ADOLESCENCE Depression and suicide,

Depression and suicide,

What is depression;
·      Major depressive disorder, depressed mood/irritability and/or anhedonia, reduced interest or pleasure in all or most activities.
·      Sleep or appetite disturbance.
·      Recurrent thought of death and suicide.
·      Decreased energy/psychomotor agitation.
·      Difficulties concentrating/making decisions.
·      Hopelessness.
·      Feelings of worthless or guilty.
·      Symptoms which ocur together, persist for at least two weeks anda re associated with a significant loss of ability to function.

Adolescent depression;
·      Extreme sensitivity to rejection of failure.
·      Low self-esteem and feelings of guilt.
·      Frequent complaints of physical illness such as headaches and stomahaches.
·      Frequent absences from school or poor performance in school.
·      Threats or attempts to run away from home.
·      Sad, blue, irritable and/or complaints that nothing is fun anymore.
·      Socially withdrawn
·      Can be suicidal.

Scope of the problem;
·      Mean lenght of episodes: 7 to 9 months.
·      Associated with significant, comorbidity, functional impairment, risk for suicide, substance use.

Prevalence of depression;
·      Children: prevalence range form 1.5 to 2.5%.
·      Lifetime prevalence ( up to age 18 ) 15%-20%.
·      65% of adolescents report some depressive symptoms.

Increasing prevalence;
·      Adults:15-20% rates, 2:1 female to male.
·      Age 11: incidence low, males > females.
·      Age 13: incidence rising, maes = females.
·      Age 15, 18, 21: incidence rising, males < females.

Gender differences;
·      Females tend to ruminate in their depressed mood.
·      Experience more weight-related concerns than do males.
·      Hormonal changes alter vulnerability to depression.

Influences on the development of depression;
·      Genetic influences, greater heritability if the onset of depression occured before 20 years of age, biochemistry, neuroendocrine system.
·      Social-Psychological influences, negative attributional style/cognitive style, parential depression, peer relations.

Social-psychological influences;
·      Negative attributional style and cognitive distortions, an explanatory style in which one blames oeself for negative events and views the causes of events as stable over time and as generalizable across situations.

Parential depression;
·      Heredity.
·      Parental depression may result in poor parenting.
·      Modeling certain ways of thinking and cognitive styles/maladaptive ways of thinking.

Life events associated with depression;
·      Changes in family structure.
·      Changes in school.
·      Poor peer relationships, peer rejection, bullying.
·      Death, illness, accident, or trauma.

Suicide;
·      Most people who are depressed do not commit suicide.
·      But depression increases the risk for suicide or suicide attempts.
·      Suicidal behavior in adloescents is commonly precipitated by events or challenges that the teenager finds too difficult to tolerate.
·      Even things that seem minor to an adult can be major to a young person, who does not have the life experience to put them into perspective or the coping skills that an adult has honed.
·      Problem-solving and self-regulatory skills are not yet well developed.
·      Ability to cope with stressful circumstances develops.
·      Undesirable situations can and often do change!

Facts about suicide;
·      Teen with depression are at particularly high risk for suicide and suicide attempts.
·      While teen girls attempt suicide almost twice as often as teen boys, boysa re more likely to succeed because girls usually use less lethal means and survive the attempt.
·      Approximately one-third of teen who die by suicide have made a previous suicide attempt.
·      Males use more violent means, guns, hanging.
·      Only 33 to 50% were identified by their doctors as having mental illness at the time of their death and only 15 percent of suicide victims were in treatment at the time of their death.
·      Spring and falla re the months of highest risk.
·      A estimated 80% of all those who commit suicide give some warnings of their intentions or mentions their eelings to a friend or family member.

Suicide risk factor;
·      Multiple risk factors.
·      Mental disorders-particularly mood or eating disorders.
·      Feeling of hopelessness.
·      Low self-esteem, self-blame.
·      Substance abuse disorders.
·      Family history of suicide, death a family member or close friend.
·      Impulsive and /or aggressive tendencies.
·      Divorced parents or poor family communication.
·      A history of being exposed to family violence or abuse.
·      Social isolation/alienation, including because of being gay or being bullied.
·      Loss of romantic relationship or goog friendship.
·      Unwanted pregnancy.
·      Poor grades.