Anti-Depressants and Their Link to Adolescent and Teenage Suicide
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Anti-Depressants and Their Link to Adolescent and Teenage Suicide
Abstract
Two percent of preteens and five percent of adolescents suffer from depression (www.about-teen-depression.com 2004). There are specific signs and symptoms associated with depression, which are helpful in detection of the illness. There are various ways to treat depression, such as medication, group therapy, and/or herbal supplements. There are pros and cons with each treatment, but the worst coincides with the medication -suicide. Much research has been conducted, which will be discussed in the paper that has shown a link to antidepressants and suicide. However, there is also evidence that the suicide rate could be decreased with proper diagnosis and early, supervised treatment for depression, especially when dealing with children and adolescents.
Introduction
Depression is the newest epidemic sweeping across the world, affecting adults, teenagers, and even children. In fact, surveys have indicated that one in every five teenagers suffer from clinical depression (NMHA 2004). The illness can be found anywhere and appears to make the news each and every day. Depression is a condition that has no preference in its victims, meaning that it will strike people of all ages, races, and backgrounds. However, research has indicated that the onset of depression is now occurring earlier in life compared to past decades (Klerman and Weissman 1989). Knowing this, depression is a condition that needs to be cured immediately.
There are many signs and symptoms commonly associated with depression, although most do vary with each individual. Most symptoms include frequent sadness, feelings of hopelessness, decreased activity, persistent boredom and low energy, social isolation, low self esteem, extreme sensitivity, frequents complaints of illness, poor concentration, and thoughts or expression of suicide (www.focusas.com). In order to be diagnosed as suffering from depression, patients must have 2 or more of the above symptoms for at least two weeks that cause severe distress or interfere with daily life (Zoloft 2001).
The specific causes of depression are not known. It is suggested that depression is actually a result of a combination of certain factors, such as biological and psychosocial factors (Kendler 1995, www.surgeongeneral.gov 2004). Most likely, depression is the result of a chemical imbalance of neurotransmitters in the brain (NYU 2004). These neurotransmitters, such as serotonin, help regulate mood and positive behavior.
While a diagnosis of depression is critical, it is really only half of the battle of fighting the illness. There are still several options for treatment that you must choose from, as well as having to deal with side effects that accompany each treatment. Of all the treatments, antidepressants tend to have the most side effects. Some of the side effects common to all three types of antidepressants are: anxiety, vomiting, confusion, chest pain, blurred vision, irritability, insomnia, sexual dysfunction, weight gain, headache, and nervousness (Cheung et al. 2003, Vanderkooy et al. 2002). Some other, more severe, side effects are difficulty urinating, decreased appetite, heart complications, and suicide (Simon and Stern 2003 – Review). It is the last side effect, suicide, which has recently caused some controversy within the medical field. With recent research showing a correlation between antidepressants and suicide, as well as the FDA ordering warning labels for suicide on antidepressant medication, physicians have to be careful prescribing the drugs, especially to children and adolescents.
Statistics show suicide to be the third leading cause of death among 13-19 year olds, with approximately 6000 suicide deaths each year (Dickinson 1999). Because of statistics like this, the National Institute of Mental Health (NIMH) researchers are vying to find interventions to help prevent suicide among children and adolescents. However, until then, the best prevention appears to lie in early diagnosis and treatment of mental disorders, limiting access to certain lethal agents like medications and weapons, as well as communication between parents and children (Shaffer & Craft 1999).
Discussion
Among children and adolescents, the three most frequently diagnosed mood disorders are major depressive disorder, dysthymic disorder, and bipolar disorder (www.surgeongeneral.gov 2004). Major depressive disorder is characterized by one or more major depressive episodes, lasting approximately 7-9 months (Birmaher et al. 1996). The symptoms for major depressive disorder are the same in children as they are in adults. Dysthymic disorder is similar to major depressive disorder, but has fewer symptoms and is more chronic. This disorder is generally more persistent and, therefore, is more likely to interfere with daily life (Klein et al. 1997). The average duration of this disorder is about 4 years in children and adolescents (Kovacs et al. 1997). Bipolar disorder is a disorder in which episodes of mania alternate with depression (www.surgeongeneral.gov 2004). This disorder generally manifests with depression and then manic episodes months or even years later (Strober et al. 1995).
The causes of depression are not exactly clear. There are many theories about the cause and risk factors associated with depression. Adoption and family studies have concluded that depression runs in families and that most of this is due to genetic factors, not environmental influences (Sullivan et al. 2000). Traumatic experiences, especially abuse or neglect, have been found to interfere with normal emotional and psychological development (Brown et al. 1999). A more recent view of depression is centered around the neurogenic theory of depression. This theory suggests that antidepressants work by producing sustained, or prolonged, activation of cAMP. This, in turn, leads to increases in levels of neurotrophic factors in the brain, such as brain-derived neurotrophic factor that can reverse the damaging effects of stress in the hippocampus and cerebral cortex of the brain (Reid & Stewart 2001).
Treatment for depression via medication comes in a variety of shapes and sizes. There are literally hundreds of drugs that can be used for treatment of depression symptoms. Despite the large number of drugs, all of these medications fall into one of three categories: SSRIs, MAOIs, or TCAs.
SSRIs, or selective serotonin re-uptake inhibitors, are among the most widely distributed antidepressant drugs when it comes to adolescents. However, several studies in 2003 raised a concern about the effectiveness of SSRIs in children (Hayes 2004).