Challenges of Adolescence
Overview
Recognizing adolescence
Adolescence is a period of life with specific health and developmental needs and rights. It is also a time to develop knowledge and skills, learn to manage emotions and relationships, and acquire attributes and abilities that will be important for enjoying the adolescent years and assuming adult roles.
All societies recognize that there is a difference between being a child and becoming an adult. How this transition from childhood to adulthood is defined and recognized differs between cultures and over time. In the past it has often been relatively rapid, and in some societies it still is. In many countries, however, this is changing.
Age: not the whole story
Age is a convenient way to define adolescence. But it is only one characteristic that delineates this period of development. Age is often more appropriate for assessing and comparing biological changes (e.g. puberty), which are fairly universal, than the social transitions, which vary more with the socio-cultural environment.
S.Mathangi
CHALLENGES OF ADOLESCENCE
Adolescence is a time in a young person’s life where they move from dependency on their parents to independence, autonomy and maturity. The young person begins to move from the family group being their major social system, to the family taking a lesser role and being part of a peer group becomes a greater attraction that will eventually lead to the young person to standing alone as an adult.
No-one can deny that for any one person facing changes in their lives in the biological, cognitive, psychological, social, moral and spiritual sense, could find this time both exciting and daunting. With the increase in independence comes increases in freedom, but with that freedom, comes responsibilities. Attitudes and perspectives change and close family members often feel they are suddenly living with a stranger.
Biological Challenges
Adolescence begins with the first well-defined maturation event called puberty. Included in the biological challenges are the changes that occur due to the release of the sexual hormones that affect emotions. Mood changes can increase, which can impact on relationships both at home with parents and siblings and socially or at school.
Cognitive Challenges
Piaget, in his theory of social development believed that adolescence is the time when young people develop cognitively from “concrete operations” to “formal operations”. So they are able to deal with ideas, concepts and abstract theories. It takes time for confidence to build with using these newly acquired skills, and they may make mistakes in judgement. Learning through success and failure is part of the challenge of the learning process for the adolescent.
Adolescents are egocentric, they can become self-conscious; thinking they are being watched by others, and at other times want to behave as if they were on a centre stage and perform for a non-existent audience. For example, acting like a music idol, singing their favourites songs in their room, with all the accompanying dance steps.
Psychological Challenges
The psychological challenges that the adolescent must cope with are moving from childhood to adulthood. A new person is emerging, where rules will change, maybe more responsibilities will be placed on him/her so that a certain standard of behaviour is now required to be maintained. Accountability is becoming an expectation from both a parental and legal concept.
As adolescents continue their journey of self-discovery, they continually have to adjust to new experiences as well as the other changes happening to them biologically and socially. This can be both stressful and anxiety provoking. It therefore is not surprising that adolescents can have a decreased tolerance for change; hence it becomes increasingly more difficult for them to modulate their behaviours which are sometimes displayed by inappropriate mood swings and angry outbursts.
Health Issues of adolescence:
Eating Disorders
An eating disorder is a serious mental illness, characterised by eating, exercise and body weight or shape becoming an unhealthy preoccupation of someone's life. Eating disorders are not a lifestyle choice, a diet gone wrong or a cry for attention. Eating disorders can take many different forms and interfere with a person’s day to day life.
Types of Eating Disorders
An eating disorder is commonly defined as an all-consuming desire to be thin and/or an intense fear of weight gain. The most common eating disorders among adolescents are anorexia, bulimia and binge-eating disorder. Even patients that do not meet all of the clinical criteria for an eating disorder can be at serious risk and should seek medical treatment.
Anorexia Nervosa
Teenagers with anorexia may take extreme measures to avoid eating and control the quantity and quality of the foods they do eat. They may become abnormally thin, or thin for their body, and still talk about feeling fat. They typically continue to diet even at very unhealthy weights because they have a distorted image of their body.
Signs of anorexia nervosa
- A distorted view of one’s body weight, size or shape; sees self as too fat, even when very underweight
- Hiding or discarding food
- Obsessively counting calories and/or grams of fat in the diet
- Denial of feelings of hunger
- Developing rituals around preparing food and eating
- Compulsive or excessive exercise
- Social withdrawal
- Pronounced emotional changes, such as irritability, depression and anxiety
Physical signs of anorexia include rapid or excessive weight loss; feeling cold, tired and weak; thinning hair; absence of menstrual cycles in females; and dizziness or fainting.
