NSG6430 Week 2 discussion

Discussion: iHuman Case Study-Adolescent Depression Case

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered. For this assignment, make sure you post your initial response to the Dicussion Area by Saturday, May 27, 2017.

To support your work, use your course textbook readings and the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates’ initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a realtionship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates. Complete your participation for this assignment by Tuesday, May 30, 2017.NSG6430 Week 2 discussion

For this assignment, you will complete an iHuman case study based on the course objectives and weekly content. iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum. Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice.

The iHuman assignments are highly interactive and a dynamic way to enhance your learning. Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam.

Click here for information on how to access and navigate iHuman.

This week, complete the iHuman case titled “Angela Cortez VE.”

After completing your iHuman Case Study, answer the following questions:

Discuss the questions that would be important to include when interviewing a patient with this issue.

Describe the clinical findings that may be present in a patient with this issue.

Are there any diagnostic studies that should be ordered on this patient? Why?

List the primary diagnosis and three differential diagnoses for this patient. Explain your reasoning for each.

Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups.NSG6430 Week 2 discussion

Stress among adolescents that leads to depression will be discussed in this paper. Stress is defined as a major burden in teenage life and is illustrated on how this can stimulate the development of depression, a more severe case of stress, in which teenagers become overwhelmed with a mix of emotions. These two conditions are compared among their characteristics that identify them from each other. The growth between stress and depression are similar, but they differ in many ways. Symptoms of stress and depression are explained and how they are induced. This subject emphasizes on how teens are more commonly diagnosed with it. The cause and effects of stress are stated and how this can pressure adolescents, and eventually lead to depression. Depression cannot only pressure teens, but manipulate them, resulting in unwanted behavior, such as suicide. Prevention of stress is focused upon to point out the influence of communication and its importance. The discussion of an open relationship between troubled teens and guardians is included. Research showed how these conditions are highly associated with teenage suicide. Although suicide is commonly associated with stress, there are many exhibited behaviors that are listed. Stress and depression in adolescents are highly emphasized to differentiate these two conditions and distinguish the importance of communication.

Keywords: teen stress, teen depression

Teenage Stress and Depression

“Your teenage years are the best years of your life.” Ever heard someone say this? Through Experience, adults commonly tell young people these words to let them know that time is gold and they should be making the most of it. Teenage years through high school are usually seen with students participating in sport events, dances, and socializing. This scene is only part of the big picture. Looking into individuals sometimes reveals their life is a painful battle overflowing with mixed messages and conflicting demands form parents, teachers, friends, and even themselves (Garfinkel, Hoberman, Parsons, & Walker, 1986). Growing up and learning to be independent from others is a hard job. Relying on oneself to find a path to success and self-fulfillment creates stress. The stress created can lead to serious depression, overwhelming to young people who have never been in a situation that requires communication and problem solving. As a situation like this usually takes time to develop, friends, family, and loved ones can prevent depression from taking over teenage victims, but can’t this socialization also lead to stress and eventually depression?NSG6430 Week 2 discussion

Factors associated with depression

Depression and stress have many factors often associated with antisocial and bad behavior such as suicide and solitude. Characterized feelings of tension, frustration, worry and sadness define stress. These feelings of emotion can usually last from a few hours to days (Walker, 1985). Overcoming stress can already be a hard task for some young people, but what about the more severe and longer lasting condition – depression? In a study of high school students in Minnesota, 47 common life events were presented. The students were instructed to point out the experiences they had in the past six months which they considered to be “bad.” Based on their responses, an average of two “bad” life events per pupil were experienced in the last six months. The most common negative life events of these were:

Break up with boy/girl friend

Increased arguments with parents

Trouble with brother or sister

Increased arguments between parents

Change in parents’ financial status

Serious illness or injury of family member

Trouble with classmates. NSG6430 Week 2 discussion

Trouble with parents

(Garfinkel et al., 1986).

Many young teens suffer from much more reasons to why they become stressed. As teenagers cope and overcome their battle with stress, they soon learn how to solve these problems. They usually learn at their own rate and recover form their struggle over time when they get to know their own weaknesses and strengths. Even though this learning process can be self-attained, it is critical for parents and helping adults to be consciously aware that sometimes stress factors can accumulate and overwhelm vulnerable individuals who seem to be able to handle it on their own.

Family history can create an overview to why certain teens have vulnerabilities to stress. Psychosocial abuse patterns within the family can be factors that contribute to stress related problems in the household. Patterns such as childhood neglect or abuse (physical, emotional, or sexual), socioeconomic deprivations, and loss of loved ones (Bhatia, S.K., 2007; Bhatia, S.C., 2010). These events that may be seen a few times a month or even everyday, will always contribute to teen stress.

