VARIETY Of IMPACTS TO DEPRESSION IN

TEENAGERS AND YOUNG ADULTS

In fulfilment of the requirements for the

completion of
PRACTICAL RESEARCH

By
Lovely Joy Paro Amor of 11 – Einstein (Stem)
From Taguig Integrated School

Date: May 18, 2022

 CHAPTER I

INTRODUCTION

Depression is a state of mental illness. It is

characterised by deep, long- lasting feelings of
sadness or despair. Depression can change an
individual’s thinking/feelings and also affects his/her
social behaviour and sense of physical well-being.

BACKGROUND OF THE STUDY

Depression has been outlined as a mental disorder

characterised by sadness, loss of interest or pleasure,
feelings of guilt or low self-esteem, disturbed sleep or
appetite, feelings of tiredness and poor concentration.
Depression is a mood disorder that causes a persistent
feeling of sadness and loss of interest. Also called major
depressive disorder or clinical depression, it affects how
you feel, think and behave and can lead to a variety of
emotional and physical problems.
This research suggests that depression doesn’t spring
from simply having too much or too little of certain brain
chemicals. Rather, there are many possible causes of
depression, including faulty mood regulation by the
brain, genetic vulnerability, and stressful life events.

Depression is the principal cause of illness and disability

in the world. The World Health Organization (WHO) has
been issuing warnings about this pathology for years,
given that it affects over 300 million people all over the
world and is characterized by a high risk of suicide (the
second most common cause of death in those aged
between 15 and 29) [World Health Organization (WHO),
2017]. Studies on the child population which use self-
reports to evaluate severe symptoms of depression,
specifically the Children’s Depression Inventory (CDI,
Kovacs, 1992) and the Children’s Depression Scale (CDS,
Lang and Tisher, 1978), have observed prevalence rates
of, for example, 4% in Spain (Demir et al., 2011; Bernaras
et al., 2013), 6% in Finland (Puura et al., 1997), 8% in
Greece (Kleftaras and Didaskalou, 2006), 10% in Australia
(McCabe et al., 2011), and 25% in Colombia (Vinaccia et
al., 2006). The main classifications of mental disorders
are the Diagnostic and Statistical Manual of Mental
Disorders, DSM-5 (American Psychiatric Association,
2014), published by the American Psychiatric Association,
which has become a key reference in clinical practice,
and version 10 of the International Classification of
Diseases (ICD-10, 1992), published by the WHO, which
classifies and codifies all diseases, although initially its
aim was to chart mortality rates.

STATEMENT OF THE PROBLEM

1. What the study of this depression in U.S.A

2. Who is being affected in this depression?

3. What research indicates that depression can be

associated with both cognitive impairment and
dementia?
 4. Where the study focus on?

5. What are the possibles outcome of this kind of

depression?

6. What indicates treatment of this or advantage?

SIGNIFICANCE OF THE STUDY

Depression is a major cause of psychological illness in the

United States,
Affecting more than 19 million Americans
(http://www.intelihealth.com). It is
Estimated that 25% of women and 10% of men will have
one or more episodes of
Clinically significant depression i.e., requiring some form
of intervention, during their
Lifetimes.
(http://www.depressionclinic.com/mentalhealth/
depression/causeetiology/default.htm).
Depression affects not only the life of the person who
suffers from the disorder, but Also the lives of family
and friends and depression ultimately affects society
as a Whole. It is estimated that people with depression
cost the economy 30 to 44 billion Dollars per year
(http://www.intelihealth.com).

Research indicates that depression can be associated

with both cognitive impairment and dementia, and that
depression increases the risk of developing dementia
(Steffens et al, 2006). It is not always easy to diagnose
depression in a person with Alzheimer’s disease, as
Alzheimer’s itself may mimic the signs of depression.
Specifically, diagnosed depression is associated with half
a letter grade decrease in students’ grade point average
(Hysenbegasi et al., 2005), and 21.6% of undergraduates
reported that depression negatively affected their
academic performance within the last year (American
College Health Association, 2019).
The study of depression focuses on neuroscience,
reflecting the essential characteristics of depression as a
category of mental illness and better reflecting the fact
that depression is an important link in the human public
health care.
People diagnosed with major depression are nearly 30
percent less healthy on average than those not
diagnosed with major depression. This decrease in
overall health translates to nearly 10 years of healthy life
lost for both men and women.

