By Mrs.Nadeesha Widanapthirana – Psychologist

MSc in Clinical & Health Psychology (UK),BSc in Psychology(USA),

Dip in Counselling & Psychotherapy

Member of Sri Lankan National Institute of Professional Counsellors (SLNIPC)

Adolescence is a transitional stage of human development with drastic changes of physical and psychological development which occurs during the period from childhood to adulthood.  Adolescence generally falls in the age period from 10 to 21. There are three stages in adolescence: Early Adolescence, Middle Adolescence and Late Adolescence.  At each stage there are many physical, sexual, cognitive, social and emotional changes which needed to be identified to promote healthy development among adolescents.

Early Adolescence (age of 10-14)

Puberty begins at this stage. In this stage adolescent become aware of their bodily changes and worry about their physical appearances. This includes experiencing shyness, blushing and greater interest in privacy. Teenagers explore ways of being independent within the family context sometimes react strongly towards boundaries placed by their parents. At the same time, this period characterised with sexual curiosity which is portrayed through following celebrities, teen idols and musicians. Moreover, adolescent converge their thinking to themselves which is known as “egocentrism”. As a result pre teens are more self conscious about their appearance and constant feeling of being judged by peers.

Middle Adolescence (age 14 to 17)

At this stage adolescents explore their sexual identity and become interested in romantic and sexual relationships. As they search for more independence tend to make arguments with parents and spend less time with family and more time with peers. They tend to consider more towards their appearance and peer pressure plays a major role in this stage. Middle adolescents brain has not fully developed compared to an adult they can think of ‘big picture’ but lack the ability to apply in the situation. For example: “I am doing well in mathematics and I want to watch this movie…one night skipping studying won’t matter”

Late Adolescence (Age 18-21)

Late adolescents are physically and psychologically strong compared to early and middle adolescents. They have higher sense of individuality and identify their own values and future goals. Sometimes they may be emotionally and physically separated from the family but maintain relationships with adults to seek advice and share experiences.

Considering all the stages of adolescents mentioned in this article the most important psychological and psychosocial changes in adolescence are development of abstract thinking, sexual identity, ability to grasp viewpoint of others, ability of introspection, increasing autonomy from family and greater need for peer relationships.

There are many factors that could affect mental health of adolescents. Factors such as stress build upon peer pressure, negative parenting styles, violence (sexual violence, childhood trauma and bullying), Genetics (with a history of mental illness) and socioeconomics problems can be considered as risky factors which affect negatively towards mental health. Adolescents with mental health conditions are more vulnerable to social discrimination, stigma, educational problems and risk-taking behaviours

Young people at this development phase showed rapidly change in their physical appearance and behaviour and also highly susceptible to suffer from various range of mental disorders.  According to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), the most common mental health disorders in teens are classified as Anxiety Disorders, Mood disorders, OCD (Obsessive Compulsive disorders), Eating disorders, Behavioral disorders (ADHD -Attention Deficit Hyperactivity Disorder, Risk taking behaviour) and Suicidal thoughts and self harm.

Anxiety disorder is one of the common disorders among adolescents which marked with traits of panic or excessive worry. Anxiety disorders negatively interfere with important areas of social functioning such as school, work or relationships with family and peers. Social withdrawal intensifies isolation and loneliness which is highly associated with risk of suicide. Physical symptoms appears at this mental condition includes chest pains, shortness of breath, dizziness, nausea, vomiting, recurrent abdominal pain, disturbed sleep cycle, loss of appetite and energy levels.

Obsessive compulsive disorder (OCD) and Posttraumatic stress disorder (PTSD) closely related to anxiety disorders.  Obsessive compulsive disorder (OCD) in teenagers shows excessive attention to hygiene and bodily hormonal changes. Also those who are with Post-traumatic stress disorder (PTSD) have excessive fear of medical examination with a disturbed past memories of sexual abuse in childhood.

Mood disorders and depression is another mental issue experience by some teens in their late adolescence. Adolescents with mood disorder show signs of fatigue and low energy and more irritability compared with adults with mood disorders. Along with mood disorders they may have one or more mental health disorders such as anxiety disorders, conduct disorders and attention deficit hyperactivity disorder. Depression is another major concern in teens that could adversely affect school performance, work life and interpersonal relationships. Depressive mood can cause adolescents to engage in health risk behaviours such as refrain from safety measures in sexual relationship with partners may result in unwanted pregnancy and suffer from sexual transmitted diseases

Behavioural disorders also marked with most common among younger adolescents than older adolescents.  Adolescents with ADHD (Attention Deficit Hyperactivity Disorder) usually get easily distracted, inattentive, emotionally immature, act without reading to the consequences. Thus they have increase tendency for risk taking behaviour. Disruptive behaviour disorders include conduct disorder where teenagers tend to run away from home and engage in high risk sexual and criminal behaviour. Disruptive disorders coexist with substance use disorder, mood and anxiety disorders as well. In this context adolescent depicts a person who is argumentative and ignoring advice from adults.

Risk taking behaviours is considered to be an unhelpful strategy to cope with emotional trauma and can be negatively impact in adolescent’s mental and physical wellbeing.  Globally the rate of episodic drinking among adolescents increased among males. Another concern is use of tobacco and cannabis, first use at the age of 18 years. Substance abuse for a long term can cause the development of mental illness in teenagers as well. There have been studies that proven strong correlation between alcohol and depression and amphetamines and anxiety disorders. Adolescents who use drugs such as cannabis and amphetamines can be diagnosed with schizophrenia (Hallucinations and delusions) in later life which severely affects personal and social lifestyles.

Eating disorders such as anorexia nervosa (restrictive food intake) and bulimia nervosa (binge eating) commonly emerge during adolescence. This includes abnormal eating behaviour and preoccupation with food along with more concern towards physical appearance body weight and shape. Anorexia nervosa condition can results in premature death due to medical complications or suicidal behaviour.

Suicide and self harm also factor presented in adolescence stage with emotional instability and lack of self perception. Suicide is a major cause of death in older adolescents (15-19 years). Risk factors in suicidal acts include educational problems, alcohol usage, childhood trauma, social stigma, family history of suicide etc. Pregnant teenagers and those with anxiety disorders are more inclined towards depression and some suicidal ideations. Apart from suicidal thoughts non suicidal self injury or self harm is a major concern in adolescence. Non suicidal self injury such as cutting is intentionally self inflicted minor or moderate injury to the body. This type of physical harm is performed either to draw attention to obtain relief from negative emotions or cognitive states. Self harm can be emerged with anxiety disorders, mood disorders, personality disorders, eating disorders and sexual abuse in childhood.

In conclusion, mental health problems have impacted a significant financial and social burden on individuals, families and society. Parents, teachers, mental health practitioners and policymakers have a major role in bringing youth towards better mental and physical health, guide towards more socially positive behaviours and to overcome obstacles in lifetime. Also, psychiatric problems emerge during adolescence needed to be prevented or identified early to seek medical assistance. Further, it is important to be aware of that adolescents often seek for love, support, encouragement, acceptance and attention from parents or adults. Mental health Promotion and Prevention Campaigns needed to be implemented in the community with a motive to reduce risk taking behaviours, build reliance, self confidence and promote supportive social environment.  

References

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