Five common Mental Health Issues Affecting Teens

First things first, what is teenage? According to the general definition teenage refers to the age group starting from 13 years to about 19 years, but is it really just that? I’m sure all of us who have been through teenage will agree with me if I claim that it is a lot more than just that and we will all definitely have our own very unique experiences of teenage. But one thing is common for all teenagers and that is ‘Transformation’, a lot is changing, the body, the mind and with all the change and chaos going on inside the teen, there is no escaping the pressure from all aspects of life be it the society, academics, family or peer groups.

According to psychologist Erik Homburger Erikson (1902-1994), this period is primarily the period of ‘Identity vs Role confusion’, that is the fifth stage in his renowned theory of psychosocial development. The teens are primarily struggling to establish their individual identity at this stage, in essence, the teens are troubled about questions like “who am I?”, “What is my purpose in life?” and the likes. Erikson saw this stage as a stage of confusion and discovery and exploration. Another crucial aspect of defining this stage is ‘Psychological Moratorium.’ Now, what is that? According to American Psychological Association (APA), a moratorium in Erik Erikson’s theory of psychosocial development is the experimental period of adolescence in which, during the task of discovering who one is as an individual separate from family of origin and as part of the broader social context, young people try out alternative roles before making permanent commitments to an identity. Adolescents/teens who are unsuccessful at negotiating this stage risk confusion over their role in life.

Now, it is quite obvious that with so much mental and physical turmoil going on in a teen’s life, he/she is at a high risk of experiencing issues related to mental health. An estimated 10–20% of adolescents globally experience mental health conditions, yet these remain underdiagnosed and undertreated. Mental health conditions account for 16% of the global burden of disease and injury in people aged 10–19 years. Half of all mental health conditions start by 14 years of age but most cases are undetected and untreated. The consequences of not addressing adolescent mental health conditions extend to adulthood, impairing both physical and mental health and limiting opportunities to lead fulfilling lives as adults; as stated by the World Health Organization (WHO) till August 23, 2019.

Lets then try and have a deeper look into some of the most common mental health issues faced by teenagers.

 

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Depression (Major depressive disorder/unipolar depression/clinical depression)

One of the most common mental illness faced by teenagers, or if I may call it so, “the elephant in the room.” So many teens have lost their lives to this silent killer of an illness. Globally, depression is one of the leading causes of illness and disability among adolescents (World Health Organization).

What is Depression?

It is a type of mood disorder, the most common form of mood disturbance, involving a depressive episode, in which a person is markedly depressed or loses interest in formerly pleasurable activities which is also known as anhedonia (or both) for at least 2 weeks, as well as other symptoms such as changes in sleep or appetite, or feelings of worthlessness. Teens suffering from depression find it difficult or sometimes even impossible to keep up with the day to day activities like studying, eating or maintaining hygiene; the smallest appearing errand could be a herculean task for someone with depression, sometimes even getting out of the bed is a task.

The quality of sleep is also poor, but it can differ from person to person, some people tend to oversleep while certain others experience insomnia or inability to sleep. In the worst cases, individuals might develop suicidal ideations and no will to live. Depression, if not taken care of, can prove fatal.

The good news is that depression can be treated.

The treatments include:

• Pharmacotherapy: Antidepressant, mood-stabilizing, and antipsychotic drugs are all used in the treatment of unipolar depression, to name a few; monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs).
• Alternative Biological Therapy includes electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), deep brain stimulation, bright light therapy.
• Psychotherapy: Cognitive behavioural therapy (CBT) and behavioural activation therapy are the most commonly applied psychotherapies to treat unipolar depression.

[Source: Abnormal Psychology, Global Edition by Butcher, James Neal Hooley, Jill M. Mineka, Susan Nock, Matthew K]

 

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Anxiety

Anxiety is an emotion characterized by feelings of tension, worried thoughts and physical changes like increased blood pressure; American Psychological Association.

At the cognitive/subjective level, anxiety involves the negative mood, worry about possible future threats or danger, self-preoccupation, and a sense of being unable to predict the future threat or to control it if it occurs. At a physiological level, anxiety often creates a state of tension and chronic overarousal, which may reflect risk assessment and readiness for dealing with danger should it occur.

