Extra attention to stressful situations at home during corona

Depressed adolescents? Treat stress and exhaustion

Depression in adolescents is almost always associated with stress and exhaustion. Treatment of depression now too often focuses exclusively on mood improvement, but should be more associated with treatment of the underlying stress and exhaustion. That is the message of paper that Utrecht researchers published in Frontiers of Psychiatry.

Depression in adolescents is not an isolated disorder, but often a symptom of chronic stress and exhaustion. “Physical manifestations thereof in the form of fatigue and signs of exhaustion are too often not recognised and adequately treated”, says research leader Toine Pieters.

Environment - Life Events - Genes
Life events, genetics, and environment all have an impact on the development of stress, coping with stress, and ultimately exhaustion and depression symptoms in adolescents and young adults.

Currently, treatment is primarily aimed at improving mood, and mostly consists of treatment with several antidepressant drugs, just like in adults. Yet, between one third to half of patients show no response in the first weeks or at all.

“The current therapeutic shortcomings are the consequences of our lack of knowledge of causes, the underlying neurobiology and chemistry, and risk factors that contribute to the onset and maintenance of depression”, the researchers say.

The reseachers propose a new approach. “We propose to open up a symptom-based, mood-centered view to a model in which adolescent depression is framed as a consecutive failure of stress coping mechanisms and chronic exhaustion. Addressing exhaustion and coping primarily as a treatment strategy in adolescents and young adults might work in synergy with existing treatments and improve overall outcomes.”

It shows that in this coronacrisis we have to be extra alert to coping with stressful situations at home.

Prof. dr. Toine Pieters

This is particularly relevant during this coronacrisis, Toine Pieters says: "It shows that in this coronacrisis we have to be extra alert to coping with stressful situations at home. Failure to identify and deal with them in time could lead to serious psychological suffering in the near future."

Publication

Toward a new model of understanding, preventing and treating adolescent depression focussing on exhaustion and stress. Frontier in Psychiatry, 6 mei 2020. Toon van der Gronde*, Leontien Los, Arnoud Herremans*, Ronald Oosting*, Rafaela Zorzanelli en Toine Pieters*

* Affiliated with Utrecht University