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Depressed Teens in the United States

Depressed Teens in the United States

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Depressed Teens in the United States

Teenage depression is a major public health threat in the US today. Although the prevalence of depression in the US has increased rapidly in the past decade, teenagers bear a greater burden of this mental illness. The rate of rise in the prevalence of depression is significantly more rapid among teenagers compared to other vulnerable population groups in the US (Weinberger et al., 2018). Similarly, more than 70% of depressed teenagers have severe impairment of psychosocial functioning, indicating that the quality of treatment may be suboptimal (NIMH, 2020). As such, while it is important to address the burden of depression in other population groups in the US, depressed teenagers require priority consideration in light of their greater susceptibility to depression and its negative effects.

Teenagers are more susceptible to depression and its consequences because of unique risk factors arising from exposure to technology, such as cyberbullying and the problematic use of various social media platforms. In addition, teenagers are also affected by the socioeconomic stresses of their families (Weinberger et al., 2018). Furthermore, additional health and social problems such as substance use, teenage pregnancy, and academic pressures intersect with other risk factors, increasing their vulnerability to depression (Yung, 2016).

Similarly, teenagers have greater media exposure than other age groups. The use of media platforms and technology in the form of virtual games, the internet, social media, and television is significantly higher in this age group (Shensa et al., 2017). The wide variety of social media platforms increases the risk of maladaptive patterns of use indicated by an immoderate concern towards social media, an overwhelming desire to use social media, and devotion of a large amount of time to social media indulgence (Vorobyeva & Kruzhkova, 2018). Increased social media use is consistent with the age group’s predilection for maximalism. Teenagers also value social media as a platform for discussing personal issues and beliefs (Shensa et al, 2017).


The teenage category includes all young people who are between the age of 12 years and 17 years (, 2020). One eligibility criterion for categorization as a depressed teenager is reporting feelings of sadness or hopelessness for most days over at least two consecutive weeks. The feelings of sadness should be accompanied by a reduced interest in usual activities. Related symptoms and behaviors that indicate the severity of depression, such as suicidal ideation or suicide attempts, are also included (, 2020).

Figure 1

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There were more than 24 million teenagers aged 12 years to 17 years in the US in 2017. This represented about 7.3% (24 million/326 million) of the general population. The population of adolescents (10-19 years) is projected to rise to about 44 million by 2050. This will represent 11.3% (43.9 million/388 million) of the general population (, 2020). Conceivably, the teenage population will also increase significantly.

Figure 2

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7.2 million/24 million (30%) teenagers between the ages of 12 and 17 years experienced feelings of sadness or hopelessness for most days in two consecutive weeks in 2015. A large proportion of teenagers, therefore, fit the criteria for depression. This number increased to more than 7.4 million/24 million (31%) in 2017 (, 2020).

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FIG 4: Suicide rates by age and gender, ages 10-18

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4.3 million/24 million (18%) teenagers reported that they seriously considered suicide in the year 2015. The number decreased to 4 million/24 million (17%) in 2017. The proportions of teenagers who reported that they had attempted suicide in 2015 and 2017 were 2.2 million/24 million (9%) and 1.7 million/42 million (7%), respectively. Suicidal ideation and suicide attempts are severe symptoms of depression. Suicide is a leading cause of death among young people who are between the age of 15 years and 24 years (, 2020). The significant number of teenagers with a history of suicidal ideation or suicide attempts indicates that the rates of treatment for depression among teenagers may be quite low.

Figure 5

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Approximately 13.3% (3.2 million) of individuals aged 12 to 17 years have experienced at least one episode of major depression. More females (20%) than males (6.8%) are affected by depression. Similarly, the prevalence of depression increases with age within the teenage age group, with the greatest prevalence witnessed among 17-year-old teenagers (NIMH).

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Notably, 2.3 million teenagers (12-17 years) have experienced depression with significant functional impairment, representing approximately 71% (2.3 million/3.2 million) of teenagers who have had a major episode of depression and 9.4% (2.3 million/24 million) of the population in this age group (NIMH). The high prevalence of depression-associated disability reflects the poor quality of mental health interventions targeting depressed teenagers.

Figure 7

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More than 1.9 million/3.2 million (60%) depressed teenagers do not receive any form of treatment. These teenagers are at risk of severe disability due to depression. Similarly, only 1.2 million/3.2 million (37.5%) teenagers with major depression have access to a health professional. The large proportion of depressed teenagers who do not have access to a health professional explains why several depressed teenagers develop severe impairment.