Depression is a leading cause of disability worldwide and

is a major contributor to the overall global burden of
disease. More women are affected by depression than
men. Depression can lead to suicide. There is effective
treatment for mild, moderate, and severe depression.

A depression treatment plan helps you to feel motivated

to be happy again. At the most basic level, treatment can
stabilize someone who has suicidal thoughts and
provides them with the support and tools they need.
Treating severe depression is just as critical as treating
any other health concern.
Depression leads to more analytical thinking.
We are able to break down complex problems into
smaller components. Depressed folks actually do better
on certain tests than those who are not. We also do a
better job solving social problems (think spouse having
an affair) when depressed.

SCOPE AND DELIMITATION

The scope of this topic is limited to people who are

undergoing depression, has loved ones with depression,
and experts or doctors specializing depression. Since
depression is a very sensitive topic, the scope of the
study would be limited to the researcher and the
respondents. The time frame that the researcher should
follow must be those cases that is still ongoing. If you’re
doing a qualitative study, sample size must me around
ten to fifteen respondents only so that you won’t have a
hard time analyzing the results. The study can also be
limited to places inside the country only to get more
accurate and closer results or data.

DEFINATION OF TERMS

Depression is a common mental disorder, characterized

by sadness, loss of interest or pleasure, feelings of guilt
or low self-worth, disturbed sleep or appetite, feelings of
tiredness and poor concentration.

Antidepressant. A drug used to treat depression.

Selective serotonin reuptake inhibitors (SSRIs) are a class
of antidepressants that includes drugs like citalopram
(Celexa), escitalopram (Lexapro), fluoxetine (Prozac),
paroxetine (Paxil), and Zoloft (sertraline)
Anxiety disorder. A chronic condition that causes anxiety
so severe it interferes with your life. Some people with
depression also have overlapping anxiety disorders.

Bipolar disorder. A type of depression that causes

sometimes extreme mood swings between depression
and mania (or hypomania.) This condition used to be
called manic depression.

Depression. An illness that involves the body, mood, and

thoughts that affects the way a person eats and sleeps,
the way one feels about oneself, and the way one thinks
about things. Dysphoric mood. Low mood that may
include dissatisfaction, restlessness, or depression.
Dysthymia. A type of chronic, low-grade depression that
is less severe than major depression. It can also last for
years. Dysthymia may not disable a person, but it
prevents one from functioning normally or feeling well.
Modern diagnostic systems include "dysthymia" with
"chronic major depression" (that is, a major depressive
episode lasting 2 years or more in an adult or 1 year or
more in children and adolescents) under the general
term "persistent depressive disorder."
 CHAPTER II

REVIEW OF RELATED LITERATURE

Depression is a form of mental disorder that implies the

presence of such symptoms like irritation, constant,
prevailing, and unexplained sadness, changes in appetite,
weight, a decreased interest in life, boredom, lack of
motivation to lead an active lifestyle. The fact that other
symptoms relate closely to one another creates a firm
dependence of mental health on physiological
conditions. The significance of investigating adolescent
depression has been set as a central part of this work
because contemporary scientific methods allow other
researchers to discover the most successful solutions to
the issue. This review aims to gather and analyze the
information on the origins of teen depression, its impact
on society, and variants suggesting how to deal with this
global problem.

