Teenage

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Adolescence is both a time of tremendous gains and some inherent losses. You can help your teenage patients through this turbulent time by asking a few specific questions, checking their psychosocial functioning, and distinguishing the somewhat common depressive symptoms from a true depressive disorder. Approximately 10% of patients will need further evaluation sometime during their adolescence, and a few will require urgent referral to protect their safety if you uncover any suicidal ideation or planning. As children enter adolescence, they make major gains--in intellectual capacity, autonomy from their parents, and physical stature--all things that bring them closer to adulthood. Increasingly, they readily go to school independently, even driving during the later high school years, and participate in activities with less or no adult supervision. We often look at adolescence as the second major time in fife, the first during the beginning 2 or 3 years of life, with rapid, multifaceted growth. But what people often don't appreciate as much is that, as a child becomes a teenager, they lose a bit of their childhood. Part of the expected moodiness of adolescence stems from puberty and hormonal changes, but some also comes from an unspoken, even unconscious, undercurrent of loss. The home is no longer seen as the center of their universe. Developmentally, adolescents become closer to adults who are not their parents. They might suddenly develop an intense relationship to a teacher, coach, or friends. This is often appropriate as they transition to adulthood and test out different relationships. Teenagers often have several of these close ties and integrate aspects of these relationships into their emerging identity. Teens learn to transition from counting on their parents, to relying on friends and, in early adulthood, looking primarily to themselves for decision making. In our society, this transition often takes about a decade, starting when a child is 12 or 13...
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