*This post was written by Ventura County young adult, Alycia Eade.
Today, a major problem continues to fester in our society. Many people do not accept mental illness as an illness at all, simply because they cannot see a mental illness like they would a physical ailment. The disregard for the issue of depression in youths is supremely incorrect. Depression is a mental ailment that can have physical consequences. Because of this, oftentimes adolescents do not receive the genuine support they need from their families. Depression is often misunderstood as something that you can “get over”, but in fact, having such a mental illness requires daily battles and constant support to reduce the searing ebb of one’s inner demons. Some parents argue that they are doing wonderfully in terms of providing all that is needed for their child’s battle with depression. In terms of driving him or her to therapy appointments, doctors appointments, or medication pickups, that may be true, but what about the love and support they need?
A lack of familial support produces negative consequences and often exacerbates an adolescent’s depressive condition. The consequences of this vary from one individual to the other, but the most common consequences include a loss of interest in activities and life, a lack of self worth, an increase in risky or dangerous behavior, self harming, and suicidal thoughts or behavior. These consequences have been confirmed over the span of several decades through the work of a dedicated community of concerned parents, professors and doctors, and individuals that suffer from clinical depression.
Strengthening and empowering the adolescent to fight back against depression requires the emotional inclusion of parents in the recovery process. Participating actively in family therapy provides needed changes to interpersonal relationships within the family and demonstrates supportive behavior in the home for the adolescent. Conversely, a negative family relationship can force adolescents to continue their downward slide into depression. Despite substantial evidence that shows the rising importance of mental health awareness in teens, many people still believe that adolescent depression is not an issue of importance, as it only affects a small percentage of the adolescent population. Even then, they believe that it is questionable whether or not an adolescent does in fact have depression, or if they are simply acting immaturely. Similarly, some people debate whether mental illnesses exist at all. In refutation to their skepticism, studies- including individual experiences and historical evidence- prove these objections to be false.
The history of the mental health issue began in the early nineteenth century, when families started to send their adolescent children away to lunatic asylums for unusual behaviors, often for a duration of months- or even years- in lonely and harsh isolation. While this common practice was thought to cure mental illness, it only emphasized and caused the child’s condition to progress sometimes to the point of no return. Modern practices are much different, but the opinions of doctors, professors, parents, and patients still vary widely over the existence of mental disorders. Organizations such as NAMI (National Alliance on Mental Illness, founded in 1979) and MHA (Mental Health America, founded in 1909) strive to provide information that mental health advocates can utilize to spread awareness of this issue and educate people on the best ways to help and the most successful treatments.
Over time, family therapy came to be most clearly defined as, “‘a type of psychotherapy that works with families and couples. It emphasizes family relationships as an important factor in psychological health. As such, family problems are seen in relation to family interactions, rather than to be based only on individual members. Family therapists tend to focus on what goes on between people; that is, on how patterns of interaction within the family may foster or maintain the problem”.
There are three main branches of family therapy, such as structural family therapy, intergenerational family therapy and strategic family therapy. Structural family therapy, as devised by Salvador Minuchin in 1967, is a form of psychotherapy where the individual’s feelings, thoughts, and emotions are thought to have a direct correlation with the dysfunctional structure and inner workings of the family. The structure and functions are how each family member connects/interacts with one another and how tasks are carried out. In this instance, the complex hierarchy of the family is thought to be haphazard, distressing, and even toxic, therefore being the causation of the adolescent’s depressive condition to become exacerbated or prominent. The interaction between the patient and the family is carefully analyzed in each therapy session. (“Family Systems Therapy”).
Intergenerational family therapy, developed by Murray Bowen, is a form of psychotherapy where the past is analyzed with the present. The mental health history of past generations of the family are taken into consideration and linked to the mental health problems of the current generation-meaning that this problem of adolescent depression originated from the past (“Family Systems Therapy”).
Strategic family therapy, as comprised by Jay Haley, Milton Erickson, and Cloe Madanes in 1953, is a form of psychotherapy where the psychotherapist focus on how to solve a problem at hand; In this instance, how to make the family change their behavior now in other, more positive ways to cure an adolescent of his or her current depression. This is analyzed strategically outside of therapy sessions, in daily life to address the here and now (“Family Systems Therapy”).
Adolescent depression stems from many causes: the biology of an individual, low self esteem being typical in early adolescence, and stressful family or life conditions can all be contributing factors. But the major contributing factor to recovery and the remission of depression symptoms is the role of family relationships.