Depression is one of the most common conditions to

emerge after traumatic brain injury (TBI), and despite its
potentially serious consequences it remains
undertreated. Treatment for post-traumatic depression
(PTD) is complicated due to the multifactorial etiology of
PTD, ranging from biological pathways to psychosocial
adjustment. Identifying the unique, personalized factors
contributing to the development of PTD could improve
long-term treatment and management for individuals
with TBI. The purpose of this narrative literature review
was to summarize the prevalence and impact of PTD
among those with moderate to severe TBI and to discuss
current challenges in its management. Overall, PTD has
an estimated point prevalence of 30%, with 50% of
individuals with moderate to severe TBI experiencing an
episode of PTD in the first year after injury alone. PTD
has significant implications for health, leading to more
hospitalizations and greater caregiver burden, for
participation, reducing rates of return to work and
affecting social relationships, and for quality of life. PTD
may develop directly or indirectly as a result of biological
changes after injury, most notably post-injury
inflammation, or through psychological and psychosocial
factors, including pre injury personal characteristics and
post-injury adjustment to disability. Current evidence for
effective treatments is limited, although the strongest
evidence supports antidepressants and cognitive
behavioral interventions. More personalized approaches
to treatment and further research into unique therapy
combinations may improve the management of PTD and
improve the health, functioning, and quality of life for
individuals with TBI.

THEORETICAL FRAME WORK

According to Seligman’s learned helplessness theory,

depression occurs when a person learns that their
attempts to escape negative situations make no
difference. As a consequence they become passive and
will endure aversive stimuli or environments even when
escape is possible.

Research suggests that depression doesn’t spring from

simply having too much or too little of certain brain
chemicals. Rather, there are many possible causes of
depression, including faulty mood regulation by the
brain, genetic vulnerability, and stressful life events.
An appropriate point of departure might be the question
of why we need another theory and questionnaire to
describe, explain, and differentiate between anxiety and
depression.

First, the presented theory allows for examining anxiety

and depression in a general, not only clinical population.
It seems to be very important in light of the latest meta-
analysis (e.g., Ayuso-Mateos et al., 2010). Among others
points, it demonstrated that the consequences of
anxiety/depression for the general well-being in non-
clinical populations when the main/full range of clinical
criteria of anxiety/depression are not identified (e.g., low
intensity of symptoms, low number of symptoms) are
comparable with clinical populations. This implies the
significance of analyzing the mechanisms of non-clinical
forms of anxiety/depression and assessing them in the
self-report instruments. As a review of the appropriate
literature suggests, there are not many approaches and
questionnaires that fulfill this need (see Fajkowska,
2013).
Second, the proposed theory represents a belief that
non-clinical forms of anxiety/depression can be seen as
relatively stable personality characteristics and reflects
the newest results of the studies on cognitive and
affective mechanisms in anxiety/depression (e.g.,
Eysenck and Fajkowska, 2017 for a review). Therefore,
the questionnaire developed within it permits more
precise hypotheses related to the origin of
anxiety/depression to be formulated, supports the
understanding of different consequences of functioning
in these phenomena, and allows them to be evaluated
on the basis of their maladaptive mechanisms (e.g.,
attentional, cf. Arditte and Joormann, 2014).

Third, the central finding in previous studies of anxiety

and depression is the high degree of comorbidity that
occurs between them (e.g., Gorman, 1996). Possible
explanations of this co-occurrence relate to the poor
discriminant validity of measures (e.g., Fox, 2008) and
the fact that both phenomena are associated with
negative affect (e.g., Watson, 2000), stressful life events
(Naragon-Gainey and Watson, 2011), and impaired
cognitive processes or a common biological/genetic
diathesis (Watson and Kendall, 1989; Fox, 2008).
However, despite a set of nonspecific features, anxiety
and depression are clearly not identical phenomena. The
theory demonstrated here advocates that the differences
between them might be best viewed through their
heterogeneous and multilayered nature, adaptive
functions, and relations with regulatory processes,
positive affect, and motivation or complex cognitive
processes (cf. Fajkowska, 2013). More precisely,
differentiation should be improved by reducing the
importance of overlapping features and by giving greater
weight to distinctive aspects of these affective
phenomena.