Teenagers with anorexia often restrict not only food, but relationships, social activities and pleasurable experiences.
Physical Signs and Effects of Anorexia Nervosa
Bulimia Nervosa
Teenagers with bulimia nervosa typically ‘binge and purge’ by engaging in uncontrollable episodes of overeating (bingeing) usually followed by compensatory behavior such as: purging through vomiting, use of laxatives, enemas, fasting, or excessive exercise. Eating binges may occur as often as several times a day but are most common in the evening and night hours.
Teenagers with bulimia often go unnoticed due to the ability to maintain a normal body weight.
Bulimia Nervosa often starts with weight-loss dieting. The resulting food deprivation and inadequate nutrition can trigger what is, in effect, a starvation reaction - an overriding urge to eat. Once the person gives in to this urge, the desire to eat is uncontrollable, leading to a substantial binge on whatever food is available (often foods with high fat and sugar content), followed by compensatory behaviours. A repeat of weight-loss dieting often follows, leading to a binge/purge/exercise cycle which becomes more compulsive and uncontrollable over time.
Signs of bulimia nervosa
- Eating unusually large amounts of food with no apparent change in weight
- Hiding food or discarded food containers and wrappers
- Excessive exercise or fasting
- Peculiar eating habits or rituals
- Frequent tips to the bathroom after meals
- Inappropriate use of laxatives, diuretics, or other cathartics
- Overachieving and impulsive behaviors
- Frequently clogged showers or toilets
Physical signs of bulimia include discolored teeth, odor on the breath, stomach pain, calluses/scarring on the hands caused by self-inducing vomiting, irregular or absent menstrual periods, and weakness or fatigue.
Teenagers with bulimia often have a preoccupation with body weight and shape, as well as a distorted body image. The clinical diagnosis commonly defines a teenager as having bulimia if they binge and purge on average once a week for at least three consecutive months.
Physical Signs and Effects of Bulimia Nervosa
Sexually Transmitted Diseases
Sexually transmitted diseases (STDs) are infections that are passed from one person to another through sexual contact. The causes of STDs are bacteria, parasites, yeast, and viruses. There are more than 20 types of STDs, including
Most STDs affect both men and women, but in many cases the health problems they cause can be more severe for women. If a pregnant woman has an STD, it can cause serious health problems for the baby.
Antibiotics can treat STDs caused by bacteria, yeast, or parasites. There is no cure for STDs caused by a virus, but medicines can often help with the symptoms and keep the disease under control.
Correct usage of latex condoms greatly reduces, but does not completely eliminate, the risk of catching or spreading STDs. The most reliable way to avoid infection is to not have anal, vaginal, or oral sex.
Chlamydia
Chlamydia is an STD caused by Chlamydia trachomatis (C. trachomatis). This bacterium only infects humans. Chlamydia is the most common infectious cause of genital and eye diseases globally. It is also the most common bacterial STD.
Women with chlamydia do not usually show symptoms. Any symptoms are usually non-specific and may include:
- bladder infection
- a change in vaginal discharge
- mild lower abdominal pain
If a person does not receive treatment for chlamydia, it may lead to the following symptoms:
- pelvic pain
- painful sexual intercourse, either intermittently or every time
- bleeding between periods
Genital herpes
This STD is caused by the herpes simplex virus (HSV). The virus affects the skin, cervix, genitals, and some other parts of the body. There are two types:
- HSV-1, also known as herpes type 1
- HSV-2, also known as herpes type 2
Herpes is a chronic condition. A significant number of individuals with herpes never show symptoms and do not know about their herpes status.
HSV is easily transmissible from human to human through direct contact. Most commonly, transmission of type 2 HSV occurs through vaginal, oral, or anal sex. Type 1 is more commonly transmitted from shared straws, utensils, and surfaces.
In most cases, the virus remains dormant after entering the human body and shows no symptoms.
Symptoms of genital herpes
- blisters and ulceration on the cervix
- vaginal discharge
- pain on urinating
- fever
- generally feeling unwell
- cold sores around the mouth in type 1 HSV
Gonorrhea
This sexually transmitted bacterial infection usually attacks the mucous membranes. It is also known as the clap or the drip. The bacterium, which is highly contagious, stays in the warmer and moister cavities of the body.
The majority of women with gonorrhea show no signs or symptoms. If left untreated, females may develop pelvic inflammatory disease (PID). Males may develop inflammation of the prostate gland, urethra, or epididymis.
