Written by Dr Isaac Yip, Specialist in Psychiatry

Mental Health used to be an issue that was under-recognised, or even avoided in the past. With the development of the society, more people came to understand that mental health is important. As quoted by the World Health Organisation, “There is no health without mental health.” Over the past few years of COVID-19 pandemic, mental health needs of the community have significantly increased. As opined by the President of the Royal College of Psychiatrists, “The coronavirus crisis poses the greatest threat to mental health since the Second World War”.

Under this context, more people have come to understand the importance of youth mental health, and there were also reports of increase in youth mental health needs since the COVID-19 pandemic. A study by the United States of America found that rates of adolescent (aged 12-17 years-old) depression increased from 8.1% in 2009 to 15.8% in 2019 [1]. Another meta-analysis of studies published from 2001 to December 2020 showed that 8% of adolescents had Depression, and another 4% of adolescents had Dysthymia – a clinical condition with persistent low mood [2]. Apart from mood disorders (including Depression, Bipolar Affective Disorder), other common youth mental health issues include Attention-deficit/Hyperactivity Disorder, and Autistic Spectrum Disorder.   

There are quite a lot of misconceptions about mental health issues including Depression. Some believed that it was only the individual being “weak”, “incompetent”, “thinking too much”, or “unable to let go”. The cause of Depression, like many other mental health conditions, is multi-factorial. While we need to understand the various psychological (including childhood experience, personality factors) and social factors (such as the stressors one is facing, and the degree of social support available), we have to understand that Depression, just like any other kinds of illness or disease, has underlying biological causes, such as genetic reasons, or imbalance of chemical transmitters in the brain. Sometimes, Depression could occur when there are not much identifiable psychological factors or environmental stressors. 

Early identification and early treatment are always essential. I often came across the question, “What if someone around us appeared to have mental health needs but was reluctant to seek help?” In these situations, our first step towards helping them is empathic listening. Empathy is our capacity to “put ourselves into others’ shoes” to understand others’ feelings and thoughts. Persistent listening with patience, empathy, and a non-judgemental attitude, and letting them know that we understand their feelings (with empathic statements such as “I can see that you feel very upset by this”), rather than prematurely jumping to offer “rational” advice or analysis, usually leads to better rapport, and more willingness for them to tell us what they are experiencing. With time and rapport, as well as a deeper understanding of their situation and needs, we understand what has been distressing them the most, and what they cared about the most. With that, we could more accurately position an angle to encourage them to seek professional help. It is also important to let them know that Depression, as well as other mental health issues, are very common; in addition, those who are willing to seek help would likely have significant improvements. 

On the other hand, what would NOT help are the superficial comments that we commonly heard every day, such as “Don’t be unhappy!”, “Cheer up!”, “Everything’s going to be ok!”, “Be more positive!”, “Many people are more stressed than you!” etc. For those who have Depression, they would not feel better from these comments. Instead, they would feel that you do not understand their degree of pain and suffering.

With the multi-factorial nature of Depression, and other mental health conditions, different treatment choices are available, including medications, psychological/behavioural therapies, and various measures to relieve the stressors that one is facing. If we have special concerns about any treatment option, we could always discuss openly with the doctor or therapist, so as to address the concerns, and work out together the treatment option that one feels most agreeable to. 

In conclusion, Depression, and other mental health issues, are common and treatable. The key to early identification and treatment is the society’s understanding and awareness of mental health issues, as well as our concern and care to those around us.

Reference

1. Wilson S, Dumornay NM. Rising Rates of Adolescent Depression in the United States: Challenges and Opportunities in the 2020s. J Adolesc Health. 2022 Mar;70(3):354-355. doi: 10.1016/j.jadohealth.2021.12.003. PMID: 35183317; PMCID: PMC8868033.
2. Shorey S, Ng ED, Wong CHJ. Global prevalence of depression and elevated depressive symptoms among adolescents: A systematic review and meta-analysis. Br J Clin Psychol. 2022 Jun;61(2):287-305. doi: 10.1111/bjc.12333. Epub 2021 Sep 26. PMID: 34569066.