Being a young adult can be a confusing moment. Not only is it a period of physical and psychological growth and development but also marks transition from puberty to adulthood. Adolescents face multiple demands from their parents, peers, school work, and social media life, and try to meet all these demands while still trying to maintain their autonomy. During this period, adolescents can battle a number of emotions which when coupled with their lack of knowledge, and identity crisis can cause constant emotional distress and even depression. Despite all these negative forces operating against them, they are still vulnerable to worse situations. Death of loved ones, life-threatening illnesses, and trauma are some of the worst experiences that any young adult can have to deal with. This essay discusses the distinctive psychological outcome of each situation and how the adolescents facing such situations can be helped to cope with it.
The Grieving Adolescent
The death of a loved one is undeniably one of the most painful and devastating kinds of losses. The life of a grieving teenager is particularly more complex considering their developmental teenage issues. Young adults can react to grief in different ways. These reactions can be classified as behavioral responses, cognitive responses, affective responses, and somatic and psychological responses. An adolescent’s reaction to grief can be influenced by a number of things such as the kind of relationship that they shared with the deceased, how their loved one died, their previous experiences with death, their support system, and also how strong and stable they can be when dealing with stress and high emotions.
Bereaved adolescents who experience psychological reactions show some depressive and anxiety symptoms. While depression happens due to the loss of close relatives that as siblings or parents, studies have shown that the death of other distant relatives like grandparents can also cause depression. They worry and question whether they may be the next to die, who will take care of them once the breadwinner has died, and worry that the remaining relatives could also die. Such kinds of depression and anxiety syndromes may follow young adults for a long depending on the care and support they receive during that period.
Though most studies focus on depression and anxiety as the main reactions following a bereavement, some studies report psychiatric disorders that exhibit both emotional and behavioral symptoms (Johnson, Torres, Sykes, Gibson & Baker, 2017). During the first few months after the death of a loved one, young people may be less verbally expressive and instead show behavioral changes ranging from reserved to aggressive behaviors. This change of behavior is linked to low coping mechanisms which discourages young adults from doing their normal activities such as hobbies and sports. Their school work and performance are also affected due to difficulty in concentration and emotional distress especially when memories of their loved ones are evoked. They may also become rowdy and rebellious and lose their self-worth due to the loss of the meaning of life. How adolescents behave goes down to their coping efficacy.
Young adults are also at risk of developing social problems following a bereavement. Their social network may be affected and they shut some people out of their lives or have minimal contact with the ones in their lives. These poor social relations make it harder for them to ask for help in dealing with the death of loved ones and make the grieving process a lot more difficult for them. These problems last for a short while or they may be prolonged into adulthood depending on the support system of those in their social life.
Although bereavement does not automatically cause psychiatric problems, timely interventions can help adolescents cope with the loss of loved ones and prevent the prolonged effects of grief. This could be informal interventions such as support from friends and families or formal interventions such as counseling and therapy. A wide range of services should be offered at different levels of grief Depending on the complexities of grief and the needs of the adolescent. Those with mild levels may deal with grief on their own with the help of media, booklets, web resources, or helplines. They may also join community support groups which offer a chance for them to share their common experiences and eliminate any feeling of isolation. However, the more complex types of grief may require counseling or psychotherapy where their individual needs are addressed by the psychologists. Generally, intervention provides the bereaved adolescents an opportunity to pour out their unsaid or subconscious feelings and helps them reconcile with the death giving them a better and easier method to cope with their grief.
The Traumatized Adolescent
Trauma is the physical or emotional response to terrifying and especially unpredictable or unexpected experiences. Every day, young adults are vulnerable to painful and possibly traumatic events such as domestic violence, gory accidents, divorce of parents, wars, and calamities, and even loss from death. They may experience these events from childhood and carry them to adolescence while some experience these events multiple times in their lives. Some still live in such conditions where they are frequently abused either physically, emotionally, or even sexually. Emotional responses to such traumatic experiences are mostly overwhelming. They may feel constantly terrified, helpless, and other extreme psychological emotions. Given the complex reaction and response to traumatic events, a lot of research has been directed towards diagnosing trauma and the possible and effective way to treat and help teens cope with trauma.
Trauma symptoms can be emotional, cognitive, physical, behavioral and also having interpersonal difficulties. These symptoms could also include other symptoms related to depression, anxiety, or substance abuse. The symptoms often occur due to triggers which are either internal or external such as places, photos, conversations, memories, smells, and sounds that remind the adolescents of their original traumatic experiences. These reminders make them feel as if the events are recurring even though they are now safe.
