Teens in Distress Series
Adolescent Stress and Depression

Joyce Walker
4-H Youth Development

Copyright ©  2002  Regents of the University of Minnesota. All rights reserved.

Adults commonly tell young people that the teenage years are the "best years of your life." The rosy remembrance highlights happy groups of high school students energetically involved at a dance or sporting event, and a bright-eyed couple holding hands or sipping sodas at a local restaurant. This is only part of the picture. Life for many young people is a painful tug of war filled with mixed messages and conflicting demands from parents, teachers, coaches, employers, friends and oneself. Growing up—negotiating a path between independence and reliance on others—is a tough business. It creates stress, and it can create serious depression for young people ill-equipped to cope, communicate and solve problems.

A study and a survey conducted recently in Minnesota provide information about the prevalence of adolescent stress and depression. The study and survey point out some of the stressful events young people experience, describe how young people deal with stress, and indicate the risk factors for young people most vulnerable to stress, depression and self destructive behavior. This major research project provides data on adolescent stress, depression and suicide collected from nearly 4300 high school students in 52 rural Minnesota counties. (Garfinkel, et al., 1986).

Adults need to be familiar with the family, biological and personality factors that predispose a young person to depression. They can learn to recognize the kinds of psychological, behavioral and social events that most often signal trouble. Awareness of the way these risk factors "pile up" helps any adult living and working with adolescents to be sensitive when stress and depression are imminent.

Stress and Depression Are Real

Stress and depression are serious problems for many teenagers, as the 1986 study of Minnesota high school students reveals. Although 61 percent of the students are not depressed and seem to handle their problems in constructive ways, 39 percent suffer from mild to severe depression. These young people often rely on passive or negative behaviors in their attempts to deal with problems.

Stress is characterized by feelings of tension, frustration, worry, sadness and withdrawal that commonly last from a few hours to a few days. Depression is both more severe and longer lasting. Depression is characterized by more extreme feelings of hopelessness, sadness, isolation, worry, withdrawal and worthlessness that last for two weeks or more. The finding that 9 percent of high school students are severely depressed is important since depression is the most important risk factor for suicide. The Minnesota Study found that 88 percent of the youth who reported making suicide attempts were depressed. Approximately 6 percent of the students reported suicide attempts in the previous six months.

Common Causes and Responses to Stress

Young people become stressed for many reasons. The Minnesota study presented students with a list of 47 common life events and asked them to identify those they had experienced in the last six months that they considered to be "bad." The responses indicated that they had experienced an average of two negative life events in the last six months. The most common of these were:

1. Break up with boy/girl friend
2. Increased arguments with parents
3. Trouble with brother or sister
4. Increased arguments between parents
5. Change in parents' financial status
6. Serious illness or injury of family member
7. Trouble with classmates
8. Trouble with parents

These events are centered in the two most important domains of a teenager's life: home and school. They relate to issues of conflict and loss. Loss can reflect the real or perceived loss of something concrete such as a friend or money, and it can mean the loss of such intrinsic things as self-worth, respect, friendship or love.

In a more informal survey of 60 young people (Walker, 1985), the primary sources of tension and trouble for teens and their friends were: relationships with friends and family; the pressure of expectations from self and others; pressure at school from teachers, coaches, grades and homework; financial pressures; and tragedy in the lives of family and friends (described as death, divorce, cancer).

Most teenagers respond to stressful events in their lives by doing something relaxing, trying positive and self-reliant problem-solving, or seeking friendship and support from others. Common examples include listening to music, trying to make their own decisions, daydreaming, trying to figure out solutions, keeping up friendships, watching television and being close to people they care about. These behaviors are appropriate for adolescents who are trying to become independent, take responsibility for themselves, and draw on friends and family for support.

Troubled Youth Respond Differently

The majority of young people face the stress of negative life events, find internal or external resources to cope. and move on. But for others, the events pile up and the stressors are too great. In the Minnesota study teens who reported that they had made a suicide attempt had five additional "bad" events on their list: parents' divorce, loss of a close friend, change to a new school, failing grades and personal illness or injury. It is significant that the young people who showed high degrees of depression and who had made suicide attempts reported over five of these "bad" events in the past six months, more than twice as many as the rest of the group.

The actions in response to stress were also different for those who reported serious depression or a suicide attempt. Young people who are depressed are at much greater risk of attempting suicide than non-depressed youth—although not all youth who attempt suicide are depressed. These young people report exhibiting much more anger and ventilation; avoidance and passivity; and aggressive, antisocial behavior. They describe yelling. fighting and complaining; drinking, smoking and using doctor-prescribed drugs more frequently; and sleeping, riding around in cars and crying more often. They are less inclined to do things with their family or to go along with parents' rules and requests.

