Treatment of Depression: 18-25 Year Olds

Introduction

Depression is a mood disorder and disability that profoundly impacts how individuals feel, think, and perform daily activities such as sleeping, eating, and working. An official diagnosis requires symptoms to persist for at least two weeks. According to the National Survey on Drug Use and Health, in 2023, 50% of adults aged 18–25 reported symptoms of depression. This increase may be linked to life transitions, relationship challenges, poverty, trauma, and other stressors.

Several types of depression are prevalent among young adults:

• Major Depression: Characterized by a loss of interest in once-pleasurable activities. Symptoms include sleep disturbances, unexpected weight changes, low energy, and feelings of emptiness.
  
  
• Persistent Depressive Disorder (PDD): Also known as dysthymia, this condition lasts for at least two years but is less severe than major depression. Individuals with PDD can function day-to-day but experience reduced joy and engagement in activities.
  
  
• Seasonal Affective Disorder (SAD): Depression linked to seasonal changes, possibly due to altered serotonin and melatonin activity, light sensitivity, or circadian rhythm disruptions.
  

Perinatal Depression: Occurs during pregnancy or within the first year postpartum. It can range from mild to severe and affects the well-being of the mother, family, and infant.

Background

Chemical messengers, or neurotransmitters, play a central role in mood regulation. Serotonin, a neurotransmitter associated with positive mood, is often found at low levels in individuals with depression. Treatments commonly aim to raise serotonin levels using antidepressants such as SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Serotonin–Norepinephrine Reuptake Inhibitors).

However, many people can improve serotonin levels naturally. Exercise releases tryptophan, which the body converts to serotonin. Sunlight or artificial light can also help, as a lack of light is linked to SAD. A diet rich in tryptophan—found in foods like meat, fish, eggs, and yogurt—can also support serotonin production.

Contributing Factors and Risk Factors

Both genetic predisposition and environmental influences contribute to depression in young adults. Genetics affect neurotransmitter production and signaling; when these processes are disrupted, mood regulation can falter. Social media misuse is another major factor—heavy use increases exposure to unrealistic standards, social pressure, and negative comparisons. Research shows that individuals who spend four or more hours per day on social media have higher rates of depression compared to those who use it less.

Other significant contributors include:

• Financial stress: College students often face debt and job uncertainty.
  
  
• Academic pressure: Fear of underperformance can erode self-esteem.
  
  
• Social changes: Moving away from family and friends can trigger homesickness and isolation.
  
  
• Life events: Breakups, the death of loved ones, and interpersonal conflicts can cause emotional instability.
  
  
• Substance abuse: Alcohol and drugs can worsen or trigger depressive symptoms.
  

Low socioeconomic status: This often correlates with higher stress and reduced access to mental health care.

Symptoms and Diagnosis

Young adults may experience symptoms such as anxiety, emptiness, hopelessness, irritability, loss of interest in activities, fatigue, concentration difficulties, sleep disturbances, appetite changes, headaches, digestive problems without a physical cause, thoughts of death or suicide, impulsivity, and substance misuse.

Diagnosis typically involves:

1. Physical examination: To rule out other causes.
   
   
2. Laboratory testing: Including thyroid function tests and complete blood counts.
   
   
3. Psychiatric evaluation: Using interviews and questionnaires to understand thoughts, behaviors, and emotional patterns.
   

A comprehensive approach ensures an accurate diagnosis and allows for individualized treatment planning.

Treatment Strategies

Treating depression is challenging because symptoms vary widely between individuals. Dr. Carlos Zarate of the NIH has suggested that “there’s not one depression, but hundreds of depressions,” underscoring the need for tailored care.

Psychotherapy is often used for mild to moderate depression, while moderate to severe cases may require medication in addition to therapy. Common forms include:

• Cognitive Therapy: Focuses on changing negative thought patterns.
  
  
• Interpersonal Therapy (IPT): Addresses relationship issues contributing to depression.
  
  
• Dialectical Behavior Therapy (DBT): Emphasizes mindfulness, emotional regulation, stress management, and goal-setting.
  
  
• Problem-Solving Therapy: Builds confidence and strategies to tackle life challenges.
  
  
• Psychodynamic Therapy: Explores past experiences, particularly in childhood, to address underlying issues.
  

Antidepressants, particularly SSRIs, are widely prescribed for depression. They block serotonin reuptake in the brain, allowing for better communication between neurons. Common SSRIs include citalopram (Celexa), escitalopram (Lexapro), and fluoxetine (Prozac).

Rapid-acting antidepressants, such as ketamine, offer relief within hours, although they carry side effects like dissociation and require careful monitoring.

When other treatments fail, brain stimulation therapies may be used:

• Electroconvulsive Therapy (ECT): Uses controlled electric currents to stimulate brain activity.
  
  
• Transcranial Magnetic Stimulation (TMS): Uses magnetic fields to influence brain function.
  

Emerging approaches like Precision Psychiatry aim to match treatments to individual patients using biomarkers and tools such as EEG (electroencephalography).

Natural interventions—exercise, healthy diet, and sunlight—can complement formal treatments. Exercise increases serotonin, sunlight helps regulate mood-related hormones, and nutrient-rich diets support overall brain function.

Prevention Strategies for Young Adults

Colleges are increasingly providing mental health resources to prevent depression. On-campus counseling and partnerships with telehealth providers ensure around-the-clock access to care. Educational programs teach students stress management and coping skills before crises arise. For example, Florida State University requires new students to complete a course on managing stress and anxiety, while Brandeis University offers RISE, a program focused on resilience and healthy habits.

Peer support programs also help reduce isolation. Research shows that individuals with peer support experience improved self-care, optimism, and depression outcomes. National organizations like Active Minds and Radical Hope promote mental health awareness, provide coping strategies, and build social connections among students.

However, barriers remain. Many students avoid seeking help due to stigma, cost, or prior negative experiences. Increasing awareness of available resources is essential to encouraging more students to seek support early.

Conclusion

Depression in young adults aged 18–25 is a multifaceted condition influenced by genetic, environmental, and social factors. Symptoms range from emotional distress to physical complaints, and treatment must be personalized to the individual. Psychotherapy, antidepressants, brain stimulation, and emerging precision-based treatments all have a role, while natural lifestyle adjustments can serve as valuable complements.

Prevention is equally important. Universities can help reduce depression rates by offering accessible counseling, teaching coping skills, and fostering peer support networks. By addressing mental health proactively and removing barriers to care, we can improve outcomes for young adults facing depression and help them lead healthier, more fulfilling lives.

Paper written by: Aadi Jain, Volunteer of North Texas Med360