The majority of individuals in the teenage age group are between grades 9 and 12 (, 2020). Therefore, the group consists of individuals who are unemployed and economically dependent on their parents and guardians. As such, their health status and quality of life are significantly influenced by the socioeconomic status of their households.

Figure 8

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The adolescent age group (10-19 years) approximates the teenage age group (12-17 years). There are about 42 million adolescents in the US, with a large proportion of adolescents belonging to families in the low socioeconomic status category. 15 million/42 million (36%) of adolescents live in low-income families. 6.7 million/42 million (16%) of the group belong to families that earn an income that is below the national poverty line (, 2020). This low socioeconomic status contributes to poor health outcomes.

The teenage age group is a nexus of other health problems, which compound the morbidity of depression. Three major health problems among teenagers include obesity, asthma, and substance use.

Figure 9

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Approximately 21% (5 million/24 million) of teenagers have obesity. Additionally, among individuals aged 2 to 19 years in the US, teenagers have the highest total prevalence of obesity. The difference in the prevalence of obesity between boys and girls is negligible (CDC, 2018).

Similarly, about 10.8 million/24 million (45%) teenagers have a chronic health condition such as asthma, with at least 1/5 (23%) high school students being asthmatic. Asthma is a leading chronic illness that negatively affects teenagers’ quality of life, resulting in socio-occupational dysfunctions, particularly school absenteeism. The third health problem affecting this group is substance use. Teenagers use different types of substances, including tobacco and marijuana (, 2020).

Figure 10: Percentage of teenagers in 12th grade who use alcohol, marijuana, or illicit drugs.

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The prevalence of alcohol use among teenagers has decreased steadily over the last 2 decades. Nevertheless, more than 30% of 12th graders still drink alcohol. Similarly, the prevalence of marijuana and illicit drug use has remained stable, with 22.2% of teenagers in the 12th grade using marijuana.


One hardship facing teenagers in the US is bullying. Cyberbullying is a particularly significant challenge due to the high prevalence of problematic media use among individuals in the age group. Bullying increases the risk of psychological distress and mental health problems, such as eating and mood disorders (Vorobyeva & Kruzhkova, 2018). The other major hardship is poverty. Living in poverty increases the susceptibility of teenagers to health problems associated with unhealthy diets and social problems such as teenage pregnancy and emotional distress (, 2020).

A large number of social support resources are available at the community level for teenagers in the US. Sexual and reproductive health and counseling services are offered to individuals in this health group through accessible school-based clinics (CDC, 2020). Social support is also offered through peer promoter programs and community health promoters. Dedicated information centers and hotlines are also available that target teenage problems such as mental illness, cyberbullying, suicide, substance use, and teenage pregnancy. However, the high prevalence of problematic social media use suggests that teenagers enjoy little psychosocial support within the family setting. For example, the parental substance abuse communication rate was 47% in 2016, a reduction of 19% compared to 2003 (Salas-Wright et al., 2019).

2.35 million/24 million (9.8%) teenagers do not have health insurance coverage (Cohen et al., 2019). Among teenagers who are eligible for public insurance, only 39% are covered by Medicaid and Children’s Health Insurance Program (CHIP). However, a significant number of teenagers are also covered by employer-sponsored insurance plans of their caregivers, direct purchase, and medicare (AAP, 2020).

The Affordable Care Act (ACA) contained several provisions that targeted teenagers. It expanded the eligibility for health insurance coverage for teenagers starting in 2014, increasing coverage for this age group by more than 4 million. This resulted in a significant reduction in uninsurance rates between 2014 and 2016.

Teenagers (below 18 years) from families earning less than 133% of the federal poverty level became eligible for Medicaid and CHIP coverage (Pilkey et al., 2013). The ACA increased healthcare access for teenagers belonging to ethno-racial minorities such as non-white Hispanics, African Americans, and immigrants (Spencer et al., 2018). Health promotion and preventive healthcare services are covered under the ACA with no out-of-pocket co-payments (Pilkey et al., 2013).

Teenagers are the target of various health promotion services, including immunization, sexually transmitted disease prevention education, mental and behavioral health assessments, patient education, and contraception (Pilkey et al., 2013). However, since most of these services are designed by adults, current services are poorly adapted to the age group. For example, preventive services are significantly fragmented, with specific service providers only offering services such as sexual and reproductive health. Negative experiences such as stigma, scolding, and breach of confidentiality during health-seeking also encourage poor health-seeking behaviors due to waning trust in service providers (Berglas et al., 2016).


