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I can personally tell you that as a step-parent to three kids who are now in their middle 20’s, two of them put both of my wife and me through the ringer! The primary contributing factor is an underlying, undiagnosed mental illness. As the child matures, they don’t understand how to cope with the changes they are experiencing and resort to self-medicating with drugs and alcohol. For one of the kids, it started out as alcohol, then marijuana, and quickly spiraled out of control from there, to MDMA (Ecstacy), Heroin, and finally Meth. This particular child has almost committed suicide twice and both times bought a ticket to the Critical Care Unit for drug overdoses which ended up being a polypharmacy of drugs. According to a journal article published in the National Institute of Health, contributing factors to depression are a familial history, with signs and symptoms being difficult to diagnose; however, presenting problems are unexplained physical symptoms, eating disorders, anxiety, refusing to attend school, decline in academic performance, substance misuse, or behavioral problems (Thapar, Collishaw, Pine, & Thapar, 2012). Although there is a significant past medical history of mental illness on my wife’s side of the family, my step children’s only symptom exhibited from the list discussed was anxiety. The child is now diagnosed with Depression, Bi-Polar, and Schizophrenia. In addition, she is homosexual and struggles with gender identity.

Primary prevention strategies are an attempt to avert the occurrence of depression in a currently unaffected population. Secondary prevention is focused on the early detection and treatment of depression, and tertiary prevention attempts to minimize disability arising from depression (Bennett, Jones, & Smith, 2014 p. 117). In our case, all the children were well socialized, involved with extracurricular activities, and were literally straight “A” students. In addition, regular “well-child” doctor visits were performed. After the issues started to develop, one to one counseling sessions were conducted, but after the first suicide attempt, she was transferred to a Libertas Drug and Treatment facility. This was a three week program which incorporated 16hrs of family counseling. Many interventions were suggested such as: learning what makes the individual feel sad or depressed and develop healthy ways to cope with stress, use a code word for when the individual is at their breaking point, and establishing rules/boundaries/limitations. Although we utilized our local and state programs, some other resources adolescents can be directed to are: Beyond Blue and Adolescent Depression Awareness Program (Bennett, et al., 2014 p. 118).

References:

Bennett, C., Jones, R. B., & Smith, D. (2014). Prevention strategies for adolescent depression. Advances in psychiatric treatment, 20, 116-124. doi: 10.1192/apt.bp.112.010314