The disease is caused by Neisseria gonorrhoeae. The bacteria can survive in the vagina, penis, mouth, rectum, or eye. They can be transmitted during sexual contact.
Symptoms of gonorrhea may occur between 2 to 10 days after initial infection, in some cases, it may take 30 days. Some people experience very mild symptoms that lead to mistaking gonorrhea for a different condition, such as a yeast infection.
Males may experience the following symptoms:
- burning during urination
- testicular pain or swelling
- a green, white, or yellow discharge from the penis
Females are less likely to show symptoms, but if they do, these may include:
- spotting after sexual intercourse
- swelling of the vulva, or vulvitis
- irregular bleeding between periods
- pink eye, or conjunctivitis
- pain in the pelvic area
- burning or pain during urination
HIV and AIDS
Human immunodeficiency virus (HIV) attacks the immune system, leaving its host much more vulnerable to infections and diseases. If the virus is left untreated, the susceptibility to infection worsens.
HIV can be found in semen, blood, breast milk, and vaginal and rectal fluids. HIV can be transmitted through blood-to-blood contact, sexual contact, breast-feeding, childbirth, the sharing of equipment to inject drugs, such as needles and syringes, and, in rare instances, blood transfusions.
With treatment, the amount of the virus present within the body can be reduced to an undetectable level. This means the amount of HIV virus within the blood is at such low levels that it cannot be detected in blood tests. It also means that HIV cannot be transmitted to other people. A person with undetectable HIV must continue to take their treatment as normal, as the virus is being managed, not cured.
HIV is a virus that targets and alters the immune system, increasing the risk and impact of other infections and diseases. Without treatment, the infection might progress to an advanced disease stage 3 called AIDS. However, modern advances in treatment mean that people living with HIV in countries with good access to healthcare very rarely develop AIDS once they are receiving treatment.
Mental Health Disorder
1.Anxiety Disorders
Anxiety disorders are a group of mental disorders characterized by significant feelings of anxiety and fear. Anxiety is a worry about future events, and fear is a reaction to current events. These feelings may cause physical symptoms, such as a fast heart rate and shakiness.
Occasional anxiety is an expected part of life. You might feel anxious when faced with a problem at work, before taking a test, or before making an important decision. But anxiety disorders involve more than temporary worry or fear. For a person with an anxiety disorder, the anxiety does not go away and can get worse over time. The symptoms can interfere with daily activities such as job performance, school work, and relationships.
There are several types of anxiety disorders, including generalized anxiety disorder, panic disorder, and various phobia-related disorders.
Generalized Anxiety Disorder
People with generalized anxiety disorder (GAD) display feel excessive, unrealistic worry and tension with little or no reason, most days for atleast 6 months, about a number of things such as personal health, work, social interactions, and everyday routine life circumstances. The fear and anxiety can cause significant problems in areas of their life, such as social interactions, school, and work.
Generalized anxiety disorder symptoms include:
- Feeling restless, wound-up, or on-edge
- Being easily fatigued
- Having difficulty concentrating; mind going blank
- Being irritable
- Having muscle tension
- Difficulty controlling feelings of worry
- Having sleep problems, such as difficulty falling or staying asleep, restlessness, or unsatisfying sleep
Panic Disorder
People with panic disorder have recurrent unexpected panic attacks. Panic attacks are sudden periods of intense fear that come on quickly and reach their peak within minutes. Attacks can occur unexpectedly or can be brought on by a trigger, such as a feared object or situation.
During a panic attack, people may experience:
- Heart palpitations (unusually strong or irregular heartbeats), a pounding heartbeat, or an accelerated heart rate.
- Sweating
- Trembling or shaking
- Sensations of shortness of breath, smothering, or choking
- Feelings of impending doom
- Feelings of being out of control
People with panic disorder often worry about when the next attack will happen and actively try to prevent future attacks by avoiding places, situations, or behaviors they associate with panic attacks. Worry about panic attacks, and the effort spent trying to avoid attacks, because significant problems in various areas of the person’s life, including the development of agoraphobia - People with agoraphobia have an intense fear of two or more of the following situations:
- Using public transportation
- Being in open spaces
- Being in enclosed spaces
- Standing in line or being in a crowd
- Being outside of the home alone
2. Mood Disorders
The development of emotional or behavioral symptoms in response to an identifiable stressors that occur within 3 months of the onset of the stressors in which low mood, tearfulness, or feelings of hopelessness are predominant.
