Adolescent Depression: Do Your Patients Have a Trusted Adult to Talk With?

If you or a loved one never had a trusted adult you could talk to when you were an adolescent, here’s your chance for a do-over of sorts, a way to save someone else.

Based on preliminary analysis for her dissertation study, doctoral candidate Halima Al-Khattab, RN, BSN, Indiana University School of Nursing, wants you to ask your adolescent patients with depression if they have an adultwho they trust to talk with. Emphasize the importance of this and then think about how those adults could help your patients.

• Al-Khattab says you might ask your patients:
• Do you have any adult with whom you don’t need to put on a happy face?
• Are there other ways you can express your feelings other than lashing out?
• Are there adults with whom they don't need to put on a happy face?
• Are there other ways they can express their feelings other than lashing out?

Adolescent depression is a serious mental illness that results in negative health consequences and frequently recurs later in life. Although the prevalence rate of depression is around 20 percent among African American and European-American adolescents, the associated risks and utilization rates vary greatly.

Urban African American teens disproportionally experience high rates of: substance abuse, academic failure, and arrest and incarceration. Unrecognized and untreated mental health problems may cause these problems. Adolescents with depression, particularly African American adolescents, often do not receive adequate mental health services.

The American Psychiatric Nurses Association (APNA) 28th Annual Conference, held October 22-25, 2014, in Indianapolis, IN, featured Al-Khattab’s preliminary analysis on the processes of disease management and treatment use in adolescent depression.

She is currently in the process of collecting data for a grounded theory study on how African American adolescents understand and manage their depressive symptoms. Supported by an Individual F31 Predoctoral Fellowship Award, she is interviewing young adults who were either depressed or in treatment for depression as adolescents. Thus far, she has interviewed 15 young, single adults in Indianapolis, including 12 women and 3 men, with a mean age of 20. The most surprising thing for her has been the level of anger and amount of trauma that the young adults have been through.

Al-Khattab has learned that adolescents manage their depression through four different ways of being with people:

• Pulling Back: Participating, but not being present
• Joining In: Seeking out and participating in group activities as a distraction
• Being Noticed: Opening up after someone else notices something wrong
• Keeping Others At Bay: Doing things to shut others out

Withdrawal is not the only way adolescents show depression. Sometimes, they change how they interact with others when they want to hide their feelings.

This study is still ongoing and Al-Khattab said she looks forward to developing the full theoretical framework that describes how African American adolescents understand their depression and its effects, manage their symptoms, and, in some cases, seek and use mental health services over the course of their adolescent years.