Abstract
This essay will research and investigate depression in young adults. It will review the recent evidence-based literature to provide a discussion on the effect of depression on young adults. This discussion will include a general overview of the illness and the incidence and prevalence within the selected population group. The critique of the assessment processes and strategies and supportive care strategies for the depression that are identified within the research based literature will be also provided. The research paper will refer to the following topics: treatment methods for the depression; depression diagnostics, and ways to prevent depression. In conclusion, the possible question for further research in this field will be generated in order to make the actual contribution to the discussed area.
Inroduction
Depression is a widely studied illness that has been the subject of much research. According to Fava (2008), “clinical depression is a mood disorder in which feelings of sadness, loss, anger, or frustration interfere with everyday life for a longer period of time.” Patients with depression suffer from loss of pleasure in usual activities, sleep disturbance, loss of appetite or overeating, social withdrawal, and often thoughts of suicide. The current discourse on this subject raises such serious questions as the efficiency of today’s treatment methods, issues related to diagnostics, and direction for further research (Polgar, Thomas, 2008). The research of the assigned topic starts with answering these questions.
Diagnostics
The major difficulties related to the treatment of depression lie in the field of diagnostics (Goldberg, 2010). The primary goal for the successful treatment of any disease is identifying its causes. The reasons for depression may vary from alcohol abuse and stressful events to genetic predisposition. Such diversity of possible causes sometimes makes it hard to diagnose the illness and provide the right treatment. Clarke, Cook, Smith, and Piterman (2008) suggest their way of identifying the depression and distress for general practitioners by asking three most important questions:
- Is this an episode of clinical depression or distress? Is this a change from normal?
- Is there an identifiable cause? Is it “situational”?
- Which symptoms are most prominent?
The first question is crucial in terms of diagnosing the illness. The answer to this question may be determined by the presence of the following symptoms: depression or distress evident on first sight; crying; loss of interest, motivation or drive; sleep disturbance (Beck, 2009). These disorders may be also conditioned by the impairment of functioning in areas of work, family or recreation. If these symptoms are present, and this is a change from normal – this is a case of clinical depression. If there are such symptoms, though they were present before, this may mean the patient has chronic depression, or these disturbances are within the range of normal mood fluctuations or that the patient is not depressed at all.
If there is an identifiable cause – it is a depressive reaction. If the cause is hard to define, it might be endogenous depression, generally characterized by an underlying lack of interest and motivation (Clarke, Cook, Smith, and Piterman, 2008). While proceeding to the third question, the practitioner should identify the most prominent symptoms. If such symptoms are worry and anxiety, then it is a case of anxious depression. If the patient’s condition is characterized by the senses of helplessness and hopelessness – it might be a hopeless depression or demoralization (Clarke, Cook, Smith, and Piterman, 2008). In order to make a correct diagnosis the doctor must focus on these questions and investigate the patient’s answers in detail.
The described approach may help to identify the disease. However, it is only a start. Finding the right method for treatment may be the biggest problem in the process of therapy. Although there is a wide range of commonly used practices of the depression treatment, it is important to remember that each case requires an individual approach. This is the major issue the psychiatrists face in their practice (Jacob, 2009).
Depression in Young Adalts
As it was previously mentioned, the main purpose of this essay is investigating depression in young adults. To serve this purpose, this paper identifies this specific population group and explains how it can be affected by depression. In the following section of this research paper, evidence based literature on this topic will be reviewed and discussion in regards to young adults and depression prevalence within this population group will be provided.
Vanheusden’s (2008) research on the discussed topic defines young adults as people from 20 to 40 who have not defined their relationship to existing society, possible vocation, social role, and lifestyle. In other words, young adults face the situation when it is hard to identify one’s expectations and desires, and set goals for the future. It is a situation of uncertainty and disorganization. It is not surprisingly that such a situation may cause serious emotional problems, including depression. According to Vanheusden (2008), “…young people are often unattached to romantic partners or permanent homes. In attempts to find themselves they go back to school for lack of better options, try to travel, avoid commitments, and compete for unpaid internships.” Young adults often work on short-term projects, or as temporary workers, being unable to settle down or become a part of a collective. Others, however, try to make a career and work hard in order to achieve this goal. Unfortunately, many of them are at risk of a fast decrease of productivity and overstrain due to unpreparedness to failures and long-term projects.
