Mental Health Support for Youth Depression

Introduction
Feeling sad, unhappy, or “down in the dumps” occasionally is not unusual, however when these feelings outweigh a youth’s happiness or excitement it is concerning. Depression is a common and severe disorder amongst adolescences. Depression has lasting effects on an individuals’ feelings, thoughts, self-worth, behaviors, social relationships, physical functioning, biological developments, work productivity, and life fulfillment. It is a common psychiatric disorder that often affects adolescences and has been ranked as the fourth leading cause of disability and early death worldwide. Depression not only affects emotions but is a serious condition which makes coping difficult and leaves a person feeling sad most of the time. Feelings of sadness and low self-worth are overwhelming and can last for weeks, months or even longer for individuals (Beyondblue, n.d.). 

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Incorporating mental health programs into the lives of youth is valuable to send a message to individuals that depression is treatable, people can help, and that things can improve. Children and adolescents spend a considerable amount of time at school, and it is necessary for schools to offer mental health programs that include prevention and intervention services targeted at youth suffering from depression (Stallard, 2013). This paper will discuss the causation of adolescent depression, physical manifestations, educational supports, and professional supports. 
Causation
Everyone experiences depression differently and there is not an easy answer for why youth develop the condition, but there is a combination of reasons. It is a mental illness that significantly affects youth. Depression is more common amongst girls than boys but boys often find it hard to share their feelings (Beyondblue, n.d.). Some of the common causes of youth depression are the same as adults such as biological causes, stress, and trying life events. Other causes of youth depression include parenting, substance abuse, and low self-worth (Coleman, Walker, Lee, Friesen, & Squire, 2009). According to Mental Health America, depressed youth can have too much or too little of certain brain chemicals which also causes depression. Other sources of depression are having a family history of depression, side-effects from medications, and persistent negative thought patterns (Depression in Teens, 2016,).  
It is normal for people to feel sad or discouraged at times because we all feel these emotions at some point due to various life events. Such life events like fighting with a friend, a breakup happening, getting a poor grade on an assignment or test, or the death of someone can all create feelings of sadness or disappointment. Non-depressed individuals experiencing these events and feelings manage to deal with the emotions and get past them with a little time and care. However, depressed people experience these events differently because the feelings last longer and affects not only the person’s mood but their thinking too (Lyness, 2016,).
Many things can change how we think, feel, and behave; however stressful life events can cause youth to develop depression. Symptoms might present with feelings of sadness, distress, and anxiety, however over time they become more intense and overwhelming. Prevalent causes of depression in youth are loss and grief, bullying, alcohol and drug use, low self-esteem and body image, discrimination, physical health problems, life events, family breakups, and loneliness. Stress is another common factor in an adolescent’s life and when young people are under stress, it can increase their likely hood of developing depression. At times problems can seem too big and overwhelming to solve, but the best thing adolescents can do is talk to someone. Youth who take steps and recognize how they feel are on their way to recovery (Andersen, & Teicher, 2008; Beyondblue, n.d.).   
Physical Manifestations
One in five youth suffer from clinical depression, and more than 25% of adolescents will experience a major depressive disorder by age nineteen. Depression is also prevalent amongst 1% of the population under age twelve, but between age fifteen to eighteen is dominant amongst 17% to 25% of youth. Depression is not an easy diagnosis amongst youth because they have different signs compared to adults. Moodiness amongst youth is common, but when it lasts for more than two weeks help should be sought. Adolescents are likely to be irritable without visible signs of sadness. On the other hand, depressed youth will have low school performance, withdraw from friends and activities, feel hopeless, lack enthusiasm and energy, overreact to criticism, have low self-esteem, lack concentration, feel restless and on edge, have a change in eating and sleeping patterns, develop problems with authority, and exhibit suicidal thoughts or actions. Young people feeling depressed have increased feelings of irritability, sadness, stress, anger, restless, and over analyze what is on their mind. Other feelings youth might experience are guilt, worthlessness, frustration, unhappiness, indecisiveness, and disappointment (Depression in Teens, 2016). 
Adolescents experience more emotional and behavioral problems than do non-depressed youth. Young people who are depressed can have co-occurring disorders such as anxiety, difficulties paying attention and hyperactivity, aggression, substance use, and Post Traumatic Stress Disorder (PTSD) symptoms. Youth who are experiencing depression not only have personal issues, but their social relationships are affected too. Depressed adolescents feel unsupported by friends and adults. Youth also show more signs of a lack of interest in activities they find enjoyable, feel extremely sleepy throughout the day, have a decreased ability to think and focus, feel deeply saddened, and suicidal. Suicide unfolds with age, therefore before the age of ten it is rare for children to have suicidal thoughts or actions, but increases between the age of ten and fourteen, and rises ten times higher in youth ages fifteen to nineteen (Andersen, & Teicher, 2008). 
Educational Support Implications
Since depression is a common mental health diagnosis amongst youth, it is important to know depression screening is one possible method for managing depression. Then again, there are risk factors for screening youth. A few risk factors are testing is costly, it can cause harm to some people due to misdiagnoses and in proper treatment, and there could be false positive results if screening tools are not administered properly. Across the United States, screening programs have been implemented in some schools and medical settings. Screening is an early intervention to help detect signs and symptoms amongst youth who otherwise show none. Depression symptom questionnaires and small sets of questions are used for testing to identify individuals who may have current depression that has not been recognized (Thombs, Roseman, & Kloda, 2012). 
