THE teenage years can be challenging. Between physical changes in the body, intense peer pressure and an increased sense of social anxiety, teenagers often have difficulties finding their place in society.
Some want to fit in while others want to stand out, which can cause them to rebel.
Teen depression is also becoming an alarmingly frequent trait in these transition years and there are distinct gender differences in teen depression.
The National Health and Morbidity Survey 2022 (NHMS2022) indicates that one in eight adolescents in Malaysia have suicidal thoughts and one in 10 have attempted suicide, with more girls than boys having suicidal thoughts.
Even more worryingly, one in four adolescents feel depressed and twice as many girls compared with boys are depressed.
Teen depression is no different medically from adult depression explains KPJ Ampang Puteri Specialist Hospital psychiatrist Datuk Dr Azhar Md Zain.
However, the brains of adolescents are structurally different than those of adults.
Teens with depression may also have hormone differences and different levels of neurotransmitters, which are key chemicals in the brain that affect how brain cells communicate with one another. These play an important role in regulating mood and behaviour.
Depression can be associated with high levels of stress, anxiety and in the worst case scenario — suicide.
However, symptoms in teens may manifest in different ways than in adults, says Dr Azhar. This may be because teens face different social and developmental challenges.
"Depression can also affect aspects of their personal life, school, social and family life, and lead to social isolation and other problems."
Teen depression is also gender relative, he adds. Females are three times as likely as males to report a depressive episode.
This difference can be attributed to differences in the rate of physical changes between boys and girls.
"Puberty typically starts earlier, and hormonal changes tend to be more evident in young girls. Teenage girls are also more concerned about how others perceive them."
THE IMPACT OF SOCIAL MEDIA
Dr Azhar says the rise in depression among teenagers coincides with the popularity of smartphones.
Today's teenagers have not known a world that does not include social media. Both young men and women spend a significant amount of time on their smartphones and the impact of this is being felt in many ways, he explains.
NHMS2022 indicates that one in five adolescents have been bullied and harassed by somebody through the Internet, cell phones, or other electronic devices.
Another study by the United Nations International Children's Emergency Fund, reports that Malaysia ranked second in Asia in 2020 for cyberbullying among youths.
Dr Azhar says the use of smartphones and social media appears to correlate with the increase in depression among teenagers. However, it seems to have impacted girls more than boys.
"One reason for this could be that girls spend more time socialising on their smartphones, including texting and interacting on social media. Boys also text and use social media, but tend to use their smartphones more for playing games."
One study found that the rate of depression also aligns with the amount of time spent on social media, he adds. In that study, girls who spent six hours or more on social media daily were significantly unhappier than those who spent only 30 minutes a day. The differences for boys were less noticeable.
Factors That Increase Risk Of Depression
*Personal/personality issues.
*Trouble adjusting socially.
*Having no social or emotional support.
*Living in a violent household - victim or witness of violence, such as physical or sexual abuse.
*Having issues that negatively impact self-esteem, such as obesity, peer pressure or being bullied.
*Having a chronic illness or mental health condition - such as bipolar, anxiety and personality disorders.
*Suffering from anorexia or bulimia.
*Having a learning disability or Attention Deficit Hyperactivity Disorder.
SPOTTING THE SIGNS
Symptoms of depression can often be difficult for parents to spot and may be confused with typical feelings of puberty and teenage adjustment.
Symptoms can vary in severity, too, but generally, may include:
Personality Changes
*Feeling sad, which can include crying spells for no apparent reason.
*Frustration/anger even over small matters.
*Feeling hopeless, helpless or empty.
*Irritable/annoyed, having self-injurious behaviour.
*Loss of interest or pleasure in usual activities.
*Conflict with family and friends.
*Low self-esteem.
*Feelings of worthlessness, unrealistic guilt.
*Fixation on past failures/exaggerated self-blame/ self-criticism.
*Extreme sensitivity to rejection/failure and the need for excessive reassurance.
*Frequent thoughts of death, dying or suicide.
Physical Changes
*Changes in appetite and weight, less attention to personal hygiene or appearance.
*Alcohol or drug misuse.
*Major changes in sleeping habits/ insomnia.
*Frequent complaints of unexplained body aches and headaches.
*Trouble thinking, concentrating, making decisions and remembering things, poor school performance.