Rose was 15 when her parents informed her that they would have to move for her father's job. Rose handled the change well until the first day of school at the new school. There she was full of anxiety and fear about how to make new friends. Unfortunately, very few friends appeared over the next three years and Rose also began to gain a lot of weight. This results in very low self-esteem. When Rose went to college, she faced fears very similar to those she experienced during her time in high school. Shortly after this transition, he was diagnosed with MDD. Say no to plagiarism. Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”? Get the original essay Rose's situation is not unique. Although the details of the story may be different from other teens dealing with depression, many teens struggle with low self-esteem throughout high school only to learn later in life that they suffer from depression. Today, 5.5% of eighteen-year-olds are diagnosed with major depressive disorder (MDD) (van Tuijl, de Jong, Sportel, de Hullu, & Nauta, 2014), but probably 20 to 40% of adolescents suffer from MDD and are simply not. diagnosed (Hu and Ai, 2016). Specifically, depressive symptoms begin to increase between the ages of fourteen and seventeen and are even more pronounced in women (Rawana and Morgan, 2014). This depression is considered to be the result of low self-esteem, but it also appears to further decrease self-esteem (Steiger, Fend, & Allemand, 2015). Even if adolescents are not diagnosed with depression, most adolescents have fairly low self-esteem, especially when compared to their childhood self-esteem (van Tuijl et al., 2014). Although it appears that depression leads to low self-esteem, research clearly shows that the opposite is true, in that low self-esteem leads to depression, especially during adolescence. This is particularly visible in longitudinal studies which show that adolescents with low self-esteem develop depression over time, particularly when they have negative relationships with their parents and low attachment with their peers. Depression in Teenagers Adolescence is a time of many changes in all aspects. of an individual's life. Not only are there drastic changes, but these changes occur at different rates. For example, most adolescents reach physical maturity at this time of life, but all lack psychological maturity until their mid-20s (Hu & Ai, 2016). Another change is the immense socialization with peers that adolescents are beginning to participate in (Steiger et al, 2015). These changes may be why we see such an increase in depressive symptoms during adolescence (Hu & Ai, 2016). However, depression may go undiagnosed in some adolescents because people view the symptoms as just a "phase." Ignoring depressive symptoms in adolescents because it is assumed that the symptoms will go away is extremely dangerous, as depression seriously harms an individual's well-being. A depressed person normally develops feelings of helplessness in social, achievement, and physical contexts (Steiger et al., 2015). Depressed patients also have a shorter life expectancy and an overall less physical lifestyle (Bruce, Seeman, Merrill, & Blazer,1994). There is also significant evidence to suggest that when depression develops in young adolescents, their normal development is seriously affected, causing them to lead very different lives from those who do not suffer from psychopathology (Nolen-Hoeksema, Girgus, & Seligman, 1992). When looking at all the negative side effects of depression, it becomes clear that depression needs to be detected as early as possible in order to alleviate some of these consequences. Once teen depression is identified, the next step is to treat it. Depression in adolescents is difficult to treat and understand because it is etiologically and neurologically different from depression in adults. Some even argue that it should not be considered the same disorder. At the same time, even self-esteem and understanding of the concept may differ between adolescents and adults (van Tuijl et al., 2014). However, because most available treatments for depression are intended for adults, this same treatment is often applied to adolescents. Over time, differences in responses to this same treatment have shed light on some of the differences between adolescent and adult depression. Specifically, adolescents with depression have been shown to be more likely to be pessimistic, have poor social skills, and perform worse in school. These results are more significant for depressed adolescents than for depressed adults. These changes are thought to evolve in part due to the natural development that occurs from adolescence to adulthood (Nolen-Hoeksema et al., 1992). As more of these differences are identified, more effective treatment for adolescent depression can be developed. Self-Esteem Self-esteem is widely involved in a person's life. A person's self-esteem affects their mental health, cognition, motivation, emotional behaviors, social behaviors, and personality. However, it seems that self-esteem is more important in people suffering from depression. If self-esteem is high, people are able to easily adapt to different situations, avoid depressive symptoms, and lead healthier lives (Hu & Ai, 2016; Krug, Wittchen, Lieb, Beesdo- Baum and Knappe, 2016). If self-esteem is low, research shows, individuals are more likely to be involved in delinquent behavior and suffer from poverty. People with low self-esteem also focus more on their failures than their successes