Mental health can be defined as a continuum: at one end lies healthy balance, at the other, disorder. As we move closer to one pole or the other, we may experience more or less distress, with varying degrees of severity.
Although we may detect that the young person’s situation does not meet the diagnostic criteria for depression, we can assess the existence of traits, that is, depressive characteristics, which still constitute a symptomatology that determines some level of suffering and requires therapeutic attention.
Adolescents are people who are developing their personality and identity: for this reason, the presence of symptomatology that interferes with daily activities, emotional health, and socialization is particularly concerning. The warning sign will be a sad, empty, or irritable mood, and somatic and/or cognitive changes that disrupt the young person’s functioning.
Depressive symptoms in adolescence
Emotional symptoms: sadness, loss of interest, sudden mood swings or absence of mood, hopelessness, irritability, excessive crying.
Motor symptoms: lack of expression, hypoactivity or hyperactivity, lethargy, slowing down.
Cognitive symptoms: lack of concentration, memory loss, indecisiveness, feelings of guilt, low self-esteem, decline in performance, low level of attention.
Social symptoms: isolation, social incompetence.
Behavioral symptoms: anger, school conflicts, delinquent behaviors, substance abuse.
Psychosomatic symptoms: loss of energy, weight loss, muscle pain, nightmares, alterations in appetite and sleep.
It is important to keep in mind that, in adolescents, depressive symptomatology manifests more as irritability than as sadness. For this reason, some depressive disorders go unnoticed, as the young person tends to be labeled as “antisocial” following conflicts with authority, for example in the school setting. Likewise, family conflicts can be justified as normal behavior of the developing young person, and in the same way, deeper suffering can be normalized.
How to deal with depressive symptoms in adolescence?
In cases of suspected depressive symptomatology, I base my approach on the following exploration and intervention protocol:
- Clinical interview with parents: identifying critical events that may coincide with the period of onset of symptoms;
- Exploration with the young person: person-under-the-rain test; administration of the IDER questionnaire; sociogram and systemic exploration;
- Therapeutic sessions: systemic work is very important because behavioral activation cannot take place without family, school, friend groups, and incentives such as sports or other hobbies that positively influence self-image and the secretion of endorphins, which are natural endogenous antidepressants;
- Collaboration with the school: it may be considered to administer the SENA questionnaire through the EAP (Educational Assistance Team);
- When the young person manifests severe symptomatology, with significant social isolation and high irritability, and when there are thoughts of death that may pose a vital risk, it is essential to refer to child psychiatry to assess the need to reinforce psychotherapeutic work with medication.
I invite you to contact me so we can talk about all the benefits our groups and individual therapies can provide you.
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Bibliography
Servera, M. (2002). Intervención en los Trastornos del Comportamiento Infantil. Pirámide.