Personality traits that change greatly also demand attention because this usually signals trouble. Antisocial behavior such as preferring solitude rather than being accompanied by friends, can lead to stress related depression. Lastly, psychological and social events also accumulate to the problems teens may face. An unexpected pregnancy is common among many female teenagers who are burdened with depression. Such life events all contribute to the growing list of stress inducing factors like social rejection, humiliation and frustration.NSG6430 Week 2 discussion

Teens find outlets to help move on

As teens grow maturely in the world they face, being independent is a characteristic that teens take seriously. Stress and depression in teens all develop in their own way. Some teens may have a disturbing family history as a factor to their stress related experiences while others have negative social impacts that contribute to their depression. With the independent characteristic teens have, they will all respond to stress and depression differently. Some may find an outlet to relieve their struggles and be able to move on, such as socialization. This association with others can provide teens with necessary skills that will help them in their everyday life, such as trusting another person. Practicing on problem solving can help teens learn to deal with everyday conflicts that can get them through any immediate problems. Communication skills also play a big role by allowing troubled teens to vent emotions and express feelings towards their conflicts.

The relationships made in socializing play an important role in dealing with depression. Relationships between friends may be shorter than of family, but being “close” to others is an essential factor in decreasing the chances of depression (Giordano, 2003). These friendships may change over time, especially during the short years of high school. Even though it may not last as long as most would want it to, close relationships are vital in supporting a sense of belonging within a group.NSG6430 Week 2 discussion

Although socialization may be a primary step on preventing stress and depression, social factors may influence the teen negatively. Social groups that teens participate in may cause more stress than expected. For example, a varsity player on a basketball team may be perform well on the court he plays on and within his team, but he may not be doing well with his academic output. When he realizes that more focus should be put into his education or his varsity privileges will be revoked, this will cause stress to develop in other areas such as his parents putting pressure on him, sibling rivalry, and even with himself with self-confidence issues. For some teens, socialization may not be an effective mean of stress prevention. The transition from middle school to high school usually puts teens in overwhelming situations that require socialization. This emphasis on social interaction creates an environment that teens need to consider to fit in and acquire a sense of belonging. Considering that teens must maintain an identity creates another source of pressure that induces stress. Teens who are recovering from stress or depression may take time to adapt to new circumstances. They may not be ready for an environment with high levels of interaction. It will always take time for certain individuals to cope with new surroundings and situations. Teens, as such, have tough times because stress and depression may have deprived them of their social abilities for a long period of time. In times like this, communication is key for teens that require help from peers and family.

Stress and depression are a dangerous threat. Many factors can cause these problems, make life difficult, and intimidate teens. This is of great importance to youth because, at this time of their life, they are still in the process of developing the skills to define their self-responsibility and rely on the awareness of their guardians and peers that can be of assistance in prevailing over this threat. Although many solutions and alternatives can prevent stress and depression, guardians or parents can have the biggest impact on the factors that expose teens to depression. These adults should be able to identify warning signs that are most commonly signaled with behavioral, psychological and social events. For instance, persistent sadness, hopelessness, helplessness and social withdraw are common symptoms of depression (Edward, 2009). All these factors pile up and burden teens, but aware adults or parents with adolescent members in the family, may find it easier to cope and deal with stress a lot quicker by being sensitive to where stress and depression accumulate (Walker, 1985).NSG6430 Week 2 discussion

Communication can make things easier when signals of stress have been identified. This process where information is relayed and received enables teens to express how they really feel. When teens have this opportunity to release their emotions, they become vulnerable to feedback given. At this time participants in the conversation should emphasize on positive feedback and provide a feeling of security that it is okay for a teen to be troubled. Acceptance and the feeling of it may reinforce a teen to become more emotionally unstable but, this is a vital step of overcoming stress and depression. Denial may be a trait that some teens portray, but accepting the fact that they are burdened with stress will enable them to identify their source of frustration and find ways to overcome it.

When socialization and other efforts to overcome stress and depression seem to be of no use, there are two more ways to battle it; therapy and medication. Communication therapy is often an initial treatment for mild to moderate cases of depression. Over the course of this therapy, teen depression may reside. If it doesn’t, medication may be prescribed. However, antidepressants should only be used as only a part of the overall treatment plan (Smith, 2010). Medication for treating depression is usually chosen by parents who feel it’s too late for their teen to be admitted into therapy sessions. Experts in adolescent depression should only prescribe medication to teens with high risks of suicide with constant observation.NSG6430 Week 2 discussion