Service Integration

Service integration will involve providing preventive mental, behavioral, and physical health and social care services for teenagers at a central point. This will increase the number of entry points into a depression treatment program. Additionally, service integration will enhance the networking and cooperation between the service providers (Yung, 2016). This intervention will benefit 1.9 million/3.2 million (60%) depressed teenagers.

Telehealth-Based Depression Treatment Program

The widespread use of digital and networked technologies among teenagers provides an excellent opportunity for treating depression. A treatment program including continuing education, lifestyle coaching, and teleconsultation can be provided to depressed teenagers through a networked platform accessible through devices such as personal computers, tablets, and mobile phone applications (Das et al., 2016). This intervention will benefit 2.3 million/3.2 million (70%) depressed teenagers.

Resilience-Based Treatment Program

This is a strength-based approach to depression treatment and prevention. Groups of teenagers with a clinical diagnosis of depression without severe impairment will be recruited into a multi-center resilience-based treatment program. The program will involve identifying a protective psychosocial trait of the teenager, such as high self-esteem, and optimizing it to build the teenager’s capacity for emotional regulation (Freire et al., 2014). This will empower the depressed teenager to anticipate, identify, and self-manage depressive symptoms. Nine hundred thousand teenagers in the US have depression without severe impairment (NIMH). This intervention will benefit 100,000/900,000 (11%) teenagers who have depression without severe impairment.

Community-Based Creative Program

Community-based creative programs that enable teenagers to participate in a wide range of creative activities can enhance the well-being of teenagers who are depressed or at risk for depression by improving different psychological and behavioral competencies. Activities such as dance, visual arts, and music can provide excellent constructive distractions and opportunities for teenagers to improve their level of self-knowledge and positive self-concept (Das et al., 2016). This will prevent depression among at-risk teenagers and reduce symptoms among their depressed counterparts. Since this intervention is community-based, it will benefit 2.5 million/3.2 million (78%) teenagers who have depression without severe impairment.

Exercise Program

An elaborate and regular physical fitness program for teenagers can benefit both depressed teenagers and at-risk teenagers. Exercise improves self-esteem and socio-emotional well-being and has a potential for positive outcomes in depression that is similar to pharmacological and psychological interventions (Das et al., 2016). A physical fitness program will result in the reduction of symptoms of depression and improvement in the socio-occupational functioning of depressed teenagers. This intervention will also benefit 2.5million/3.2million (78%) of teenagers who have depression without severe impairment

The lack of effective interventions to prevent and manage depression among teenagers will predispose teenagers to the complications of depression. The majority of depressed teenagers will develop severe disabilities (NIMH). Recurrent and chronic episodes of depression will increase the risk of substance abuse in this age group. Additionally, the socioeconomic outcomes of the group will also be affected due to school dropout rates and poor academic outcomes. Maladaptive behaviors such as suicide attempts may increase, potentially increasing the incidence of suicide-related deaths among teenagers (Freire et al., 2014).

Effective interventions will improve the management of depression by encouraging the entry of depressed teenagers into a depression treatment program, followed by comprehensive teenager-centered follow-up. Intervention will also improve health-seeking by creating multiple entry points, which may increase the availability of appropriate services (Yung, 2016). Additionally, proper interventions will enhance symptom reduction and improve socio-occupational functioning among depressed teenagers (Freire et al., 2014).

Admittedly, a wide range of interventions for teenage depression is already offered at the public health and community level. However, these services are poorly adapted to the needs and preferences of the teenager. Perceived barriers such as stigma, limited access, and academic and recreational commitments are the greatest contributors to poor health-seeking behaviors and low treatment rates (Meredith et al., 2009). Therefore, addressing barriers to service utilization through teenage-centered programs will improve treatment rates.

In the short term, these interventions will increase the rates of enrollment for the treatment of depression among teenagers because of a larger number of service user entry points. In the medium term, interventions will reduce the prevalence of severe impairment and morbidity due to depression by promoting symptom reduction and improving socio-emotional well-being. In the long term, interventions will improve the outcomes of depression among teenagers by reducing the incidence and rates of suicide attempts and suicides.