A specific type of parenting can significantly influence the success of treatment for adolescents. Historically, there have been three common styles of parenting an adolescent, as identified by Diana Baumrind in a compilation of her research, published in nineteen sixty six. Throughout her research, she clarifies that all three styles of parenting styles share an important quality- a parent is meant to be a non-violent, humane role model and a leader for their adolescent(s). The styles of parenting, such as authoritarian parenting, permissive parenting, and authoritative parenting, have been proven to be the most utilized styles of parenting throughout history.
Authoritarian parenting is a style of parenting that is comprised of absolute rules. These rules cannot be broken or made exceptions to at any time. The child cannot question these rules, as the parents, so aptly put by Baurind, “believe that the child should accept his/her word for what is right.” (Baurind). These parents regard their adolescent not as a child, but as a future adult that needs very firm rules and regulations to be a proper individual in the world. Parenting tools such as punishment and force are exercised as a means of enforcing rules and behavior. The parents are seen as the authority figures and the adolescent is seen as the compliant follower.
Permissive parenting is a style of parenting that is considered lenient and lax. This style of parenting provides the child with a friendly relationship to his or her parents. The parents cater to the desires and whims of the children. There are not any concrete rules or responsibilities for the adolescent to follow. Instead of a role model the adolescent should aspire to, the parents are “presented to the child as a resource” for the children to use. These parents encourage every freedom and liberty for their child, as well as self-reliance and self-regulation.
Authoritative parenting is a style of parenting that contains a harmony of “clear, high expectations with emotional support and recognition of children’s autonomy.” (Baumrind, 1991). This method also utilizes parenting tools such as guidance and logic (common sense) to subtly direct children on the right path without being absurd or unethical. Often times, these parents will put rules into place, but are fair to questions and exceptions. The parent considers and performs making exceptions to the rules placed. The parent also will listen to the child’s concerns, and answer questions as to why such rules are set in place, and when they became necessary to be required.
Out of these styles of parenting, authoritative parenting has been proven to be the most successful form of parenting for the success of treatment for depression in adolescents. Changes in mood and mental mindset from a severe depressive state to a mild manageable state arise very gradually. An adolescent should receive treatment for the duration of at least 6 months to maintain improvement in mental stability and mood ( Emslie GJ, Mayes TL. Mood disorders in children and adolescents: psychopharmacological treatment. Biol Psychiatry. 2001;49(12):1082–1090.) Treatment, (in terms of attending family therapy sessions), usually lasts a length of a year to a year and a half (keyword being usually).
The decision to bring to fruition an end to the participation of family therapy is a difficult one, and one that should not be taken lightly. The therapist, family, and patient should all come to a universal agreement as to when the treatment should cease. The reasons for ceasing treatment should be also considered. The general consensus is that treatment should end when the family, therapist, and patient feel that the patient is emotionally and mentally ready to metaphorically stand without the added help of continued family therapy. For the adolescent patients, getting through each day is a new battle, a new challenge. Therefore, it may take a lengthy period of time before the family and adolescent reach that point together.
The MHA provides facts on how we came to the current situation in treating this mental illness: “The most commonly used treatments are antidepressant medication, psychotherapy or a combination of the two. The choice of treatment depends on the pattern, severity, persistence of depressive symptoms and the history of the illness”
Taking medication as a form of treatment is also a refutation that could be argued. Many people, particularly adults aged forty or older, argue that medication is never a proficient option for any case of any illness whatsoever, as it is not only ineffective, but detrimental to the health of the individual. In opposition, there have been an overwhelming amount of studies and data to prove that medication is in fact a viable and successful option to treat or remedy mental and physical illnesses.
The active emotional involvement of parents in the adolescent’s recovery process from depression is paramount. The active engagement in family therapy provides essential change to various family relationships. This can also propel the family to exhibit supportive behavior in the household for the adolescent. Adolescent depression has remained an imminent problem because each year there is a steady increase in the quantity of youth who grapple with the claws of depression. It is of the utmost importance to not only remedy this issue, but to raise awareness and acceptance of it as well.
To solve this issue, parents and family should be present in family-oriented psychotherapy sessions with their depressed child and make positive revisions to their style of parenting to provide a secure and loving atmosphere for the child to heal. By solving this issue in such a way, we lay the foundation for a bright future in a world accepting of mental illness.
It is only logical to desire a world in which people receive one another with open arms, and therefore desire a robust population of the world in which all are regarded of equal standing, no matter race, ethnicity, religion, political stance, illness, appearance, or other equivalent differences.
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