3. Major Depressive Disorder (MDD):
A period of atleast 2 weeks during which there is either depressed mood or the loss of interest or pleasure in nearly all activities. In children and adolescents, the mood may be irritable rather than sad.
4. Bipolar Disorder:
A period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistency increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day, or that requires hospitalization.
5. Attention Deficit Hyperactivity Disorder
Definitions of the symptom complex known as attention-deficit/hyperactivity disorder (ADHD) differ, but severe problems with concentration or attention and/or hyperactivity are estimated to affect adolescents. Six times as many boys as girls are affected. The main consequences of ADHD are poor academic performance and behavioural problems, although adolescents with ADHD are at substantially higher risk of serious accidents, depression, and other psychological problems. About 80% of children with ADHD continue to have the disorder during adolescence, and as many as 50% of adolescents still do throughout adulthood.
6. School phobia
School phobia also called school refusal, is defined as a persistent and irrational fear of going to school. It must be distinguished from a mere dislike of school that is related to issues such as a new teacher, a difficult examination, the class bully, lack of confidence, or having to undress for a gym class. The phobic adolescent shows an irrational fear of school and may show marked anxiety symptoms when in or near the school.
7. Learning disabilities
Learning abilities encompasses disorders that affect the way individuals with normal or above normal intelligence receive, store, organize, retrieve, and use information. Problems included dyslexia and other specific learning problems involving reading, spelling, writing, reasoning, and mathematics. Undiagnosed learning disabilities are a common but managerable cause of young people deciding to leave school at the earliest opportunity.
Social Issues
Sexual Abuse
Sexual abuse is sexual behavior or a sexual act forced upon a woman, man or child without their consent. Sexual abuse includes abuse of a woman, man or child by a man, woman or child.
Sexual abuse or violence against children and adolescents is defined as a situation in which children or adolescents are used for the sexual pleasure of an adult or older adolescent, (legally responsible for them or who has some family relationship, either current or previous), which ranges from petting, fondling of genitalia, breasts or anus, sexual exploitation, voyeurism, pornography, exhibitionism, to the sexual intercourse itself, with or without penetration.
Sexual abuse in childhood may result in problems of depression and low self-esteem as well as in sexual difficulties, either avoidance of sexual contact or, on the other hand, promiscuity or prostitution. Research studies suggest that the kinds of abuse that appear to be the most damaging are those that involve father figures, genital contact, and force.
As reports of sexual abuse of children have increased, ways to protect children are now being carried out. Some information campaigns have concentrated on children’s contacts with strangers-for example, “Never get into a car with anyone you don’t know, “Never go with someone who says he or she has some candy for you”. However, in the majority of reported assaults children are victimized by people they know. To prevent this kind of assaults, children need to be taught to recognize signs of trouble and to be assertive enough to report them to a responsible adult. How to accomplish this task represents an important challenge to prevention-oriented researchers.
Sexual abuse of children is regarded by the World Health Organization (WHO) as one of the major public health problems. Studies conducted in different countries suggest that 7-36% of girls and 3-29% of boys suffered sexual abuse.
Substance Abuse
Many communities are plagued with problems of substance abuse among youth. Some children start smoking or chewing tobacco at an early age, aided by easy access to tobacco products. Many of our youth, with limited supervision or few positive alternatives, drink too much beer and liquor. Other youth, influenced by their peers, use other illegal drugs. Our youth suffer from substance abuse in familiar ways: diminished health, compromised school performance, and reduced opportunities for development. Our communities also bear a heavy burden for adolescent substance abuse. Widespread use and abuse of tobacco, alcohol, and illegal drugs by teens can result in increased accidents, health costs, violence, crime, and an erosion of their future potential as workers and citizens.
Protective factors are personal and environmental factors that decrease the likelihood that a person may experience a particular problem. Protective factors act as buffers against risk factors and are frequently the inverse of risk factors.
Personal risk factors for substance abuse include: poor school grades, low expectations for education, school dropout, poor parent communication, low self-esteem, strong negative peer influences, peer use, lack of perceived life options, low religiosity, lack of belief about risk, and involvement in other high-risk behaviours. Environmental risk factors include: lack of parental support, parental practice of high-risk behaviors, lack of resources in the home, living in an urban area, poor school quality, availability of substances, community norms favorable to substance use, extreme economic deprivation, and family conflict.