and are extremely sensitive to rejection, and this is even worse if the adolescent feels rejection from their parents. If a person develops low self-esteem in adolescence, and consequently these negative associations with low self-esteem, it is more difficult for them to increase their self-esteem as they age (Steiger et al. , 2015). This idea leads to the belief that low self-esteem leads to depression and not the other way around. Self-esteem has many definitions and therefore can sometimes be difficult to study and understand. In adolescence, this most often comes down to physical attractiveness, academic competence, self-acceptance, and self-respect (Krug et al., 2016; Steiger, Allemand, Robins, & Fend, 2014 ). There are two types of self-esteem: implicit and explicit. Implicit self-esteem is the automatic self-evaluation experienced in a given situation. Explicit self-esteem is adopted through motivation and is more stable than implicit self-esteem, particularly during adolescence. People with implicit self-esteemhave more difficulty adapting to negative situations. Therefore, people with depression are more likely to have implicit self-esteem. However, those with low explicit self-esteem also develop high depressive symptomatology. Specifically, low implicit self-esteem affects depression immediately, while low explicit self-esteem affects it slowly over long periods of time (van Tuijl et al., 2014). Therefore, both types of low self-esteem are linked to symptoms of depression, they just appear at different times. The relationship between these types of self-esteem leads to different labels for self-esteem. Divergent self-esteem occurs when implicit and explicit self-esteems are inversely related. Fragile self-esteem is specifically high explicit self-esteem with low implicit self-esteem and manifests itself in narcissistic behaviors. Damaged self-esteem is high implicit self-esteem with low explicit self-esteem and is observed in depressive behaviors (van Tuijl et al., 2014). Therefore, understanding these different types of self-esteem can help clinicians identify a patient's type of self-esteem and therefore see whether they are likely to suffer from depression or not. There are two theories about the relationship between self-esteem and depression. One of them is the vulnerability model which suggests that low self-esteem leads to depression. The other is the scar hypothesis which suggests that depression leads to low self-esteem because of all the "scars" that depressive episodes leave on the individual. These scars are usually related to social relationships, because depressed people put a lot of pressure on the people they have relationships with, whoever they are. These scars may also be the result of their inability to think positively about themselves because they have been thinking negatively for so long (Steiger et al., 2015). Most research supports the vulnerability model, but the two most often work together. It is also suggested that the scar hypothesis can only truly be observed in adults and not adolescents. The scar hypothesis is also most commonly observed in individuals with an unusually high number of MDD episodes (van Tuijl et al., 2014). Distinguishing between these two theories can help researchers better understand their patients, especially if those patients are adolescents suffering from depression. Self-esteem is correlated with depression, but it has also been observed to change over time. It can therefore be assumed that depression also evolves over time. For example, when individuals enter adolescence with low self-esteem, this self-esteem declines over time and these individuals are more likely to be diagnosed with depression later in life (Steiger et al., 2014 ). In adolescents who have already been diagnosed with depression, their depression turns into severe depression and suicidal behavior appears in adulthood (van Tuijl et al., 2014). This supports the vulnerability hypothesis that depression worsens as self-esteem deteriorates. Parents One aspect of adolescents' lives that can impact their depression and self-esteem is their relationship with their parents. In order to adapt to all the changes happening now, teens need a strong support system at home. Adolescents are very aware of the changes they are going through and therefore assume thateveryone is also fully aware of it (Hu & Ai, 2016). This makes self-esteem a big part of teenagers' lives. Parents should support teenagers' self-esteem because everything around them tends to lower their self-esteem. The way they can increase their child's self-esteem is by being warm and understanding, or in other words, emotionally supportive (Hu and Ai, 2016). When parents treat their children with warmth and understanding, adolescents are better able to learn to cope with difficult situations, which then serves as a barrier to low self-esteem (Steiger et al. 2015). For most depressed adolescents, research has found a lack of emotional support from parents. Depression involves many factors, such as personality, heredity, and negative life events. However, the most telling sign of depression, especially in adolescents, are dysfunctional attitudes such as being a perfectionist or expecting constant praise from those around you. Parents' job is to detect these dysfunctional attitudes before they develop into depression and help educate their children on how to think healthily (Hu & Ai, 2016). Although parents have the ability to help their children with depressive symptoms, a problem