CONCEPTUAL FRAMEWORK

Depression and stress have a bidirectional relationship

whereby depression may be both a cause and an effect
of psychological stress (Kinser et al. 2012). Typically, the
brain moderates the effects of stressors to maintain
optimal functioning. Microprocesses regulate
neurotransmission, endocrine, and immune functioning
centrally, and sympathetic and parasympathetic activity
in the periphery, all of which maintain allostasis or
psychological and physical balance (McEwen and Lasley
2003; Peters and McEwen 2012). In the short term, these
regulatory functions enhance the individual’s response to
stressors and the ability to manage negative
physiological effects (Epel 2009). However, when
stressors continue unabated, these same processes begin
to impair neuronal function and other regulatory systems
(Logan and Barksdale 2008; Kinser et al. 2012). The
cumulative wear and tear associated with these
physiological efforts to manage chronic stressors can
cause depression and additional comorbidities. Without
the availability and use of biopsychosocial resources,
long-term exposure to the chronic stress of depression
and/or repeated episodic life stressors can overload
one’s coping capacity; this may place an individual in a
continuous cycle of stress response with negative affect
states which can decrease quality of life and increase
morbidity and mortality (McEwen 2000, 2007; McEwen
and Lasley 2003; Luyten et al. 2006; Clark et al. 2007;
Taylor et al. 2010). It has been suggested that high levels
of stress and depression are associated with accelerated
cellular aging, a potential biomarker of the overloaded
coping capacity of an individual (Kinser and Lyon 2013).
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SYNTHESIS

The focus of this review was primary qualitative research

studies which, using methods such as interviews and
focus groups, explicitly asked adults with mental health
problems what they considered to be important to their
quality of life or how their quality of life had been
affected by their mental health problems. A range of
approaches is available for synthesising qualitative
research.196 Paterson et al. 197 recommend that the
choice is made based on the nature of the research
question and design, the prevailing paradigm and the
researcher’s personal preference. In this review,
framework synthesis was used. This is based on the
‘framework’ approach for the analysis of primary
data198 and is a structured approach to organising and
analysing data which permits the expansion and
refinement of an a priori framework to incorporate new
themes emerging from the data.196

This chapter reports a summary of the main findings of

the review. A more detailed account is provided in
Connell et al. 2012.199
Systematic reviews of evidence of clinical effectiveness
require extensive searching based on a clearly focused
search question. Defining a focused question was not
possible nor appropriate here, given the exploratory and
inductive nature of the review process. An iterative
approach to searching was used, in order to
accommodate within the search process new themes
emerging throughout the review. Extensive searching
was undertaken, using a number of search techniques.
Database searches were undertaken between October
2009 and April 2010 and included MEDLINE, Applied
Social Sciences Index and Abstracts (ASSIA), Cumulative
Index to Nursing and Allied Health Literature (CINAHL),
PsycINFO and Web of Science. Search techniques
included keyword searching, taking advice from experts,
hand searching, citation searching of relevant references
and internet searching. Four iterations of searching were
undertaken (see Appendix 4 , Table 56 ). The searches
were not restricted by date, language or country. Key
search terms used were mental health, mental illness,
mental disorder, quality of life, well-being, life
satisfaction, life functioning, life change, recovery,
subjective experience, lived experience, lifestyle, coping,
adaptation, qualitative and qualitative research. For a full
list of search terms and details of the search iterations
see Appendix 4 .
 CHAPTER III

METHODOLOGY OF THE STUDY

RESEARCH DESIGN

This research study will explain the depression more and

the effects of this in people

Depression (major depressive disorder) is a common and

serious medical illness that negatively affects how you
feel, the way you think and how you act. Fortunately, it is
also treatable. Depression causes feelings of sadness
and/or a loss of interest in activities you once enjoyed. It
can lead to a variety of emotional and physical problems
and can decrease your ability to function at work and at
home.

Depression symptoms can vary from mild to severe and

can include:

• Feeling sad or having a depressed mood

• Loss of interest or pleasure in activities once enjoyed
• Changes in appetite — weight loss or gain unrelated to
dieting
• Trouble sleeping or sleeping too much
• Loss of energy or increased fatigue
• Increase in purposeless physical activity (e.g., inability
to sit still, pacing, handwringing) or slowed movements
or speech (these actions must be severe enough to be
observable by others)
• Feeling worthless or guilty
• Difficulty thinking, concentrating or making decisions
• Thoughts of death or suicide
• Symptoms must last at least two weeks and must
represent a change in your previous level of functioning
for a diagnosis of depression.