All these factors may result in depression. The sense of unbearable load of problems related to making essential choices and decisions, finding one’s role in the society, and developing important interconnections with other people make young adults depressed and make them lose feeling that they belong somewhere. However, these problems can be solved successfully with the help of psychotherapy (Beyondblue, 2011).
According to research provided by Australian Institute of Health and Welfare, “the leading specific cause of mental disease among young people is anxiety and depression, accounting for almost one quarter (24%) of the burden of disease in this age group in 2003.” (Begg et al. 2007). The statistical data provided in AIHW research indicates that young people have a considerably lower rate of general practitioner encounters on the subject of mental health than the general population: 32 encounters per 100 for the young adults population group compared with 61 for the general population (AIHW, 2010). According to the 2008 NATSISS, an estimated 31% of Indigenous young people aged 16–24 years had high or very high levels of psychological distress. The results of National Survey of Mental Health and Wellbeing (2007) presented in AIHW’s research did not show any significant differences in the prevalence of high or very high levels of mental disorders in relation to socioeconomic status and remoteness. In overall, women are more liable to mental disorders, including depression, than men (NSMHWB, 2007). This information allows to conclude that depression is common among Australian young people and prevails mostly in young women.
The practice of dealing with depression in young adults shows us that the most effective methods of treatment include individual and group therapy. In one-on-one sessions with the therapist young adults may obtain the ways of exploring their identity, including personal values, interests, and desires. Taylor (2008) believes that therapy may help the patient to find the appropriate way of transition from the “in between” stage to the next one. In terms of young adults, this stage may refer to separation from parents and obtaining financial and emotional independence. Other major features of depression in young adults are their focus on self, and inability to see the bigger picture in terms of how they fit into the world (Fava, 2008). Psychotherapy may resolve this issue by shifting the focus from patient’s inner experiences to external opportunities the world has to offer. Young adults’ sense of possibilities can help to achieve this goal; however, there are cases when a wider range of choices should be narrowed in order to not overwhelm the patient with a variety of opportunities while he cannot decide on what to do with his life (Fave, 2008).
Group therapy may be useful if the patient is sure that he has specific problems that no one else has. At group therapy sessions, it becomes obvious for patient that he is not alone in his struggle and others have the same difficulties trying to fit into the society. Referring to Whitfield (2010), we can say that group therapy reduces the sense of isolation and provides support to people who have the idea of what bothers members of this particular group. In
order to understand how the mentioned treatment methods can be applied in general cases, let’s focus on some of the methods of depression treatment and their utilization in healthcare practice.
However, it is important to note that depression in young adults may quickly become complicated by negative events following the illness. These may include dropping out of activities, loss of motivation and social connections, and failure at work or study. These issues may cause negative reactions from patient’s parents, professors, and colleagues due to their dissatisfaction with patient’s overall performance and lack of motivation. Such reactions complicate the process of dealing with the illness and make the patient’s condition even worse. Thereby, there is a necessity to pay attention to patient’s state and provide him with emotional support.
Treatment Methods
Today’s practice of the depression treatment is commonly based on methods of psychotherapy and antidepressant medicines (Taylor, 2008). In order to provide the best results, psychotherapy and medical treatment usually go hand in hand. There are few forms of therapy: individual, group, and couple therapy.
Most people think about one-on-one interaction at first, when they hear the word “therapy.” However, group therapy has its advantages and specific features. For example, the issues people discuss at the group therapy may reveal some unexpected ways of dealing with the problems. A patient may change his attitude towards his difficulties in the result of listening to the stories of people with similar issues. Group therapy may help in building self-esteem and obtaining confidence. The main purpose of group therapy is increasing the patient’s social activities and network (Whitfield, 2010).
At individual therapy session patient gets more attention from the therapist. Individual approach ensures establishing strong emotional connection with the therapist (Taylor, 2008). As a result, patients may feel more comfortable sharing intimate information that could be hard to discuss in the group sessions. Law (2011) states: “the fundamental principle of individual therapy is establishing a trusting relationship between patient and the therapist. Without the honest discussion of patient’s feelings and reactions, the therapist will not be able to reveal the causes of illness and provide the appropriate treatment.” Thereby, it is very important not to give up on the therapy and continue developing a sincere relationship with the therapist.
