Select an issue in nurse practitioner (NP) practice that is of interest to you and in which you would like to see a practice change occur. Conduct a review of the literature to see what is currently known about the topic. In 1-2 paragraphs, describe the scope and relevance of the issue and your recommended change.
Area of Interest in NP
Teenage depression is an issue of concern. NIMH.gov (2022) reports that more than four million American teens aged between twelve and seventeen years reported at least one episode of depression in 2020. This represents a prevalence of about 17 percent among this population. Furthermore, NIMH.gov (2022) reports that the prevalence of depression is higher among teenage females (about 25 percent) than males (about nine percent). NIMH.gov (2022) indicates that the prevalence of depression was higher among mixed-race teenagers (about 29 percent) compared to Asians (about 13.9 percent), blacks (about 13 percent), whites (about 18.6 percent), and Hispanics (about 15.6 percent).
Various factors increase the risk of depression. Firstly, life crises increase the risk of depression among teenagers. For instance, Jones et al. (2022) report that COVID-19 increased the incidence of depression and other mental health problems by about 37 percent among high school students. This is attributed to events such as quarantine, limited socialization, and fear. Secondly, Jones et al. (2022) report that the prevalence of depression and other mental health problems is higher among gays and lesbians compared to heterosexual teenagers. Thirdly, childhood trauma increases the likelihood of depression. For instance, teenagers with a history of sexual abuse or accident involvement are likely to be anxious and depressed compared to those without traumatic experiences (Daly, 2022). Fourthly, the environment may predispose a teenager to depression. For example, dysfunctional families and bullies increase the likelihood of depression (Horowitz & Graf, 2019). Fifthly, substance abuse and misuse predispose teenagers to depression. Examples of these substances and drugs include alcohol and benzodiazepines (Daly, 2022).
Depression is diagnosed by evaluating an individual’s symptoms and using the DSM-5 diagnostic criteria. According to the DSM-5, depression should be diagnosed if a person fulfills at least five symptoms found in the diagnostic criteria. Firstly, the individual’s depressed mood should persist daily (Truschel, 2022). Secondly, anhedonia should persist daily. Thirdly, the individual should demonstrate unexplained weight loss, weight gain, or altered appetite (Truschel, 2022). Further, the fourth symptom is experiencing a diminished thought process and limited mobility, and the fifth is experiencing fatigue almost daily (Truschel, 2022). Next, the individual is guilty and feels worthless. Lastly, the individual is indecisive and unable to concentrate (Truschel, 2022).
Various approaches are used to manage depression. Psychotherapy is an example of a non-pharmacological approach. This can be accomplished via interpersonal therapy and cognitive behavioral therapy (Lee et al., 2020). Notably, interpersonal therapy aims at improving teenagers’ social lives. It improves communication and their willingness to seek help from families, friends, and teachers (Jones et al., 2022). Cognitive behavioral therapy enables teenagers to focus on positive thought processes (Lee et al., 2020). By so doing, the incidence of depression is lowered. Further, pharmacological approaches should be used cautiously. Antidepressants have been reported to increase the risk of suicide among children, teenagers, and young adults (Lee et al., 2020). As such, when antidepressants are used, teenagers should be monitored closely. This requires a concerted effort among teenagers, parents, healthcare providers, and instructors. Selective serotonin inhibitors such as escitalopram and fluoxetine are approved for the management of teenage depression (Lee et al., 2020). The risk of suicidal ideations implies that psychotherapy should be prioritized in the management of teenage depression.
Teenage depression is a relevant problem in the USA and globally. Nurses, healthcare providers, and other stakeholders should identify and address factors predisposing teenagers to depression. To accomplish this, they can embrace both pharmacological approaches and psychotherapy. Psychotherapy is the management of choice. Medications are initiated to complement psychotherapy.
References
Daly, M. (2022). Prevalence of Depression among Adolescents in the U.S. From 2009 to 2019: Analysis of Trends by Sex, Race/Ethnicity, and Income. Journal of Adolescent Health, 70(3), 496–499. https://doi.org/10.1016/j.jadohealth.2021.08.026
Horowitz, J. M., & Graf, N. (2019). Most U.S. Teens See Anxiety and Depression as Major Problems. Pew Research Center, February. https://www.pewresearch.org/social-trends/2019/02/20/most-u-s-teens-see-anxiety-and-depression-as-a-major-problem-among-their-peers