RESPONDENTS

Also, medical conditions (e.g., thyroid problems, a brain

tumor or vitamin deficiency) can mimic symptoms of
depression so it is important to rule out general medical
causes.

Depression affects an estimated one in 15 adults (6.7%)

in any given year. And one in six people (16.6%) will
experience depression at some time in their life.
Depression can occur at any time, but on average, first
appears during the late teens to mid-20s. Women are
more likely than men to experience depression. Some
studies show that one-third of women will experience a
major depressive episode in their lifetime. There is a high
degree of heritability (approximately 40%) when first-
degree relatives (parents/children/siblings) have
depression.

Five thousand six hundred fourteen adolescents aged

16–18 years old and attending 25 senior high schools
were screened and a stratified random sample of 2,427
were selected for a detailed interview. Psychiatric
morbidity was assessed with a fully structured psychiatric
interview, the revised Clinical Interview Schedule (CIS-R).
The use of substances, such as alcohol, nicotine and
cannabis, and several sociodemographic and
socioeconomic variables have been also assessed.

Results
In our sample the prevalence rates were 5.67 % for the
depressive episode according to ICD-10 and 17.43 % for a
broader definition of depressive symptoms. 49.38 % of
the adolescents with depressive episode had at least one
comorbid anxiety disorder [OR: 7.76 (5.52-10.92)]. Only
17.08 % of the adolescents with depression have visited
a doctor due to a psychological problem during the
previous year. Anxiety disorders, substance use, female
gender, older age, having one sibling, and divorce or
separation of the parents were all associated with
depression. In addition, the presence of financial
difficulties in the family was significantly associated with
an increased prevalence of both depression and
depressive symptoms.

RESEARTH INSTRUMENTS

The instrument that will be in gathering data is through

questionnaires and interviews. This was plainly used by
the researchers to gather information. It is most
appropriate tool used because of its validity and
reliability and it was easily to fill out; kept respondents
on the subjects relatively objective and was fairly easy to
tabulate and analyze.

DATA GATHERING PROCEDURE

Data is usually collected from different sources in family

studies in depression. We sought to determine what
effect different methods of data collection had on the
reporting of the lifetime prevalence of depression in the
relatives of

depressed probands.

The method of data collection had a marked effect on

the reported prevalence of depression, with direct
interview being much more sensitive in detecting the less
severe forms of the illness. The lifetime prevalence of
hospitalised depression in relatives, however, was
unaffected by the method of the data collection.

I confirm that indirect sources of family information have

reduced sensitivity for the detection of depression in
relatives compared with direct interview.

Limitations: The numbers of relatives directly

interviewed were small and the probands represented a
severely affected sample which limits the generalisability
of the findings.
 DATA ANALYSIS PROCEDURE

Depression and anxiety are common mental health

concerns worldwide. Broad-spectrum
multi-vitamin/mineral approaches have been found to
alleviate a number of psychiatric symptoms. We
investigated the effects of a nutrient intervention
program, which includes optimizing vitamin D levels, on
depression and anxiety outcomes from community-
based program. Methods: We evaluated self-reported
health measures of depression and anxiety collected as
part of a community-based program focused on
optimizing overall health through nutritional
supplementation, education and lifestyle advice. Results:
Data were collected from 16,020 participants, with
measures including European Quality of Life Five
Dimensions (EQ-5D) and Targeted Symptoms List (TSL)
providing self-reported depression and anxiety. More
than 56% of participants were identified as having
elevated levels of depression and anxiety at baseline as
reported on the EQ-5D. After one year in the program,
49.2% (n = 7878) of participants who reported any level
of depression or anxiety at baseline reported
improvement at follow-up. Of those who reported
severe/extreme depression at baseline (n = 829), 97.2%
reported improvement after one year. Regression
analyses revealed a significant association of
improvement in depression and anxiety with higher
vitamin D status (>100 nmol/L) and more strenuous
physical activity. Conclusion: Overall, people from the
general population who suffer from mood and anxiety
problems may benefit from improved nutritional status
achieved with nutritional supplements.