A Closer Look At High Risk Youth

It is important not to overreact to isolated incidents. Young people will have problems and will learn, at their own rate, to struggle and deal with them. But it is critical for parents and helping adults to be aware of the factors that put a youth at particular risk, especially when stressful events begin to accumulate for these vulnerable individuals. A good starting point for identifying and intervening with highly troubled and depressed young people is the careful study of suicidal adolescents.

Family history and biology can create a predisposition for dealing poorly with stress. These factors make a person susceptible to depression and self-destructive behavior.

• History of depression and/or suicide in the family
• Alcoholism or drug use in the family
• Sexual or physical abuse patterns in the family
• Chronic illness in oneself or family
• Family or individual history of psychiatric disorders such as eating disorders, schizophrenia, manic-depressive disorder, conduct disorders, delinquency
• Death or serious loss in the family
• Learning disabilities or mental/physical disabilities
• Absent or divorced parents; inadequate bonding in adoptive families
• Family conflict; poor parent/child relationships

Personality traits, especially when they change dramatically, can signal serious trouble. These traits include:

• Impulsive behaviors, obsessions and unreal fears
• Aggressive and antisocial behavior
• Withdrawal and isolation; detachment
• Poor social skills resulting in feelings of humiliation, poor self-worth, blame and feeling ugly
• Over-achieving and extreme pressure to perform
• Problems with sleeping and/or eating

Psychological and social events contribute to the accumulation of problems and stressors.

• Loss experience such as a death or suicide of a friend or family member; broken romance, loss of a close friendship or a family move
• Unmet personal or parental expectation such as failure to achieve a goal, poor grades, social rejection
• Unresolved conflict with family members, peers, teachers, coaches that results in anger, frustration, rejection
• Humiliating experience resulting in loss of self-esteem or rejection
• Unexpected events such as pregnancy or financial problems

Predispositions, stressors and behaviors weave together to form a composite picture of a youth at high risk for depression and self-destructive behavior. Symptoms such as personal drug and alcohol use, running away from home, prolonged sadness and crying, unusual impulsivity or recklessness or dramatic changes in personal habits are intertwined with the family and personal history, the individual personality and the emotional/social events taking place in a person's life.

It is not always easy for one person to see the "whole picture." That's why it is essential that people who have "hunches" that something is wrong take the lead to gather perspectives from other friends, family members and professionals who know the young person. It is all too often true that the survivors of an adolescent suicide only "put the pieces together" after the fact, when they sit together and try to figure out what happened. How fortunate a troubled young person is to have a caring adult take the initiative to look more closely before something serious happens!

The University of Minnesota Extension Service has two additional publications that can be helpful:

• Supporting Distressed Young People (FS-02786), by Ron Pitzer
• Helping Friends in Trouble (FS-02787), by Joyce Walker

Several common themes run through these two. First, young people must learn and practice coping skills to get them through an immediate conflict or problem. Coping strategies must emphasize self-responsibility to find positive, non-destructive ways to find relief. Second, communication skills are important. This involves being able to talk and selecting a good listener. It is important to express feelings, vent emotions, and talk about the problems and issues. Peers are good sympathizers, but it often takes an adult perspective to begin to plan how to make changes for the better. Third, young people need help to learn problem-solving skills. Sorting out the issues, setting goals and making plans to move forward are skills that can be taught and practiced.

Ultimately, most young people will develop and assume the responsibility for their own protection and peace of mind. But during the years of learning and practice, parents, teachers and helping adults need to be aware of the signs and patterns that signal danger. Awareness of adolescent stress and depression opens the door for adults to begin constructive interventions and stimulate emotional development.

References

• Garfinkel, B. Suicidal Behavior in Children and Adolescents. Manuscript submitted for publication, 1985.
  
  
• Garfinkel, B., Hoberman, H., Parsons, J., and Walker, J. Adolescent Stress, Depression and Suicide: Minnesota study. Unpublished raw data, 1986.
  
  
• Fairfax County Public Schools. The Adolescent Suicide Prevention Program: A Guide for Schools and Communities. Fairfax, VA: Department of Student Services and Special Education, 1985.
  
  
• Lewinsohn, P., and Teri, L. The Selection of Depressed and Non-depressed Subjects on the Basis of Self-report Data. Extended version of article in Journal of Consulting and Clinical Psychology, 1982,50, 590-591.
  
  
• Teri, L. The Use of the Beck Depression Inventory with Adolescents. Journal of Abnormal Child Psychology, 1982,10, 227-284.
  
  
• Select Committee on Aging, House of Representatives. Suicide and Suicide Prevention (Comm. Pub. No. 98497). Washington, DC: U.S. Government Printing Office, 1985.
  
  
• Walker, J. Identification of Adolescent Stressors. Unpublished raw data, 1985.

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