Effective intervention for teenage depression is indeed possible and effective. This is because a vast number of affordable, preventive health services targeting teenagers are already available at the community and primary care level clinics (CDC, 2020). As such, the only significant challenges in the current service delivery model are the fragmentation of services and poor teenager adaptation. Tailoring these services to the needs and preferences of teenagers will enhance health-seeking and service utilization and support the management of teenage depression.


Teenagers are significantly vulnerable to depression compared to the general population in the US due to the multiplicity and uniqueness of risk factors for depression. Unfortunately, treatment rates and quality are markedly poor, as indicated by the high prevalence of severe impairment. Notably, the low treatment coverage may result from poor health-seeking behaviors due to poor cultural adaptation and fragmentation of teenage health services. Integrating teenage physical, mental, behavioral health, and social services by mobilizing and networking formal and informal resources may address the treatment coverage challenge. This may improve both the short-term and long-term outcomes of depression.


AAP. (2020). Children’s Health Care Coverage Fact Sheets. Retrieved from American Academy of Pediatrics:

Berglas, N. F., Hucles, K., Constantine, N. A., Jerman, P., & Rohrbach, L. A. (2016). Predisposing, enabling and need-for-care predictors of adolescents’ intention to use sexual health services. Sexual health13(6), 540-548.

CDC. (2020). Health Services for Teens. Retrieved from Centers for Disease Control and Prevention:

Centers for Disease Control and Prevention. (2018). Youth Risk Behavior Surveillance – United States, 2017. Morbidity and Mortality Weekly Report, 67(8). Retrieved from – PDF

Cohen, R. A., Zammitti, E. P., & Martinez, M. E. (2019). Health insurance coverage: Early release of estimates from the National Health Interview Survey, 2018. National Center for Health Statistics. Retrieved from https://www.

Das, J. K., Salam, R. A., Lassi, Z. S., Khan, M. N., Mahmood, W., Patel, V., & Bhutta, Z. A. (2016). Interventions for adolescent mental health: an overview of systematic reviews. Journal of Adolescent Health, 59(4), S49-S60.

Freire, T., Teixeira, A., Silva, E., & Matias, G. P. (2014). Interventions for youth depression: From symptom reduction to well-being and optimal functioning. Journal of Behavior, Health & Social Issues6(2), 9-19.

Meredith, L. S., Stein, B. D., Paddock, S. M., Jaycox, L. H., Quinn, V. P., Chandra, A., & Burnam, A. (2009). Perceived barriers to treatment for adolescent depression. Medical Care, 677-685.

NIMH. (2020). Major Depression. Retrieved from National Institute of Mental Health:,population%20aged%2012%20to%2017.

Pilkey, D., Skopec, L., Gee, E., Finegold, K., Amaya, K., & Robinson, W. (2013). The Affordable Care Act and adolescents. ASPE research brief. Washington (DC): Office of the Assistant Secretary for Planning and Evaluation.

Salas-Wright, C. P., AbiNader, M. A., Vaughn, M. G., Sanchez, M., Oh, S., & Goings, T. C. (2019). National Trends in Parental Communication With Their Teenage Children About the Dangers of Substance Use, 2002–2016. The journal of primary prevention40(4), 483-490.

Schwarz, S. (2009). NCCP | Adolescent Mental Health in the United States. Retrieved 14 June 2020, from

Shensa, A., Escobar-Viera, C. G., Sidani, J. E., Bowman, N. D., Marshal, M. P., & Primack, B. A. (2017). Problematic social media use and depressive symptoms among US young adults: A nationally-representative study. Social Science & Medicine182, 150-157.

Spencer, D. L., McManus, M., Call, K. T., Turner, J., Harwood, C., White, P., & Alarcon, G. (2018). Health care coverage and access among children, adolescents, and young adults, 2010–2016: Implications for future health reforms. Journal of Adolescent Health62(6), 667-673.


Weinberger, A. H., Gbedemah, M., Martinez, A. M., Nash, D., Galea, S., & Goodwin, R. D. (2018). Trends in depression prevalence in the USA from 2005 to 2015: widening disparities in vulnerable groups. Psychological medicine48(8), 1308-1315.

Yung, A. R. (2016). Youth services: the need to integrate mental health, physical health and social care. Social psychiatry and psychiatric epidemiology51(3), 327-329.


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Depressed Teens in the United States

This title focuses on the teens verses the depression.

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    Depressed Teens in the United States

    Depressed Teens in the United States

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