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Along with many other afflictions, depression is on the rise in adolescence.  By the age of 18, around 11% of adolescence will be effected by depression, and of those, the majority of them are female (Edelman, C., Kudzma, E., Mandle, C., 2014).  Depression is defined as an overwhelming sadness that may or may not include an irritable, angry mood, a loss of interest in the things that used to bring joy (Edelman, C., et. al, 2014).

As healthcare professionals, nurses need to be away of the sometimes-subtle hints that adolescence may use.  The use of certain word should grab your attention, such as: low, sad, blue, worried, stressed, or bored.  Some other signs and symptoms of depression include: change in weight or loss of appetite, fatigue, malaise, insomnia or hypersomnia, a decline in school performance, difficulty with concentration and a loss of interest in things that they used to enjoy (Edelman, C., et. al, 2014).  Some contributing factors of depression in adolescence may be: biological chemistry imbalance, hormone imbalance, inherited traits, childhood trauma's or abuse, and learned patterns of negative self-talk (Jarvis, 2012).

There are three different approaches of intervention or prevention that can be taken with adolescent depression, Primary, secondary, and tertiary interventions.  In the primary level, the focus of intervention of depression should be building on foundational strengths and encouraging, informing and educating the adolescent through this difficult stage of their lives ("Children's Mental Health Project.", n.d.).  In the secondary stage, the problems of depression are starting to show and behaviors are starting to change.  The level of prevention in the secondary stage may require more outside influence to help.  The tertiary level of treatment is when treatment of the depression is necessary and will usually require professional help.  In some cases, the legal system or the state must step in when it comes to safety of the adolescent ("Children's Mental Health Project.", n.d.).

 A nursing intervention that I have done before with an adolescent that was too depressed and questionably suicidal, was to get our social worker involved.  I felt that the patient was too acute to discharge home and I felt that she would not be safe.  I notified he Dr. and he put in an order for a mental health consult with our psychiatric nurse.  That nurse also felt that the patient would not be safe and notified the doctor who promptly put the patient on a 24-hour hold.  The police were then dispatched so that they could do the appropriate paperwork that starts the legal process.

 A couple of the few resources that Idaho has is the 2-1-1 CareLine (http://211.idaho.gov/) and the Idaho Department of Health and Welfare (http://healthandwelfare.idaho.gov/).  There are a couple local shelters but they would not be of much assistance.  There are only two local psychiatric hospitals in the area and they are continuously full.  Idaho is lacking extremely far behind in mental health resources, unless you have good insurance, your chances of getting the help you need is slim.

Resources

"Children's Mental Health Project." Graduate Modules | Children's Mental Health Project | University of Calgary. University of Calgary, n.d. Web. 16 Jan. 2017.

Edelman, C., Kudzma, E., Mandle, C. (2014). Health Promotion Throughout the Life Span (8th Edition). St. Louis, MO: Mosby Elsevier.

 Jarvis, C. (2012). Physical examination and health assessment (7th ed.). Philadelphia: W. B. Saunders.

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