In light of Youth Month in South Africa it is critical that we are aware of the struggles facing some of our youth. Globally, and in South Africa, approximately 20% of teens have a mental health disorder, but the majority are either not detected or untreated. The consequences can be catastrophic: common psychiatric disorders in adolescents include anxiety-, mood-, trauma- and stress- disorders, which are all associated with an increased suicide risk.
The South African National Youth Risk Behaviour Survey recently investigated a number of key risk behaviours, including intentional and unintentional injuries, violence and traffic safety, suicide-related behaviours, behaviours related to substance abuse (tobacco, alcohol and other drugs), sexual behaviour, nutrition and dietary behaviours, physical activity and hygiene related behaviours.
The study found that 24% of youths surveyed between Grade 8 to Grade 11 had experienced feelings of depression, hopelessness and sadness, while a further 21% had attempted suicide at least once. Another recent study, among school-attendees aged 14 to 15, in a large metropolitan area of Cape Town, showed that adolescents experienced a high prevalence of depression (41%), anxiety (16%) and PTSD (21%).
“Mental illness in adolescents is associated with significant short- and long-term morbidity or illness,” says Dr Eileen Thomas, a psychiatrist at Akeso Clinic Milnerton, and researcher at the South African Research Chair in Post-traumatic Stress Research Group, at Stellenbosch University. “Mental health disorders manifest in different ways. Symptoms include low mood and anxiety, as well as thoughts and behaviours that impact negatively on the adolescent’s wellbeing and functioning. They may become withdrawn, stop participating in school activities, or struggle academically. If untreated, secondary complications can arise, such as dropping out of school, entrenchment of unhealthy behaviours like cutting or extreme weight gain or loss, and these may persist into adulthood.”
What causes adolescent mental disorders?
Mental disorders have many different causes and can result from complex interactions between a person’s genes and their environment. Adolescence itself is a period of significant physical, social and emotional change and therefore a vulnerable period for the development of mental illness.
For teens, says Dr Thomas, the risk factors for the development of mental health problems include social isolation, academic pressures, low self-esteem and poor body image, as well as health risk behaviours such as drug and alcohol use. “Research indicates mental health problems may also develop as a result of adversity, such as trauma or a stressful life event, and that childhood hardships can have significant and lasting negative effects on mental health that continue as the adolescent matures.”
Signs and symptoms to look out for
Common mental disorders such as depression may present differently in adolescents versus adults. For example, adolescents are more likely to experience irritability, apathy, sadness, low self-esteem, social withdrawal, insomnia and impaired concentration.
“They often describe themselves as useless, or life as boring,” Dr Thomas adds. “The diagnosis of depression may be missed in older adolescents, as they may present with oppositional or antisocial behaviour, such as substance use and have problems at school.”
How to address adolescent mental health issues
Preventing common and serious mental health disorders from developing is key. “Helping children to develop resilience is important. In addition, parents and caregivers need to be aware of early warning signs and symptoms, and we need to reduce the stigma about mental illness. When parents and caregivers accept mental illnesses, it becomes easier for the child to talk to them when and if they do experience worrisome symptoms. In South Africa there is an urgent need to increase awareness, and improve screening, detection and treatment of mental illness in this vulnerable group.”
Dr Thomas say treatment is multipronged and will always involve both the adolescent and their family, or support system. Treatment is geared to relieving the specific distressing symptoms and improving overall functioning; this may be through education about the illness, talk-therapy or medication use. It may also involve treatment from an allied health practitioner, such as a social worker or occupational therapist.
What can you do to help?
Good mental health allows teenagers to cope with whatever life throws at them and to grow into well-rounded, healthy adults.
“Things that can help keep your teen mentally healthy include being in good physical health, eating a balanced diet and getting regular exercise,” says Dr Thomas. “It’s also important to be part of a family that gets along most of the time, as are feelings of being loved, trusted, understood, safe and valued.”
Here are some of the steps you can take to promote your teen’s mental wellbeing:
- Be an active participant in your teen’s life.
- Get to know your teen’s friends and school-teachers.
- Be available, approachable and non-judgmental.
- Encourage participation in support-structures (e.g. youth groups) and healthy hobbies.
- Keep an eye on social media interactions. While teens can use social media to connect and create friendships with others, they also confront cyberbullying, trolls, toxic comparisons, sleep deprivation, and less frequent face-to-face interactions.
- Help your teen to set realistic goals and to build confidence in their own abilities – this involves accepting who they are and recognizing what they are good at.
“Everybody has different strengths and that’s what makes us all awesome,” Dr Thomas adds. “Every teenager has something that’s interesting and great about them, and that’s what they need to be aware of.”
If you think you (or someone you know) might have a mental disorder, please consult a professional as soon as possible. Early identification and effective intervention is the key to successfully treating the disorder and preventing future disability.
References
- Kessler RC, Berglund P, Demler O, et al. Lifetime prevalence and age of onset distributions of DSMIV in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005; 62(6):593-602. DOI:10.1001/archpsyc.62.6.593
- Hawton K, Saunders KEA, O’Conner RC. Self-harm and suicide in adolescents. Lancet 2012; 23:2773-2782.
- Patel V, Flisher AJ, Hetrick S, McGorry P. Mental health of young people: A global public health challenge. Lancet 2007; 369:1302-1313.
- Jayati Das-Munshi, Crick Lund , Catherine Mathews, Charlotte Clark, Catherine Rothon, Stephen Stansfeld. Mental Health Inequalities in Adolescents Growing Up in Post-Apartheid South Africa: Cross-Sectional Survey, SHaW Study published: May 3, 2016. https://doi.org/10.1371/journal.pone.0154478
- Barry C, Sidoti C, et al. Adolescent social media use and mental health from adolescent and parent perspectives. September 2017Journal of Adolescence 61:1-11. DOI10.1016/j.adolescence.2017.08.005
- Mental Health Foundation. Truth Hurts: Report of the National Inquiry into Self-Harm Among Young People. London; 2006.
- Stice E, Hayward C, Cameron RP, Killen JD, Taylor CB. Body-image and eating disturbances predict onset of depression among female adolescents: a longitudinal study. J Abnorm Psychol. 2000; 109(3):438–444. [PubMed]
- Gordon A. Comorbidity of Mental Disorders and Substance Use: A Brief Guide for the Primary Care Clinician. Department of Health and Ageing, Australian Government: ACT, Australia; 2008.
- Arseneault L, Cannon M, Poulton R, Murray R, Caspi A, Moffitt TE. Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study. Br Med J. 2002; 325(7374):1212–1213.
- Moore THM, Zammit S, Lingford-Hughes A, Barnes TRE, Jones PB, Burke M, Lewis G. Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet. 2007; 370(9584):319–328.
- Turner HA, Butler MJ. Direct and indirect effects of childhood adversity on depressive symptoms in young adults. J Youth Adolesc. 2003; 32(2):89–103.
Featured in and on:
- Smile FM - Thursday, 7 June 2018 - The Honest Truth Show
- IOL – Friday, 8 June 2018 – https://www.iol.co.za/mercury/sa-teens-facing-depression-crisis-15362466
- SA FM – Tuesday, 12 June 201 - The Home Run Show