Emotional trauma symptoms include fear, sadness, anger, and frequent mood swings. The adolescent can be constantly frightened during the day and cause scary dreams at night. In addition to fears, young adults could also experience anxiety because of the sudden unpredictability and a sense of impending danger. Extreme sadness and depression mainly occur due to loss of faith and trust in the world example due to the loss of loved ones. They may also feel angry at the world because they feel that the traumatic experience was unfair.
Adolescents may also exhibit behavioral trauma symptoms as they try to escape the overwhelming feelings. Many teens inflict physical injuries such as cutting and burning to reverse the numbness they feel and also to escape the mental and emotional torture. The adolescents may also indulge in recklessness such as drug abuse and risky sexual behaviors. Adolescents who have experienced domestic abuse may grow up believing that violence and anger are accepted ways of dealing with problems and they employ violence when dealing with conflicts.
Trauma may also cause cognitive and interpersonal symptoms. Young adults change how they perceive themselves following a traumatic event. For instance, when they are sexually molested, they may blame themselves for not foreseeing or avoiding the event. For example, they may blame themselves for wearing a dress and for agreeing to go to the party where they were raped. The adolescents also develop cognitions that make them lose faith in God and in humanity and also lose hope for the future (Wamser-Nanney, Scheeringa & Weems, 2014). In addition, they develop changes in their interpersonal relationships. They become poor at communication and may even withdraw from peers because they feel stigmatized and ashamed for what happened to them and also due to trust issues. They believe that no one understands what they are going through.
A number of strategies can be put in place to help the traumatized teenager. They include encouraging the adolescent to open up without judging them and showing them that you genuinely care and are interested in helping them recover. They also require lots of love and support during this period. In extreme cases of trauma, it is advisable to seek professional help from counselors and therapists and also medical assistance.
The Adolescent Living with a Chronic Illness
Thousands of adolescents die each year from chronic illnesses such as cancer, kidney problems, and AIDS. Having a chronic illness can be extremely tough for teens to deal with. They mourn for the person they were and the life they had before the diagnosis. They also lose their independence because they are forced to depend on their parent’s care. Some break their romantic relationship for fear of hurting their significant other due to the inevitable death. It is even worse when they are staring at a bleak future, with the uncertainties of whether they will come out alive. These life-threatening illnesses alter the developmental changes associated with adolescents and can be too much for adolescents to cope with.
It is even more challenging for the parents and palliative caregivers of chronically ill adolescents. They have to consider the developmental position of the teenager as well as ethical and legal issues. This is because though they are mature and capable of making decisions, the law does not allow them to make medical decisions such as discontinuation of treatment. They also have to deal with the emotional distress of watching their loved one terminally ill and coming to terms with the inevitability of their death.
Managing pain and other distressing symptoms such as nausea and lack of appetite is the best medical care that can be given to chronically ill patients. As the death of adolescents draws closer, the healthcare providers help the family give end-of-life care to their adolescents. This includes giving the teenagers honest information about their illness (Kaushansky et al., 2016). They should also not treat them like they are already dead but treat them with hope, not for recovery or a cure but for a joyful life for the remaining period and assurance of their remembrance after death.
Adolescents face unique challenges when faced with the death of loved ones, trauma, or chronic illnesses. If they are not well taken care of during such periods, the conditions can cause prolonged emotional and physical suffering. Although medical research has provided knowledge about the conditions and ways of handling them, adolescents require more care and support from close family and friends to help them get through difficult times easily.
References
Johnson, L., Torres, C., Sykes, A., Gibson, D., & Baker, J. (2017). The bereavement experience of adolescents and early young adults with cancer: Peer and parental loss due to death is associated with increased risk of adverse psychological outcomes. PLOS ONE, 12(8), e0181024. doi: 10.1371/journal.pone.0181024
Kaushansky, D., Cox, J., Dodson, C., McNeeley, M., Kumar, S., & Iverson, E. (2016). Living a secret: Disclosure among adolescents and young adults with chronic illnesses. Chronic Illness, 13(1), 49-61. doi: 10.1177/1742395316655855
Wamser-Nanney, R., Scheeringa, M., & Weems, C. (2014). Early Treatment Response in Children and Adolescents Receiving CBT for Trauma. Journal Of Pediatric Psychology, 41(1), 128-137. doi: 10.1093/jpepsy/jsu096