Depression is not easy to determine amongst youth due to the different symptoms, on the other hand few children are identified and referred for treatment. Schools are natural and convenient setting for mental health prevention programs to be offered. Youth regularly spend a substantial majority of their time at school. Many adolescents who have depression have no contact with mental health services. Schools can provide universal programs to target all youth regardless of risk, or they can provide selective interventions which target selected groups with an increased risk. When providing a global approach schools can cover a larger population and mental health is less stigmatizing; however, the programs can result in smaller treatment effects. Programs can be appealing and have a significant impact on mental health if supported and implemented correctly (Stallard, 2013).   
At school youth also need to be able to talk with a counselor or social worker about their feelings. They also need to be provided with adequate daily exercise, exposure to daylight, and healthier eating options. School personnel can teach relaxation skills to help increase sleep and decrease feelings of worry. Many adolescents find it beneficial to confide in and talk to a trusting adult. Educators can listen and show empathy, remind the youth that things can get better and that they are there for them, help them see things that are already good in their life, find enjoyable things to do, and give honest compliments and smiles. Youth need to be educated on how to manage sad feelings. In order to help youth gain positive coping skills, schools need to provide educational curriculum on eating healthy foods, getting the right amount of sleep, exercising, taking time to relax, and taking time to notice the good things in life (Lyness, 2016, August). Schools can be a common place for students to see a mental health professional; therefore, it is important for schools to have effective school-based programs to address mental health issues in the schools.
It is vital for schools to provide school personnel opportunities for training in recognizing youth depression. Classroom teachers have contact with students throughout the school day and are likely to see changes in students’ behaviors. Not only is it important to recognize depression in youth, but it is necessary to evaluate and treat depressed adolescents. School counselors, school nurses, school psychologist, and school social workers can help students experiencing depression, especially if youth are not receiving professional outside counseling. These school personnel are trained to recognize and plan for mental health issues in students and should be utilized to help students with depression. School mental health professionals can screen students for mental health, develop interventions and plans, provide prevention programs, and provide individual or group counseling. Although schools have resources, to be most helpful, schools should connect with resources outside of school (Beyondblue, n.d.; Stallard, 2013).      
Professional Supports
Youth struggling with depression need immediate treatment because if left untreated it can lead to death. Some adolescents may refuse treatment; however significant adults in their life can seek professional help. Depressed youth should see a therapist to assist them in understanding why they feel the way they do and to learn how to use coping skills to handle stressful situations. There are individual counseling options available along with group and family counseling opportunities. When working with a mental health professional, youth may be presented with the possibility of medication to help feel better. Several factors contribute to youth depression, but prompt and appropriate treatment are critical in helping youth cope with depression. When working with a therapist young people can do psychotherapy, cognitive-behavioral therapy, interpersonal therapy, and medication (Depression in Teens, 2016).
With the right care and treatment, depression can get better and easier to manage. Individuals who are depressed should not wait to get help because things can only get worse. Youth who feel depressed should talk to a parent or an adult and get the right help. A medical doctor can provide a checkup and look for symptoms causing depression. Different medical conditions that might cause depression include hypothyroidism and mono. Another resource for youth is to utilize a therapist or counselor to talk about his/her emotional state. Speaking to a counselor or therapist allows individuals to understand emotions, put feelings into words, feel understood and supported, builds confidence, increases problem-solving skills, helps change negative thinking, increases self-worth, and increases experiencing positive emotions (Lyness, 2016).
Conclusion
Youth depression is growing at a fast rate. When young people are feeling down, they can try to make new healthy friendships, participate in sports, a job, other school activities, or hobbies, join an organization, and ask a trusted adult for help. However, sometimes these will not help an individual, and they become depressed (Depression in Teens, 2016, December 08). Even though schools provide mental health programs for youth at risk, many students with mental health diagnoses are being untreated. In schools, it is common for school counselors, school nurses, school psychologist, and school social workers to provide mental health services to students. Schools are a safe place for youth to become educated positive, healthy ways to cope with stressful life circumstances. Depression can go unrecognized because people do not realize they are depressed, it might be misunderstood as a bad mood, or some people with depression have co-occurring mental health issues. Without recognition of a change in mood, thoughts, and behaviors many depressed adolescents will turn to unhealthy coping mechanisms such as alcohol, tobacco, and drugs; therefore, depression education for all individuals is essential (Depression in Teens, 2016). 
References
Andersen, S. L., & Teicher, M. H. (2008). Stress, sensitive periods and maturational events in adolescent depression. Trends in Neurosciences,31(4), 183-191. doi:10.1016/j.tins.2008.01.004
Beyondblue. (n.d.). Retrieved July
6, 2017, from https://www.youthbeyondblue.com/understand what%27s-going-on/depression
Coleman, D., Walker, J., Lee, J., Friesen, B., & Squire, P. (2009). Childrens Beliefs About Causes of Childhood Depression and ADHD: A Study of Stigmatization. Psychiatric Services,60(7). doi:10.1176/appi.ps.60.7.950
Depression in Teens. (2016, December 08). Retrieved July 07, 2017, from http://www.mentalhealthamerica.net/conditions/depression-teens
Lyness, D. (Ed.). (2016, August). Depression. Retrieved July 06, 2017, from http://kidshealth.org/en/teens/depression.html#
Stallard, P. (2013). School-based interventions for depression and anxiety in children and adolescents. Evidence Based Mental Health,16(3), 60-61. doi:10.1136/eb-2013-101242
Thombs, B. D., Roseman, M., & Kloda, L. A. (2012). Depression screening and mental health outcomes in children and adolescents: a systematic review protocol. Systematic Reviews,1(1). doi:10.1186/2046-4053-1-58