Case Study on Teenage Depression: How a 16-Year-Old Got the Right Support
Patient Information
- Age: 16
- Gender: Female
- Background: High school student, lives with both parents and two younger siblings, active in social media, previously a straight-A student.
History or Cause
Ananya was a 16-year-old high school student and studious with a vivacious social media life. At some point during a period of one year, her academic performance started decreasing, and she isolated herself from everyone. Her erstwhile adventurous, jovial mercury had faded. She started skipping family meetups and social functions. The erstwhile sharp-tongued Ananya now started facing tidal waves of sadness, hopelessness, and anxiety that seemed to overwhelm her very existence. She didn't sleep and remained perpetually drained.
There were moments that she was empty and downcast, which, to her family, were signs of the feared stage of adolescence. The curtains were drawn when Ananya's schoolwork was significantly impacted, and signs of self-injurious behaviour were observed. The scenario was probed further, and Ananya admitted that the pressure of academic expectations to maintain a highly "perfect" social media persona, with no social support at school, was overwhelming her with negative thoughts. She always felt isolated with nobody by her side, even though she had seemingly a huge number of "friends" online.
Diagnosis:
Ananya was referred for treatment of mental disorders for assessment. With clinical interviewing and standardised rating scales for depression utilised in assessment, Ananya was diagnosed as having Major Depressive Disorder (MDD) with moderate worry.
Diagnosis Highlights:
- Major Depressive Disorder (MDD): Ananya presented with recurring symptoms of depression for over two months, including sadness, hopelessness, worthlessness, and loss of interest or pleasure in activities that were previously enjoyable to her.
- Anxiety: Ananya complained of excessive worry, difficulty concentrating, and somatic symptoms like palpitations and restlessness, which is consistent with anxiety disorder comorbidity.
The therapist suspected that her social media use had heightened Ananya's inferiority feelings by comparing her to the successes of others' lives, which also worked to skew her self-perception.
Treatment
With her recoveries at the mental level and the pressure around her on the outside, Ananya's depression treatment was holistic in nature, and efforts were made to ease the external pressure on her. It was a multidisciplinary process involving psychotherapies, family engagement, and lifestyle changes.
Approach:
The treatment plan was focused on Cognitive Behavioural Therapy (CBT), a strategy based on empirical principles that had been demonstrated to be effective in reducing depression and anxiety in adolescents. Family therapy was also incorporated for Ananya's parents in order to improve their communication and support.
Program:
- Initial Assessment and Stabilisation: Ananya's initial sessions concentrated on producing a secure atmosphere wherein Ananya felt free to discuss her emotions freely without the threat of judgements. Ananya was helped by the therapist in being able to identify her negative thought patterns, which reinforced her depression and anxiety, and in challenging her distorting beliefs, she was encouraged towards developing other healthier patterns of thinking and coping.
- Cognitive Behavioural Therapy (CBT): CBT was believed to enable Ananya to recognise and dispute negative self-thoughts and irrational belief patterns. Mindfulness exercises were also introduced by the therapist to enable Ananya to cope with anxiety and stress more effectively. Ananya had home tasks such as recording her thoughts and doing grounding exercises.
- Family Therapy: Ananya's parents, of major significance to Ananya's therapy process, learnt how they could go about offering emotional support and grasping the pressures their daughter was undergoing. This later succeeded in bridging the emotional gap between Ananya and her family.
- Lifestyle Adjustments: Ananya was recommended to restrict her screen time, especially social media, and engage in exercising activities like yoga and hiking. That reduced stress to an extent and helped in her overall well-being.
Medical Treatments
Because of the intensity of her depression and anxiety, Ananya's therapist had mentioned that she could have small doses of SSRIs, something she had resisted until then. Ananya agreed to take the SSRIs as an adjunct to therapy; they seemed to help with mood stabilisation, which relieved her chronic sense of sadness and restlessness.
Therapy:
- Individual Therapy: Each week was dedicated to one subset of Ananya's thought patterns and emotions, particularly concerning body image, self-esteem, and the stress involved in coping with it.
- Group Therapy: Around this time, she began attending a bi-weekly group session for an adolescent treatment group shared with peers who had similar issues. It helped create the sense of belonging and the realisation that she wasn't alone in her experience.
- Family Therapy: The involvement of Ananya's parents in the therapeutic process was also very important. It enabled them to understand her issues better and gave the parents strategies to help support her at home effectively.
Improvements/Recovery Timeline:
Week 1-2:
- Ananya started therapy, which included journaling to detect and monitor negative thinking. She had resisted medication but, after several sessions, agreed to take a low dose of an SSRI.
Week 3-4:
- Ananya stated her mood and energy had improved a little, but she still worried about attending social functions. Results from the initial family session were communication gains that developed with parents' participation.
Week 5-8:
- She was less depressed and self-injurious and began to open up during therapy as her mood became relatively stable, owing to the use of cognitive-behavioural strategies to counter her negative thinking. Gradually, her stress management skills improved her academic performance.
Week 9-12:
- Ananya felt encouraged to share her advancements within the group therapy environment and received supportive feedback. She started to gradually cut down on screen time and spend quality time with family and friends outside of social media. Anya's relationship with her parents became better, and she regained some confidence in coping with challenges.
Week 13-16:
- By this point, Ananya had progressed significantly in her recovery. Her mood had improved significantly, and her anxiety was completely under control. She could now better manage stress and pressure, having developed healthier habits or attitudes from therapy.
Our Success
Impact on Patient’s Life:
This was a total transformation in Ananya's life. She gained control over her emotions, discovered much more fun in everyday things, and developed faith in herself. Slowly, her grades improved as she learnt to manage stress also from school without any suffocating thoughts.
Ananya's new self-esteem helped her revive friend and family relationships that seemed to have been lost. At the same time, her relatives have observed her new interest; she has begun reaching out to her peers via a mental health awareness club at school to dismantle stigmas related to depression and anxiety. Working on this project gave her a new mission in life, directing her experiences into a positive outlet.
Family and Community:
Ananya's rehabilitation had profound effects on the family. Her parents will describe feeling more attuned to her and more capable of helping her. They acknowledged their deficiency in accessibility and open communication with their children.
Well, if someone were to start having an interesting chat with the younger siblings, then maybe it would be about issues that affect them, bringing the family closer in an emotional sense. By speaking openly about her struggles with mental health and initiating the awareness club, she worked to undo the stigma against mental illness at her school. Several of her classmates were motivated to get help when she did.
Future Steps
Ananya's therapy team recommended she maintain therapy, albeit on a sporadic basis, as she was about to move into an independent phase of recovery. They recommended that she remain involved in the ongoing work with the mental health awareness group, which is a vehicle for continuous social support and a feeling of belonging. Ananya also concurred regarding staying in touch with her therapist on an occasional basis in order to forestall relapses into depression or anxiety.
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Jagruti Rehabilitation Centre is a leading facility specializing in mental health, dementia, and addiction recovery. The team of psychiatrists, psychologists, and caregivers is committed to empowering individuals on their journey to recovery.
