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Depression in teenagers is a real and significant mental health issue that causes relentless feelings of sadness and powerlessness.  Teen depression affects the way a teenager thinks and feels, how the teen behaves, and creates emotional, physical, and functional problems (Mayo Clinic, 2016). Changes within the teen's body, peer pressure, and difficulty in school can contribute to teen depression.  Depression in this age group can be very serious, even resulting in suicide, and should be treated long-term with medications and/or psychological counseling (Mayo Clinic, 2016).

Physical changes seen in depressed teens may include: loss of energy, increased sleeping, decreased sleeping, increased or decreased appetite, weight changes, poor school performance, drug or alcohol use, social isolation, risky behaviors, and self-harm.  Emotional changes may include: extreme sensitivity to rejection or failure, anger, sadness, worthlessness, and hopelessness.

Primary intervention for adolescent depression in prevention. Prevention may include programs that educate regarding the risks of smoking, drinking and driving, sex, and AIDS. It is also helpful for the teen to be involved in healthy activities/hobbies such as sports teams, artistic groups, and classes in school (Mayo Clinic, 2016).

Secondary intervention, also called early intervention, takes place after the problem has already been going on for a while, and has been identified (Mayo Clinic, 2016).  At this point, the teen's depression may not be very advanced, but has the potential to get worse if interventions do not occur.  Medication is an option at this point.  In addition, teens and parents may reach out to helplines, youth assistance programs, or out-patient counseling (Mayo Clinic, 2016).

Tertiary intervention is a wide spectrum of clinical and non-clinical options.  Medications, inpatient adolescent psychiatric wards, eating disorder clinics, drug and alcohol programs, and residential treatment facilities are all options that may be helpful.  It is important that the teenager has support of family members and/or close friends.

As nurses, we can intervene in many ways. Some examples are: encourage the teen to express and talk about his or her feelings, assess the adolescent to determine precipitating event(s) when feelings of sadness/hopelessness arise, teach positive and effective coping strategies such as guided imagery and relaxation, assist the teen in focusing on strengths rather than weaknesses, and assist the teen in identifying positive and supportive friends and family members (Mayo Clinic, 2016).

In the state of Wisconsin, there are 16 separate crisis and suicide hotlines teens can reach out to in desperate times.  Nurses can also call these numbers if they feel a teen is at risk for self-harm.  In addition, nurses can work together with doctors to make psychiatric referrals in order to ensure the teen gets the help he or she needs.

Reference: Mayo Clinic. (2016). Teen depression. Retrieved from https://www.mayoclinic.org/diseases-conditions/teen-depression/home/ovc-20164553