Anxiety disorders are the most frequent mental disorders encountered in childhood and adolescent years. Among all mental health disorders, anxiety disorders are the most frequent disorders in children and adolescents affecting almost 7% of them worldwide. In an epidemiological study from India, 14.5% of adolescents were found to be suffering from anxiety disorders. Within India, a limited number of epidemiological studies have been done in this area [Indian Journal of Community Medicine].

There are various types of anxiety disorders such as: such as phobias, social anxiety disorder or social phobia and generalized anxiety disorder (GAD), which is the most common type of anxiety disorder.

Treatment is available for anxiety disorders in the form of medications and psychotherapy, and often most effective when both are combined together to treat anxiety disorders.

 

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Body image issues

Teenage is the time of tremendous physical changes for young boys and girls through puberty, the teens are constantly making new discoveries about their bodies and struggling to accept those changes whilst also experiencing the societal pressure to appear a certain way, failing which can lead to dissatisfaction and a distorted or poor perception of the self. The conventional view holds that female teens are more likely to be dissatisfied by their body image but recent studies show that their male counterparts are equally susceptible to being unhappy with their body type, shape and size.

This can have really adverse effects on an individual’s mental health:

• Studies show that in most teens, poor body image is linked to poor self-image, such individuals have very low self-esteem and confidence.
• Certain teens also take to unhealthy coping strategies like drug abuse, alcohol abuse, addiction, obsessive behaviour regarding appearance etc.
• Teens can also become inactive and avoid social situations, becoming very antisocial, it can lead to the development of social anxiety disorder, panic disorder, depressive disorder, even eating disorders or other comorbidities.
• Inability to cope with distress caused by poor body image can very often also lead to self-harming behaviour and suicidal ideations in young adolescents.

 

Eating disorders in teens 

People with eating disorders show disturbed patterns of eating that impair their health or ability to function well. Eating disorders result in extreme eating behaviours in individuals that can have an adverse impact on the physical and psychological well being. Most teens who suffer from eating disorders are likely to have obsessive tendencies to want to appear lean, such teens are most likely to link body image with their self-image which most often is very poor and their self-esteem very low. Certain common eating disorders are

• Binge eating disorder characterised by episodes of eating significantly more food in a very short period of time than a normal person would eat in that duration, they may experience lack of control while eating, overeating even when not hungry. This causes a lot of feeling of guilt, shame, an embarrassment which can turn into serious mental health issues besides the physical symptoms that exist.
• Anorexia nervosa, marked by a pathological fear of getting fat, distorted body and self-image. Mostly seen in women and young girls.
• Bulimia nervosa can be identified by episodes of overeating followed by unusual behaviour like self-induced vomiting to avoid gaining weight.
• Other such disorders are pica, rumination and avoidant food intake disorder.

*Quick trivia: Late Princess Diana also suffered from Bulimia nervosa*

 

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Conduct disorder:

• Conduct disorder (CD) is characterized by a persistent, repetitive violation of rules and a disregard for the rights of others. CD has a median age of onset of 12 years (meaning half of those who ever develop this disorder have it by age 12) and a lifetime prevalence of 10 per cent (Nock et al., 2006). It is more common in boys (12%) than in girls (7%). Its key features include aggression to people and animals, deceitfulness and theft, destruction of property, a serious violation of rules. Children and adolescents with CD are also frequently comorbid for other disorders such as substance abuse disorder (Goldstein et al., 2006) or depressive symptoms (O’Connor et al., 1998). CD significantly increases the risk of pregnancy and substance abuse in teenage girls (Zoccolillo et al., 1997) and of the later development of anti-social personality disorder and a range of other disorders (Goldstein et al., 2006). One study that followed more than 1,000 children for many years into adulthood revealed that between 25 and 60 per cent of people who have a mental disorder during adulthood had a history of CD and/or ODD during childhood or adolescence (Kim-Cohen et al., 2003).

Reference book: Abnormal Psychology, Global Edition by Butcher, James Neal Hooley, Jill M. Mineka, Susan Nock, Matthew K