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Teenage depression is increasing briskly and often being treated erroneously. This is a major problem because depression has fatal effects on adolescents. It was stated by the National Alliance on Mental Illness, that depression is experience by 20% of people during their teen years. Each year, there are stories of thousands of adolescents committing suicide. There are also various causes of depression which lead to disastrous effects that might impair a teenager’s life. Every human being can infrequently feel down, yet depression is a constant feeling which is considered to be a mental disorder. There are two major diverse forms of depression; major and minor depression. Major depression affects one’s life from functioning normally. For instance, it affects a person’s daily routine as it also affects one’s capability to sleep, eat, and enjoy delightful events. Furthermore, minor depression is not permanent; it lasts for at least 2 weeks. Minor depression eventually leads to major depression. It is necessary for one to know the causes and symptoms of teenage depression in order to know how to avoid and confront it. Teenage depression has many different causes; this paper will discuss some of these causes. This topic is considered to be important because depression is a regular disease that affects teenagers. This essay will discuss the symptoms of depression and demonstrate some of the environmental causes of depression that alter teenagers’ lives. Some of the causes are; extreme trauma, family issues. Moreover, it demonstrates genetic causes; inherited depression. It also examines the effects of adolescents’ depression. This essay ventilates some of the previous recommended solutions on how to treat depression. Finally, it reviews the best solution acquired for teenagers to treat depression.NSG6430 Week 2 discussion

If one is alert to the symptoms; it is easy to prevent the disease. The symptoms are considered very helpful determinants that foreshadow to teenagers the depression they might face. Symptoms can also help teenagers avoid depression, since symptoms happen before they are actually depressed. Moreover, it notifies the teenagers’ parents that their children are going to suffer from depression. Most probably the teenagers’ family and friends will be the first to notice the depression symptoms. One of the main symptoms of depression is losing interest in all activities. It is an obvious symptom when teenagers start withdrawing from activities. When teenagers sleep too much or experience insomnia, it is, definitely, a symptom of depression (Schwanke, n.d.). Anhedonia is another symptom that occurs to adolescents, it is known as the teenagers’ inability to enjoy things that was previously enjoyable (Brennan, n.d.). There are no symptoms for traumatic events because it is unexpected to happen. If symptoms of depression are not noticed by teenagers and dealt with, it will not prevent the cause from happening.NSG6430 Week 2 discussion

The question ascends why depression is common in one’s teenage years. One of the main causes of teenage depression is extreme trauma. In other words, teenagers are depressed when they are sexually, mentally, or physically abused. Moreover, trauma might also occur to those who lost a parent, someone they love, or faced medical illness. An example of traumatic event, a teenage girl lost her father in a motorcycle accident which made her suffer and eventually became depressed (Kelly, 2011). Another example, two teenage brothers lost their mother in a car accident, and after six months they lost their father in another car accident. This is a traumatic situation that caused depression for both teenagers. Moreover, it was stated by their relative that both brothers have been suffering from depression for more than six months (Alleman, 2012). These examples indicate how traumatic events can cause teenage depression. Stressful events can negatively impact teenagers because if they attempted to handle a situation and it did not work out, it will eventually lead to depression. It was stated by Krans (2012) that traumatic events change adolescent’s life as it leaves a permanent effect on their brain, which suddenly leads to depression. When teenagers are traumatized, it makes them feel insecure, unsafe, and helpless (Lubow, 2010). According to teen treatment center, it was stated that teenagers who face traumatic events do not get the effective treatment they need. This is because approximately eighty six percent of sexual abuses on adolescents are not reported. It was also stated that about 5 percent of teenagers in the world suffer from depression (Framingham, n.d.). This shows the seriousness of teenage depression which leads to severe effects, moreover, it might lead to suicide.NSG6430 Week 2 discussion

Another determinant why teenagers suffer from depression is because of the inherited traits. In other words, teenagers can suffer from depression if they have a family member who suffered or still suffers from depression. Depression is known to be mental disorder; this is why it can be inherited like any other disease. According to Krucik (2012), researchers discovered that almost 40 percent of teenagers inherited their depression. Moreover, it was found that adolescents whose parents or siblings suffer from depression have a higher risk of suffering from depression. It was also examined that teenagers with depressed relatives or parents are three times more likely to suffer from depression (Krucik, 2012). Studies show that teenagers who were taken away from their biological parents, who have some sort of depressive illness, have the same possible risk as a teenager not adopted away (The Committee on Nomenclature and Statistics of the American Psychiatric Association, 1952). Researchers conducted that identical twins are an example which shows that genes are a major cause of adolescents’ depression. For instance, when one identical twin is suffering from depression the other has a chance of 76% to develop depression (Price, 2004). Another example of genetic depression, a teenage girl, Heather, believes that depression is an inherited mental disease because her father was suffering from depression and committed suicide when she was 9 years. She asserted that depression runs in her family. In her teenage years she started suffering from depression and she wanted to commit suicide (Glain, 2011). It was stated by the Norwegian institute of public health, that 74% of teenage depression is resulted by genes. Teenage depression is not only caused by environmental factors. Teens might not face traumatic events to suffer from depression; moreover, teens might suffer from depression only because they inherited it from their parents.

