Types of Teen Depression - Subtypes
Depression is categorized as Major Depressive Disorder (MDD), which manifests through a combination of depressed mood, irritability, or loss of interest in previously enjoyed activities for at least 2 weeks, combined with at least 4 of the additional symptoms listed above, or Dysthymic Disorder (DD), which is less severe in intensity than MDD, but has existed for 2 years or longer. Post Traumatic Depression (PTD) is not listed in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) as a distinct mental disorder; however, Post Traumatic Depression differs from MDD, creating different physiological responses, prognoses, and treatment requirements. Bipolar Disorder usually has alternating components of both major depression and mania or hypomania. See Bipolar Disorder.
Post Traumatic Depression
A few words about the special case of Post Traumatic Depression (PTD), which must be treated in light of the traumatizing event. Studies have shown that PTD differs from MDD in its physiological response, in
symptoms expressed, and in the requirements for treatment. Research has
also shown that childhood physical, sexual, and emotional abuse, as
well as neglect, all can lead to impaired self-concept, difficulty in
interpersonal relationships, and subsequently to increased
vulnerability for depression.
Rachel was only 13 years old when it was discovered that a group of
boys at her school were encouraging her to use alcohol and sexually molesting her.
While Rachel showed most of the signs of classic depression, she also
exhibited a profound sense of helplessness that contributed to her
vulnerability to both depression and abuse. Several sessions were
required before Rachel revealed that she had been sexually abused
between the ages of four to eight by a teenage neighborhood boy who had
repeatedly forced her to perform oral sex. When Rachel did tell the
story, her eyes became blank, her body motionless, and her voice low
and monotone. It was as if she were relating what had happened to
someone else and had no feeling about it whatsoever. Understandably,
Rachael had dissociated, literally dis-associated, from the events of
the past for emotional protection from the associated feelings.
Like many abused children, Rachel had not developed a concept of
self-worth and the corresponding concept of self-protection, leaving
her continually vulnerable to further abuse. It had not even occurred
to her that she had a right to deny the boys' requests and
abusive behaviors. Rachel showed all the signs of depression, but she
was also suffering from past trauma that would have to be worked
through in therapy if she were to improve. Seligman's (see References) experiment that led to the theory of
Learned Helplessness sheds light on the passivity that results from
repeated stress, trauma, and depression. In his experiment, Seligman placed dogs, one at a
time, in a container that had two separate compartments, both of which
were easily accessible by the dogs. The dogs were given a mild electric
shock, which was preceded by a warning signal. Each of the dogs quickly
learned that they could escape shock by jumping from one container to
the other as soon as they heard the warning sound. Within a short time,
the dogs routinely and "non-chalantly" jumped from one compartment to
the other to avoid the shock. However, if the same dogs were given
numerous shocks that were unpredictable, random, and without warning,
after several futile attempts to escape, two-thirds of the dogs gave up
trying to escape and simply lay down and whined passively. When the
dogs that gave up their effort to escape were later put in a situation
where they could escape with minimal effort, as in the first described
experiment, they made no effort to escape or avoid shock. Seligman's experiment lies at the heart of learned helplessness in
humans and provides understanding of what happened to Rachel. In the
face of the neighboring boy's demands, she learned to be helpless at an
age before she knew there were choices. She further believed that there
was no possibility of escape, and learned to accept and even expect to
be abused by others.
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