As human beings we all get ‘down’ from time to time, we all have time periods where we get sad or feel blue. When those sad or down times begin to exceed a certain time frame or start to take over an individual’s life and every day functions it may be due to depression. Depression can come in many different forms, according Smith et al., (2013) some depressed people don’t feel sad at all but instead feel lifeless, empty, and apathetic or men in particular may even feel angry, aggressive and restless. Whatever the symptoms, depression interferes with the ability to work, study, eat, and have fun, leaving the depressed individual with feelings of helplessness, hopelessness and worthlessness with little or no relief (Recognize Depression Symptoms & Get Help, para 3).
According to the DSM-V, depressive disorder may appear at any age, but the likelihood of onset increases markedly with puberty. In the United States, incidence appears to peak in the 20’s, however, first onset in later life is not uncommon. Regarding depression and gender Rizzo et al. (2006) states, “Girls’ greater investment in interpersonal relationships has been proposed to account, in part, for the emergence of the sex difference in depression during adolescence”. He goes on to state, “as compared to adolescent boys, girls report greater amounts of interpersonal stress and perceive negative interpersonal events as more stressful. Adolescent girls also appear to be more vulnerable to depression than boys in the face of interpersonal stress” (p. 469). This is in accordance with Smith et al., (2013) that states, “rates of depression in women are twice as high as they are in men. This is due in part to hormonal factors, particularly when it comes to premenstrual syndrome, premenstrual dysphonic disorder, postpartum depression and premenopausal depression. Where women’s symptoms go from feelings of guilt, excessive sleeping, overeating and weight gain, men depressive signs are usually aggression, violence, reckless behavior and substance abuse. Even though rates for women are twice as high in depression, men are a higher suicide risk (Recognize Depression Symptoms & Get Help, para 11).
Another factor of depression is culture. Saulsberry et al. (2012) state that as compared to Caucasian adolescents, more African American adolescents experience a depressive episode. Latino and African American adolescents report significantly higher levels of depressive symptoms than non-Latino white adolescents, even when controlling for adolescents’ age, gender, family structure and household income” (p. 151). Saulsberry et al., (2012) goes on to state, African American and Latino adolescents of low socioeconomic status appear to be even more vulnerable for a depressive episode. In addition to the specific mental health concern of depression, both minorities and low-income populations underutilize mental health services (p. 151). Saulsberry et al., (2012) believes that without choice and the availability of acceptable treatment options, adolescents with mental illness are less likely to engage in treatment or to participate in appropriate intervention. These vulnerabilities point to the need for early preventive interventions in the development of depressive disorder to reduce lifetime disparities in depressive outcomes for ethnic adolescents ‘(p. 152).
According to Sommers-Flanagan et al., (2000), “Clinical depression prevalence rates have raged from 0.4% and 2.5% in children to 8.3% in adolescents. An adolescence lifetime prevalence rate for major depressive disorder is between 15% and 20%”. Sommers-Flanagan et al., (2000) goes on to state, “besides the many impairments in functioning resulting from subclinical depressed mood and from depression, depressive disorders in adolescents are strongly associated with suicide, which is the third leading cause of death among adolescents” (p. 170). Understanding the severity of depression amongst children and adolescents, many individuals have come up with interventions and preventions that they believe can minimize such severe effects of depression such as suicide. Rizzo et al., (2006) believes that (IPT) Interpersonal Psychotherapy, which was developed to address interpersonal issues in depression, has been shown to lessen the impact of life events on depression recurrence among adult women. Implementing coping strategies that mitigate the effects of romantic stress will likely foster adjustment to the challenges of romantic relationships and improve the efficacy of depression interventions for adolescent girls (p.477). In contrast Saulsberry et al., (2013) believes depression is less a gendered issue and stems more from a cultural perspective that in turn would call for a more culture driven intervention. CURB (Chicago Urban Resiliency Building) is a culturally adapted, low-cost, primary care/ Internet-based depression prevention intervention for African American and Latino adolescents. CURB targets common barriers in accessing mental health services (cost, difficulty in distribution and low acceptability of some face-to-face interventions). CURB also utilizes Internet technologies to address the limited supply of mental health resources. The unique strength of CURB is its ability to be easily implemented in a primary care setting, enabling a clinician to intervene quickly for adolescents at risk for depressive disorder (p. 159). Unlike both Saulsberry et al., (2013) and Rizzo et al., (2006), Sommers-Flanagan et al., (2000) and Kane et al., (n.d), both believe helping to enhance social and coping skills will help with depression in children and adolescents. Sommers-Flanagan et al., (2000) states, ‘because both social skills deficits and poor self concept have been shown to be correlated with the development of depressive disorders, addressing deficits in both coping and social skills is a promising way to intervene in subclinical, mild, and/or moderate childhood depression. Such intervention likely serves as a preventative role as well” (p. 171). Sommers-Flanagan et al., (2000) believes because significant research evidence indicated that depression among young people is partially cause and maintained by social, cognitive and behavioral factors, school-based counseling and psychoeducational groups are an appropriate and effective context for both depression prevention and treatment. Structured groups provide members with information about a particular problem area or developmental issue and also provide a safe environment to learn and practice new coping skills (p.187). In conjunction, Kane et al., (n.d) stated, a coping with stress course; 15-session afterschool program, for 14–15-year-olds with elevated depressive symptoms was associated with a 14.5% incidence of depressive disorders in the intervention group at 12-months follow-up, compared with 25.7% of the control group. Kane et al., (n.d) also found significant prevention effects using their 12-session, cognitive–behavioral (CB) program, the Penn Prevention Program (PPP), implemented after school with 5th and 6th graders reporting elevated depressive symptoms and/or high levels of perceived parental conflict. Compared with the control group, intervention group students reported fewer depressive symptoms up to 2-year follow-up (p.622).