arises when most adolescents with depression have at least one parent who also suffers from the disorder, most likely the mother (Krug et al. , 2016). This may be due to genetic factors in depression, but adolescents also learn to respond to situations in the same way as their parents. So, if parents react in a way due to their depression, adolescents are more likely to react in the same way, which over time, they will develop depressive symptoms and eventually MDD (Steiger et al., 2015 ). This is particularly true with the construction of self-criticism. If a parent is very likely to be self-critical of themselves, they are also more likely to be extremely critical of others. If the parent is constantly critical of their child, the child will begin to become self-critical, which will lower their self-esteem and increase their depressive symptoms. Another aspect of this problem is that parents with depression are more likely to feel unsafe simply interacting with their children, putting strain on the parent-adolescent relationship (Steiger et al., 2015). Parents suffering from depression are more likely to focus on themselves and therefore less likely to be available to provide warmth and understanding to their children, who need this relationship with their parents to have greater self-esteem. Peers In addition to parents, another factor revealing adolescents' self-esteem, and therefore their depressive symptoms, is their popularity among their peers. This is particularly true among adolescent males (Steiger et al, 2015). Specifically, the concept of school connectedness, which is a student's feeling of acceptance at school, has been associated with depression and low self-esteem among adolescents. It has even been suggested that school connectedness is a specific form of self-esteem among high school students. High self-esteem is actually the strongest predictor of connectedness to high school, along with gender, socioeconomic status, and academic achievement. School connectedness also appears to be strongly influenced by how safe an adolescent feels at home. If they are very attached to their parents, they willalso the experience of hooking up in high school and vice versa. Peers may even have a greater influence on school connectedness since peers are actually at school while parents are not (Millings, Buck, Montgomery, Spears, & Stallard, 2012). Research on this topic has shown that as a student is more connected to school, they are less likely to experience low self-esteem, which therefore leads to decreased adolescent depressive symptoms. Although the research on this topic is compelling, it still needs more evidence for the concept to be truly understood as it relates to the relationship between school connectedness and adolescent depression (Millings et al., 2012). However, once this is better understood, it will give researchers another variable to look at when trying to find adolescents with early-stage depression. A large part of school connectedness lies in the attachment adolescents feel toward their peers. Although peer relationships are always important in a person's life, during adolescence, these relationships seem to become more important because they are an integral part of the adolescent's life and the interaction between the adolescent and peers becomes more complex (Millings et al., 2012). As adolescents become more attached to the peers around them, they may form a secure or insecure attachment. Insecure attachment leads to avoidant and dependent relationships, in which the individual constantly fears that the friend will avoid them and, as a result, the individual avoids friends out of fear, and ultimately, these relationships do not lead to lasting attachment (Millings et al., 2012). When an attachment breaks down, it can lower an adolescent's self-esteem and therefore make them more predisposed to depressive symptoms. Secure attachments, on the other hand, appear to increase trust, provide support, and ultimately lead to a lasting and fulfilling relationship. Secure attachments also seem to arise naturally, while insecure attachments seem more forced (Millings et al., 2012). Overall, high peer attachment also tends to demonstrate high self-esteem, and vice versa. Limitations Although the research done on adolescent depression is very well done and informative on this topic, unfortunately there are very few researchers who look into this issue. Part of this is because self-esteem and depression are huge concepts and therefore can be studied and measured in millions of different ways. This leads to a variety of research rather than multiple research studies focused on a specific topic. Another problem that arises on this topic is that most studies on self-esteem are carried out with self-report measures, because they have not yet found a way to physiologically measure self-esteem as they can with neurotransmitters in depression (van Tuijl et al., 2014). ). Self-report measures are often biased because the participant may not be completely honest in their responses in order to appear a certain way. Additionally, people's feelings can change from day to day, making self-reported responses inconsistent over time, which also skews the data. This is best avoided when self-report measures have been shown to be highly reliable and valid through psychometrics (Millings et al., 2012). Most studies on this topic are also not longitudinal, making it very difficult to know for sure whether the vulnerability or scar hypothesis will best explain the.