Chapter – 8
Adolescents Health
Adolescence is a period of rapid changes. Between the ages of 12 and 17, for example, a parent ages as much as 20 years. – Author Unknown
Adolescence is a time of rapid change. Not only the body is changing physically, the mind is also changing. The teen years can often be a time of stress. Teenagers feel pressure to conform to social trends as well as higher expectations from parents and teachers.
Adolescents can experience intense feelings of anxiety, self-doubt, pressure to conform, and demands to succeed. This is the stage, when they experiment with smoking, alcohol, drugs and sex. In 2014, according to WHO an estimated 1.3 million adolescents died, mostly from preventable and treatable causes. Other causes of adolescent death include HIV/AIDS, suicide, lower respiratory infections and violence.
Main health problems include – teen pregnancy and child birth, HIV, mental health, violence, alcohol and drugs, injuries and malnutrition and obesity.
Teen Pregnancy and Child Birth
Complications linked to pregnancy and child birth are the second cause of death for 15 – 19 years – old girls globally.
Better access to contraceptive information and services, delaying marriage age and keeping them in school can reduce the number of girls becoming pregnant. Minimum age for marriage should be 18.
Girls who do become pregnant need access to quality antenatal care. Where permitted by law, adolescents who opt to terminate their pregnancies should have access to safe abortion, including the morning after pill.
HIV (Human Immune Deficiency Virus)
More than 2 million adolescents are living with HIV. Although the overall number of HIV – related death is down, HIV related deaths among adolescents are still significant. Most HIV infected adolescents do not get tested and do not know that, they are infected.
HIV, STD, pregnancy education and counseling be available in all schools. Young people need to know how to protect themselves and have the means to do so. This includes being able to obtain condoms and the knowledge to use it. Better access to HIV, STD, pregnancy testing and counseling are also needed.
Mental Health
Depression is the top cause of illness and disability among adolescents and suicide is the third cause of death. Violence, poverty, humiliation, sexual orientation, (gay or lesbian or transgender) can increase the risk of developing mental health problems.
Building life skill in children and adolescents and providing them with psychological support in schools can promote good mental health. If problems arise, they should be detected and managed by competent and caring health workers. However, it is more said than done, even in developed countries.
Suicide Warming Signs or Signs of Depression
- Feeling of sad and hopeless for no reason, and these feelings do not go away.
- Feeling very angry most of the time.
- Crying a lot or over reacting to things.
- Feeling worthless or guilty often.
- Feeling anxious or worried often.
- Performing less well in school.
- Losing interest in things he or she once enjoyed.
- Experiencing unexplained changes in sleeping or eating patterns.
- Avoiding friends or family and wanting to be alone all the time.
- Feeling life is too hard to handle.
Prevention
If your child ever talks about suicide, even in joking way, take him/her seriously and get help immediately. Signs of depression and risk of suicide can be subtle. If you have any questions, concerns, or instinct about your child that something could be wrong, seek help immediately. You could be saving our child’s life.
Listen carefully to your child. Tell him/her that you care about what happens to him/her and that help is available. Find a doctor, counselor, psychologist, social worker, youth worker to work with your child. Most cases depression can be successfully treated.
Violence and Injuries
Violence is a leading cause of death in young people. Globally some 30% of girls aged 15 to 19 experience violence by a partner.
Unintentional injuries are another leading cause of death and disability among adolescent. Road accident is the most common cause. Many times alcohol and drugs use contribute to the cause of accident. There should be zero tolerance for drunk driving by adults as well as by the adolescents.
Drowning is also a major cause of death among adolescents. All children should learn swimming. Swimming is an excellent exercise. It will also save lives.
Malnutrition and Obesity
Many boys and girls in developing countries enter adolescence undernourished, making them more vulnerable to disease and early death. The number of adolescents who are overweight or obese is increasing in both low-and high-income countries. Adequate nutrition, healthy eating habits and physical activity and exercise, at this age are foundations for good health in adulthood. Children and adolescents who are overweight and obese are at higher risk of developing type-2 diabetes, high-blood pressure and heart disease and stroke as an adult.
Tobacco Use
The vast majority of tobacco users worldwide began when they were adolescents. Today an estimated 150 million young people use tobacco. This number is increasing globally, particularly among young women. Half of those users will die prematurely (long cancer, heart disease, stroke, pancreatic and kidney and bladder cancer) as a result of tobacco use.
Banning tobacco advertising, raising the price of tobacco products, and laws prohibiting smoking in public places can reduce the number of people who start using tobacco products. They also lower the amounts of tobacco products use and increase the number of young people who quit smoking.
Alcohol and Drugs
Alcohol, like tobacco is addictive. Many adults start drinking when they are teenagers. Harmful drinking (excessive drinking) among adolescent is a major concern in most countries. Alcohol use reduces self-control and increases risky behavior. It is a primary cause of injuries (road traffic accidents), violence (especially by a partner) and premature death. It can also lead to health problem in later life and increase disability and death.
Setting a minimum age for buying and consuming alcohol and banning alcohol advertising in all forms can reduce the use of alcohol by young people as well as adults. Taxing alcohol heavily and making it pricey also will help.
Binge Drinking – having five or more drinks in a row in one session – is particularly dangerous but common feature of adolescent drinking. Binge drinking can cause alcohol poisoning, which can lead to coma and even death. Alcohol poisoning is more common among preteens and teens than any other age group.
Alcohol can be harmful even to teens that are not drinking. If your teenager is around people who are drinking, he or she has an increased risk of being seriously injured, involve in vehicle accident, or affected by violence.
Remind your child that most teens do not drink alcohol. He/she should politely decline if offered by his friends. He/she can say –“my parents will ground me for a month if I drink”. If you suspect that your child may be drinking (like vomiting in the sink or toilet, alcohol breath, incoherent talk, unbelievable excuses), confront him/her. Don’t ignore.
Marijuana (Cannabis)
After alcohol, marijuana (cannabis, ganja) is a major drug of choice of adolescents. Long-term marijuana use can damage the airways and lungs and lead to chronic bronchitis. Marijuana smoke also contains cancer causing agents that can increase the risk for lung cancer.
Some of the telltale signs of marijuana use include the distinctive odor on your child’s clothing, the use of incense or other room deodorizers to hide the odor.
Teenagers can also get addicted to prescription drugs including pain killers, tranquilizers, stimulants and sedatives. Adolescents are more likely than young adults to become dependent on prescription drugs. Opium in all form is quite addictive.
How to Prevent Drug and Alcohol Use
Some children are abusing drugs and alcohol by age 12 or 13. Building a strong and protective relationship with your children from infancy will help reduce their risk of abusing tobacco, alcohol and other drugs. Here are some steps you can take:
- Provide emotional, intellectual, and financial support to your children.
- Keep tabs on his/her friends.
- Set clear limits and enforce them.
- Voice strong disapproval of the use of alcohol and other drugs.
- Make yourself an example –
Do not drink, smoke or do drugs.
- Establish and enforce a curfew.
- Promote involvement in extracurricular activities.
- Teach them to say “no” to smoking, alcohol, drug and sex.
Saheb Sahu, M.D., F.A.A.P., MPH.