presents as being sad but for some this may go beyond giving concern to the parent and/or healthcare worker. (American Academy, 2014)
Direct questions by the nurse to the adolescent are preferred, even if they may be considered sensitive, such as being sexually active, depression, or even suicide. Most adolescents prefer and are responsive to this manner of questioning. Inquiring about the activity of their peers, such as drinking, drugs or other risky behavior, can be beneficial as depression is associated with the high risk behavior of their peers as well as themselves.( American Academy 2014) Knowing the signs of regular sadness as opposed to depression are essential for the nurse when completing the assessment.
According to the NIMH, intense sadness, hopelessness, anger or frustration that lasts for weeks or months is considered depression. It may interfere with your regular activities, ability to focus, or energy to get through the day. Most every day they may feel sad, hopeless, empty, angry, frustrated and cranky. They may have weight changes, changes in sleep patterns, move or talk more slowly, have trouble remembering information or making decisions and may even think about dying or contemplate suicide. (NIMH)
Prevention of the disease or behavior is always related to Primary health promotion. (Edelman & Mandle, 2014) This begins with educating parents on ways to build and maintain a positive relationship with their teen. Strong unconditional support can help prevent depression:
Set aside time to talk
Encourage expression of feelings
Praise strengths
Offer positive feedback for positive behavior
Respond to teen anger with calmness
Foster friendships, encourage physical activity, promote good sleep, and monitor screen time. The most important is to get help early. (Mayo Clinic, 2015)
Secondary Prevention is to prevent progression of the depression and is initiated when there are signs observed be the clinician or parent (Edelman & Mandle, 2014). The parent needs to be open with concerns to the healthcare worker. The healthcare worker needs to be receptive to parental concerns and provide support. The healthcare worker needs to be thorough in the health assessment and refer to a child psychiatrist or psychologist for treatment (American Academy, 2014).
Tertiary health promotion is the care that is provided once the depression already exists to provide treatment in order to maximize quality of life. (Edelman & Mandle, 2014).Treatment may consist of individual, family, or group therapy. Some of the common effective ways to treat are Psychotherapy, cognitive-behavioral therapy, interpersonal therapy, and medication may need to be subscribed to help the teen feel better (MHA).
When utilizing national resources one may refer to the quick link to the Child and Adolescent Psychiatrist Finder found on the American Academy of Child & Adolescent Psychiatry (AACAP) website, https://www.aacap.org . At the state level there is a Texas Youth Help Hotline that the teen or parent can call for help and guidance. Recourses in your area to receive car can also be provided. This site is available 24 hours a day.
https://www.dfps.state.tx.us/Youth_Hotline/.
The nurse is instrumental in assessing for possible depression in teens. The nurse must be non-judgmental, listen intently, watch for signs, engage in direct positive communication and provide resources, referrals as needed. Teenage depression is on the rise and can lead to destructive outcomes and even suicide if not caught early.
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