Couple therapy refers to issues related to a romantic relationship. Couple therapy differs from relationship counseling in duration and basis of the discussed problems focusing on the relationship history and emotions involved. Couple therapy touches upon a wide range of emotional problems aroused by malfunctioning relationship. These issues may represent a variety of symptoms of different disorders, including depression. The main task of the couple therapist is analyzing the current situation and exposing maladaptive patterns formed within the relationship (Manber, 2008). Couple therapy is more complicated than individual therapy, as it has to deal with two persons at the time and their mutual relations. The difficulties refer to the fact that it is often harder to make one person openly talk in the presence of his or her partner. This leads to the rise of additional obstacles in the process of therapy.
The next method commonly used in depression treatment is the utilization of antidepressants. There are many different types of antidepressants, including selective serotonin reuptake inhibitors (SSRIs), atypical antidepressants, tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs). Beck (2009) notes: “when deciding on the necessity of medical treatment it is important to remember of the side effects of most antidepressants. The side effects could be very serious reason of rejecting the medical treatment and finding alternative ways of therapy.” Besides, there are several groups of risk: people over 65 years old; pregnant women; teenagers and young adults; people with bipolar disorder. For example, taking antidepressants may increase the risk of suicide in teenagers and young adults. The other important issue of drug treatment is that antidepressants usually help to relieve the symptoms of the illness, though do not cure the underlying problem. The reason for such weakness is that depression is not caused simply by the chemical processes occurring in the brain. Therefore, it cannot be cured just by changing the serotonin levels in the brain. However, medicines may help to reduce some of the symptoms of severe depression, bringing a sense of relief to the patient (Smith et al., 2013).
Apart from the traditional methods of depression treatment discussed above, there are also alternative methods of dealing with the illness. These methods include relaxation techniques, such as yoga, massage, aromatherapy and others; acupuncture; herbal remedies and vitamins; hypnosis, and many others (Saisan, Smith, and Segal, 2013). These methods may appear resultant; however, when implementing them to the treatment, it is better to consult with a healthcare professional first. This is important as some of these methods may interfere with prescribed medicines and cause side effects.
Other methods of treatment may include hormone replacement therapy in women and electroconvulsive therapy. Electroconvulsive therapy now is rarely used in healthcare practice. Hormone replacement therapy is applicable in some cases of depression treatment when it was caused by sudden drops in hormone levels (the Cleveland Clinic Foundation, 2009). It may occur due to menopause or after childbirth. In this case, a change in a lifestyle contributes to depression, and it might be fixed by recovering hormone levels back to normal. However, it is necessary to consult the therapist before taking any kind of medicine.
Further Research
Despite decades of neurobiological research and practice, depression remains widespread and difficult-to-treat illness. In this perspective, it is important to produce new ideas for further research in this area. There are several possible directions for research on depression and its treatment. The major long-term goal of depression research is to identify simple biological markers of depression that could be detected somehow in blood or with brain imaging. These markers could help a lot in identifying the specific depression profile for each patient. This would allow psychiatrists to select the most effective methods of treatment for each profile. Though this kind of objective is hard to achieve disposing of current methods of diagnostics and treatment, National Institute of Mental Health is already investing in such research strategies in order to build a solid ground for future discoveries (Hunter and NIMH, 2013).
Other direction for research includes advanced development in neurobiology and brain imaging technology. This would allow diagnostician to see clear linkages between research findings from different domains of emotions and moods. The results of successful research in this field would help to create “maps” of depression that will clarify understanding of brain development and the causes of depression (Hunter and NIMH, 2013).
The next important research area relates to diagnostics of disorders occurring in childhood and adolescence. As these disorders usually lead to mental disorders in adulthood, information about behavioural biases that may occur during specific periods of a child’s life may make it possible to ward off adult psychiatric disorders. In addition to this, research on thought processes can be very perspective in terms of investigating the development of negative attitudes and producing depression or anxiety. This research will provide opportunities for improving prevention and treatment of depression.
Conclusion
Research on this subject concludes that young adults have specific issues that contribute to depression though can be solved by psychotherapy and detailed analysis of every particular case. In an attempt to examine the depression prevalence in young adults, this research paper revealed the major causes of depression and modern methods of treatment related to the subject. Investigation of the issues related to diagnostics of the illness resulted in a discovery that many healthcare practitioners face the difficulties deciding which type of depression patient has. This essay presents an effective approach to diagnosing the disease based on trusted sources, and explains the importance of the correct diagnosis. In conclusion, a possible direction for further research was suggested, and the steps that should be taken in order to achieve the future goals were outlined.