how do adolescents define depression? - cIRcle - University of ...

Chapter V: Discussion
impossible condition, and may be associated with suicidal thinking. Tulloch, Blizzard, Hornsby,
and Pinkus (1994) in their article on suicide and self-harm in adolescents in Tasmania, Australia,
suggest that common motivations for self-harm or suicide were to escape an impossible situation,
rather than to attract the attention of others. Although a minor category, as defined by
adolescents' COAD, Substance Use (e.g., take drugs, alcohol) was still described by them as a
definition of depression. In the DSM-IV-TR (APA, 2000), alcohol or other substance use may be
associated with criteria for MDE, but by definition, MDE is not due to the direct physiological
effects of abuse of drug or substance. Rutter et al. (2006) suggest that there is sometimes a
progression from substance abuse to major depression from possible psychopharmacological
effects of substance abuse or interference with psychosocial functioning. What the adolescents
may be saying is that someone who is on drugs, or alcohol, or other medication, may be
depressed, or substance abuse may be a sign that he or she is depressed. Several adolescents'
COAD were clustered within the category Escaping Reality (e.g., escape reality, numb out pain).
Perhaps these terms may be the outcome of self-harm coping strategies, and may be related to
adolescents' Inner Pain. In the category Biological (e.g., chemical imbalance, hormones out of
control) adolescents' COAD suggests that it is of minor importance in their definitions of
depression. The US Department of Health and Human Services (1999) defines biological
influences on depression to include genes, infections, hormones, and toxins. In one response, an
adolescent reported that acting out sexually is part of a definition of depression. These
categories, not found in the DSM-IV-TR (APA, 2000) as criteria for depression, indicate that
adolescents are aware that a multitude of factors can affect depressive symptomatology, and
these factors form part of their understanding and descriptions of depression.
Summary
Adolescents' definitions of depression were dominated by subjective, holistic
interpretations that are intrinsically related to overt characteristics and their context or
environment. Depressed Mood and Social Impairment are the core categories reported in
adolescents' definitions of depression. Adolescents highlight Social Impairment and its more
intricate subcategories (e.g., Perceived Disconnection and Behavioral Disconnection) in their
COAD as a definition of depression, not emphasized in the DSM-IV-TR (APA, 2000). Most
adolescents define Sadness as the main subcategory of Depressed Mood followed by Irritability.
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