The last common cause of teenage depression is caused due to family circumstances. What happens when one’s inspirational and motivational force collapses? Parents have a powerful impact on their teenagers; moreover, they motivate and inspire them. However, when parents argue and start fighting a lot in front of their teenagers, it causes depression. Teenagers feel depressed because they start thinking if their parents will get divorced or not. Moreover, parents’ arguing might change the teenagers’ perspective about marriage and love which can cause temporary depression. When parents separate, most of teenagers’ lives start disintegrating. Separation causes depression because teenagers have lived their whole lives with both of their parents and now they are forced to see them drifting apart. Parental separation and family issues cause stress for teenagers which eventually lead to depression.

Teenage depression has several consequences. Some of these consequences are severe, harmful and fatal. Depression has many effects, some of these effects are; self-harm, violence or even suicide. Adolescents can harm themselves when they feel depressed; they want to feel anything other than being depressed. Moreover, they can be violent and nervy because when teenagers are depressed they feel worthless. Finally, teenagers who suffer from depression are likely to think about committing suicide. Thinking about suicide also leads to self-harm and violence. Teenagers who cannot handle family problems probably will run away from their homes because they want to escape from what is causing their depression. These effects show that actions have to be taken to prevent such disorder in a teenager’s life. Depression might alter teenagers’ lives; therefore it has to be treated effectively in order to prevent serious effects.NSG6430 Week 2 discussion

This serious mental disorder has been addressed by various solutions of which managed to solve it. The first recommendation for overcoming teenage depression is psychotherapy; the process of talking with therapist about one’s depression. Psychotherapy is considered to be effective in some cases because some teenagers refuse taking medications. Yet, psychotherapy is not very effective for teenagers suffering from severe depression. Moreover, psychotherapy’s treatment typically takes long time in healing teenagers. Antidepressant medication is another solution; it helps healing teenagers suffering from severe depression. Moreover, a U.S study conducted that antidepressant medication helped in healing about 50 percent of depressed people (Kilham, 2011). Specialists found out that antidepressant medication has various side effects; due to this fact, many teenagers might suffer from insomnia, dry mouth, anxiety or dizziness (Allen, n.d.). Cognitive behavior therapy is another solution that teenagers pursue, it helps teenagers in getting rid of their negative thoughts and altering their behavior patterns. This solution helps in improving adolescents’ mood, yet according to Harvard medical health publications, it was stated that CBT can be abortive because some teenagers might stop attending their sessions. All these solutions were formerly mentioned, yet they were never implemented effectively. Therefore, depression still exists and teenagers are still suffering.NSG6430 Week 2 discussion

One of the best solutions that were not mentioned before to approach this problem is that depressed teenagers should talk with their family members and to their trusted friends. Moreover, share their thoughts with people they trust and love because depressed people need someone talk to in order to be relieved. Furthermore, teenagers’ family and friends might help them through their tough times and can also help them overcome their problems. The second thing that teenagers should do is to participate in social activities even if they do not want to. When teenagers are depressed, they retreat in their own shell because it makes them feel more comfortable, yet in order to feel less depressed they should be around people and try participating in activities. Furthermore, teenagers should pursue new interests. Teenagers should join a support group for depression; when one finds others suffering from the same disease, it will definitely help teenagers encourage and advice each other. Moreover, by joining this group it will reduce the teenagers’ sense of being isolated. Previous solutions have some drawbacks, but if teenagers were able to discuss their problems with family and friends, participate in social activities and joining a support group for depression, definitely they will feel relieved, pleased, and delighted. It is considered the best solution because it contains no medications, therefore, teenagers will not suffer from any side effects. Teenagers might refuse to go to therapists, so, talking in the depression group will relief. This solution should be carried out by teenagers because they are the ones suffering from depression. It is also important to raise awareness, because many teenagers do not seek treatment. This should be carried out by media, since media is responsible for raising awareness. In poor areas, NGO’s and civil society organizations are responsible for increasing teenagers’ awareness. They should seek their own interest and try to overcome depression by the presented solution. This solution is considered to be affordable and accessible; teenagers should only have the intention to heal.NSG6430 Week 2 discussion

To conclude, depression is an awful disease that must come to an end. Moreover, it affects many teenagers. Depression has numerous symptoms, these symptoms should be noticed as soon as they show and teenagers should seek immediate help to prevent depression. Teenagers, who have an ambition to cease depression, should consider the presented solution since it will help in curing them. Teens should comprehend that depression is a mental disorder that might ruin their lives forever. Therefore, they should implement the given solution in order to diminish depression’s negative effects. Adolescents should seek treatments because it will definitely help them heal. However, awareness should be increased on all social levels to enlighten teenagers who suffer from depression. Depression is a severe problem that should be immediately addressed. NSG6430 Week 2 discussion