Two decades ago, the most common illness referred to as the silent killer was the condition known as hypertension or high blood pressure. 

Today's silent killer which stalks people of all ages, children, adolescents and adults is the medical condition known as depression. 

Depression comes with feelings of hopelessness, lethargy, isolation and a sense of futility. 

It can create havoc in the minds of adults and adolescents alike. 

Why is it referred to as a silent killer?Depression is frequently felt to be shameful or unacceptable and is therefore not expressed aloud or spoken of.

Depression brings about feelings of being overwhelmed and alone and sufferers often withdraw from social interaction and therefore do not reach out for help.

This is because adults and adolescents often prefer to keep their thoughts and emotions a private matter.

These negative and bleak thoughts and emotions are not processed or rationalised and end up creating cognitive dissonance (a psychological term which refers to the mental discomfort experienced by a person who holds two or more contradictory beliefs and ideas about themselves).

These thoughts and emotions may linger for weeks, months and even years building to levels of mental anguish and hopelessness which sometimes culminate in suicide if not psychologically and medically treated.

What exactly is depression?

Depression is a medical illness which refers to a mood disorder that negatively affects how a person feels, how they think as well as how a person acts as a result of depression.

Depression may vary from mild and short-lived episodes in response to change, loss and bereavement (for example a change of environment, loss of a job, death of a loved one or the termination of a relationship) to more severe and persistent episodes involving chemicals in the brain (neurotransmitters). 

This is known as clinical depression which can become a major depressive disorder and may persist over a sustained period of time. 

Depression in adolescents is common and the causes can include environmental factors such as family dysfunction, poverty and deprivation, loneliness, social isolation, bullying, physical and verbal abuse.

“Our government departments currently provide no posts at public or high schools to attend to the mental and emotional well-being of children and adolescents in schools.” Says Gillian Berkowitz, Senior Psychologist at JPCCC.

These factors if not addressed, impact on an adolescent's mental capacity and affect their self-esteem and confidence, how they interact with others and how they think about themselves.

All these factors combined have a negative influence on the self-esteem and emotional development of the adolescent.

If left untreated over a sustained period of time, an adolescent will increasingly experience emotional and physical symptoms including loss of interest in usually fun activities, sadness that persists, irritability and anger, reduced appetite or weight gain, a decline in social interaction, sleep disturbance (insomnia) or too much sleep.

In severe cases an adolescent will experience debilitating anxiety, feelings of worthlessness, fixating on past failures, intrusive thoughts and suicidal ideas. 

Suicide has become a frighteningly common option for adolescents who suffer from a mental health disorder and 90% of adolescents who commit suicide are suffering from an untreated mental health disorder.

Between the age group of 15 to 24 years of age, suicide has become the second leading cause of deaths in South Africa and the fastest growing trend of deaths among this age group.

The sad fact is that 75% of South Africans who do not know about depression or keep it a private matter will not receive the help they need, and this can have serious consequences. 

Anxiety and depression are often under-estimated or overlooked by parents whose children suffer from these conditions.

“We are failing our children at the fundamental level of attending to their basic mental health needs. We are therefore also denying their human rights to receive adequate health care.

We throw up our hands in horror at each new case of suicide”, added Berkowitz.   

Some adolescents withdraw or shut down while others cry out for help by using phrases such as: "I feel so alone, I just want to end it all.

I want to take pills to make the emptiness go away. I pray to God every night that I will die and not wake up"1. Parents may dismiss these symptoms of distress wanting to believe that their children will outgrow this phase. 

There are too many parents who ignore the signs and symptoms of anxiety and depression. 

They do not recognise that these changes in their child's mood, appetite, sleep patterns, motivation and withdrawn behaviour may be signs of severe emotional distress or depression.

We still carry many misconceptions about depression. 

Suicide is a permanent solution to a temporary problem and serious intervention is urgently needed to educate parents and children alike about the implications of depression. 

Interventions are provided by organisations such as the Johannesburg Parent and Child Counselling Centre (JPCCC) where qualified and trained professionals can facilitate awareness around anxiety and depression. 

JPCCC works within schools, its counselling centres and within the community to offer support and treatment for depression and other emotional and mental health challenges, through specialised counselling sessions.

Berkowitz concluded: “ Yet in the more than forty schools in Gauteng where JPCCC is able to send trained and supervised mental health practitioners we are able to offer safe and effective counselling as well as and referrals for children and adolescents who are experiencing anxiety and depression.” 

About JPCCC:The Johannesburg Parent and Child Counselling Centre is a counselling, training and development organisation which provides short- or long-term therapy for adolescents, adults, couples and play therapy for children.

JPCCC emerged as a result of the growing need for a specialised service for children with emotional difficulties and was established in 1944. JPCCC have successfully attended to the emotional and developmental needs of children and parents for the past 75 years.