Adolescence is considered a high risk period for major depressive disorder. During the teenage years, adolescents experience changes cognitively, physically, emotionally and socially. They struggle with issues of independence and self-identity. Studies have also shown that females are twice as likely to develop major depressive disorder when compared to males. Recognition and diagnosis of the major depressive disorder is difficult to notice in adolescents for a number of reasons. Many adolescents with depression have difficulty in accurately identifying and describing their emotions. As a result they may act out and be ill-tempered toward others, prompting parents or physicians to believe it is behavior misconduct or a normal part of a developmental stage. Physicians sometimes may be hesitant to prematurely diagnose a young individual with any mental illness diagnosis such as of major depression~sigma. However early diagnosis and treatment of depressive disorders are critical to healthy cognitive, emotional, physical, and psychosocial development. In both adolescents and young adults, depressive disorders present an increased risk for illness and interpersonal and psychosocial difficulties that persist long after the depressive episode is resolved. In both groups there is also an increased risk for substance abuse and suicidal behavior and an indication that depression in youth may also predict more severe illness in adult life (Weissman, Wolk & Goldstein, 1999). According the Centers for Disease Control and Prevention (CDC) suicide is third leading cause of death among 15 to 24 year olds in the United States. Among this age group, suicide accounts for 12.3% of all deaths. National Institute of Mental Health (NIMH) researchers have found that among adolescents who develop major depressive disorder, as many as 7% may commit suicide in the young adult years (Weissman et al., 1999). These percentages indicates that a considerable amount of high school students
nationwide have considered suicide as a solution to their difficulties in school or at home. Awareness must be raised among school staff to adequately address these adversities among adolescents. In 2009, a Youth Risk Behavior Survey was conducted by the Centers for Disease Control and Prevention. Nationwide, during the 12 months before the survey 13.8% of students had seriously considered attempting suicide and 6.3% of students had attempted suicide one or more times. Overall, the prevalence of having seriously considered attempting suicide was higher among female than male students, higher among Hispanic female and Hispanic males, and higher among females and males in the 9th grade. During the 12 months before the survey, 10.9% of students nationwide had made a plan about how they would attempt suicide and 1.9% of students nationwide had made a suicide attempt that resulted in an injury, poisoning, or an overdose that had to be treated by a doctor or nurse with a higher prevalence in female students (CDC, 2009). Therefore it is very important that therapists and parents to take all threats of suicide seriously. As a preventive measure an accurate evaluation of suicidal thinking is also essential to limit young people's access to fatal agents and to prompt immediate treatment. An evolving problem that has developed over the last few years is cyber bullying. Researchers from the National Institutes of Health (NIH) found that children who are bullied through electronic means, such as through the internet, social websites, and cell phones, may be more likely to become depressed than those who are victims of traditional bullying. This may be due to the inability for the victim to know who is victimizing them. Often cyber bullying make the victim feel scared, vulnerable and isolated at both home and in school. Cyber bullying seems to be common among middle and high school students. Other forms of bullying, such as physical
and verbal, are also present in middle and high school. Any type of bullying puts adolescents at an increased risk for suicide, especially if they have other psychological or physical illnesses.