Protective factors may include peer tutoring to improve school grades, mentoring and scholarship programs to increase educational opportunities, programs to build strong communication and refusal Preface Work Group for Community Health and Development iv skills, information to increase understanding about risk, and the enforcement of local laws prohibiting the illegal sale of tobacco and alcohol products to youth.
Influence of Electronic Media
Electronic devices are an integral part of adolescent's lives in the twenty-first century. The world of electronic devices, however, is changing dramatically. Television, which dominated the media world through the mid-1990s, now competes in an arena crowded with cell phones, computers, iPods, video games, instant messaging, interactive multiplayer video games, virtual reality sites, Web social networks, and e-mail.
Electronic devices are defined as any object or process of human origin that can be used to convey media as books, films, mobiles, television, and the Internet. With respect to education, communication or play.
Adolescents, in particular, spend a significant amount of time in viewing and interacting with electronic devices in the form of TV, video games, music, and the Internet. Considering all of these sources together, adolescence spend more than six hours per day using media. Nearly half of that time is spent in watching TV, playing, or studying with computer. The remainder of the time is spent using other electronic media alone or in combination with TV.
The electronic media mainly consist of radio, television, and movies, and are actually classrooms without four walls. Media is an important source of shared images and messages relating to political and social context. Technology of media is an important part of student’s lives in the twenty-first century and play very important role in creating awareness related various aspects of life and personality as found. The world of electronic media, however, is changing dramatically. Television, which dominated the media world through the mid-1990s, now competes with cell phones, iPods, video games, instant messaging, interactive multiplayer video games, Web social networks, and e-mail. We learn skills, values and patterns of behavior from the media both directly and indirectly. There is no doubt that electronic media have a important influence on children from a very early age, and that it will continue to affect children's cognitive and social development. Electronic media activate and reinforce attitude and contribute significantly in the formation of new attitudes.
Effects of Technology on Adolescence
Technology and internet addiction in adolescence can have far reaching effects on the addict and his family. Adolescence with technology addiction can suffer from a variety of physical and psychological health problems.
General Effects
- Poor eating habits
- Increased obesity
- Depression
- Loneliness
- Anxiety
- Aggression
- Attention problems in school, low attention span
- Lack of empathy
- Poor sleep
- Poor academic performance
- Social phobia
- Increased instances of cyberbullying
- Increased instances of substance abuse
- Growth issues
- Unable to control impulse to use the Internet/technology
- Feelings of happiness when using Internet or thinking about using the Internet
Negative effects of video games on adolescence's physical health, including obesity, video-induced seizures and postural, muscular and skeletal disorders, such as tendonitis, nerve compression, and carpal tunnel syndrome as well as delayed school achievement. However, these effects are not likely to occur for most adolescence. Parents should be most concerned about two things: the amount of time that adolescence play, and the content of the what to be play or watching.
In addition, symptoms associated with using mobile phones most commonly include headaches, earache, warmth sensations and sometimes also perceived concentration difficulties as well as fatigue However, over exposure to mobile phone use is not currently known to have major health effects. Another aspect of exposure is ergonomics. Musculoskeletal symptoms due to intensive texting on a mobile phone have been reported and techniques used for text entering have been studied in connection with developing musculoskeletal symptoms. The central factors appearing to explain high quantitative use were personal dependency, and demands for achievement and availability originating from domains of work,
To protect adolescence from harm, all health staff must have the competences to recognize adolescence maltreatment and to take effective action as appropriate to their role. They must also clearly understand their responsibilities, and should be supported by their employing organization. In addition, Parents have no idea about electronic devices effects on adolescence. So, parents need to understand that electronic devices can have an impact on everything they are concerned about with their adolescence's health and development, school performance, learning disabilities, sex, drugs, and aggressive behavior.
Preventive Measures
- Set strict time limit for phone use at home.
- Restrict the use of video games, television and other gadgets.
- Ask your teens to use only the family computer for all their online activities at home.
- Supervise the time your teens spend on the Internet.
- Spend time with your child to understand the source of his addiction. It is important for parents to know what makes their children find solace on the Internet.
- Talk to your teen’s teachers to understand problems at school, if any.
- Create positive environment at home. Your teen could be spending excessive time on the Internet to escape the problems at home. This excessive time spend on technology can easily turn into an addiction.
- Enforce no-Internet time at home or consequences for breaking rules about using technology at home.