Indian Journal of Health and Wellbeing

2013 Indian Association of Health,

Research and Welfare

2013, 4(5), 1128-1131

http://www.iahrw.com/index.php/home/journal_detail/19#list

Mental Health and Psychological Well being of Adolescents

Geetika Patnaik
Department of Psychology, BJB Autonomous College, Bhubaneswar
The field of global mental health has recently emerged, which has been defined as the area of study, research and
practice that places priority on improving mental health and achieving equity in mental health for all people
worldwide. Moreover, people who are mentally healthy can deal with difficult situations in a better manner (Smith
& Segel, 2011) and they remain focused, flexible and creative at all times. The period of adolescence is a time of
redefining and developing relationships with parents, peers and society. Biological changes interact with
psychological characteristics of the person and the changes in the social environment influence the adolescent's
mental health that affects psychological wellbeing to a great extent. Psychological wellbeing is characterized by self
acceptance, personal growth, purpose in life, environmental mastery, autonomy and positive emotions. Teenagers
of today are a pressurized lot. The fear of humiliation because of below par performance, lack of self confidence to
confront the ever changing challenges and the need to work like robots are all pervasive. The present paper
enumerates the problems of stress, depression, academic achievement and life skills in general of adolescents in the
present socio-cultural scenario. Mental health is not an end in itself but it should be treated as a means to achieve and
enhance psychological wellbeing to lead a goal-directed meaningful life, which in turn nurtures good mental health.

Keywords: mental health, adolescence, psychological wellbeing, bio-psycho-social view, identity crisis
The World Health Organization (WHO, 1948) defined health as a
Sheweder & others, 2006). During this critical and sensitive period
complete state of physical, mental and social wellbeing and not
of human development the various issues and challenges encounmerely the absence of disease or infirmity. This definition clearly
tered may be discussed in detail.
affirms that health is a positive state and not just the absence of
Issues and Challenges of Adolescence: Identity Crisis According to
pathogens, i.e. a disease-causing organism. According to the bioErik Erikson (1998), the major challenge of adolescence is the
psycho-social view, health is much more than the absence of disease.
creation of an 'adult identity'. Identity is achieved mainly by
A person who has no diseased condition is not sick, but this person
committing oneself to a particular occupation or a role in life.
may not be healthy, either. Since health is multi-dimensional all
Erikson stated that adolescents experience a life crisis of 'ego identity'
aspects of living, i.e. biological, psychological and social factors
versus 'role diffusion'. Ego identity is a firm sense of 'who one is' and
must be taken into account while examining the status of health.
'what one stands for'. It can carry one through different times and give
'Feeling good' is more than 'not feeling bad' and research in
meaning to one's achievements. Adolescents who do not develop ego
neuroscience (Zautra, 2003) found that the human brain responds in
identity may experience role diffusion that leads to anxiety.
distinctly different patterns to positive feelings and negative feelings.
Anxiety Many successful adolescents have moderate levels of
Mental Health: Emotional, Social and Psychological Wellbeing:
anxiety (Bandura, 1997), which is an unpleasant feeling of fear and
Ryff and Keyes (1995), Keyes and Lopez (2002), Keyes and Magyarapprehension. However, others may have high levels of anxiety
Moe (2003) defined mental health as the combination of emotional
which can significantly impair their achievements. For many,
wellbeing (presence of positive affect, satisfaction with life and
anxiety increases as they face more frequent evaluations, social
absence of negative affect), social wellbeing (incorporating accepcomparison and experiences of failure. Anxiety intervention
tance, actualization, contribution, coherence and integration), and
programs emphasize modifying the negative, self-damaging
psychological wellbeing (self acceptance, personal growth, purpose
thoughts into positive, task-focused thoughts (Meichenbaum &
in life, environmental mastery and positive relations with others).
Butler, 1980). When anxiety is severe and free floating, it may lead
Adolescence: Adolescence is the period between childhood and
to general anxiety disorder and perpetual depression in adolescents.
adulthood that involves biological, cognitive and socio-emotional
Depression and Suicide In major depressive disorder, an individual
changes. Hall (1904) stated that although many adolescents appear to
experiences a major depressive episode, and characteristics, such as
be passive they do experience considerable turmoil within themslethargy, and hopelessness, for at least two weeks or longer and daily
elves. The storm-and-stress view is Hall's concept that adolescence is
functioning gets impaired. According to the DSM-IV classification
turbulent time charged with conflict and mood swings. In his view,
of mental disorders (American Psychiatric Association, 1994), nine
adolescents' thoughts, feelings, and actions oscillate between conceit
symptoms define a major depressive episode, and to be classified as
and humility, good intentions and temptations, happiness and
having major depressive disorder, at least five of these must be
sadness. Each adolescent's development occurs against a cultural
present during a two-week period.
backdrop of contexts that includes
family, peers, school,
n
Depressed mood most of the day
neighborhood, community, region, and nation with its cultural
n
Reduced interest or pleasure in all or most activities
legacies (Cole, 2006; Mc Loyd, 2000; Parke & Buriel, 2006;
n
Significant weight loss or gain
n
Trouble in sleeping or sleeping too much
Correspondence should be sent to Geetika Patnaik, Department
n
Psychomotor agitation or retardation
of Psychology, BJB Autonomous
College, Bhubaneswar

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Indian Journal of Health and Wellbeing 2013, 4(5), 1128-1131

Fatigue or loss of energy

difficulties), and social factors.
Feeling worthless or guilty in excessive
n
or inappropriate manner
Biological factors: Adolescent problems are believed to be
caused
by a malfunctioning of the adolescent body. Biological
Problems in thinking, concentrating or making decisions
approach
focuses on the brain and genetic factors as causes of
Recurrent thoughts of death and suicide
adolescent's
problems (Lemery & Doelger, 2005). Drug therapy is
By about age 15, adolescent females have a rate of depression that is
frequently
used
to treat such problems, i.e. if an adolescent is
twice that of adolescent males, reasons being:
depressed, an anti-depressant drug may be prescribed.
Females tend to ruminate in their depressed mood and amplify it
n
Psychological factors:Distorted thoughts, emotional turmoil,
Females face more discrimination than males do
inappropriate learning, troubled relationships, and stressful early
Hormonal changes in females produce more visible alterations in
experiences with parents affect adolescents' mental health. Family
physique
and peer influences are especially important contributors to
Depressed parents, disturbed marital relationship of parents
adolescent problems (Dodge, Coie, & Lynam, 2006).
Poor peer relationship
n
Social factors: The psychological problems that adolescents
Peer rejection
develop appear in most cultures. However, the frequency and
intensity of the problems vary across cultures with the variation
Problems in adolescent romantic relationships
linked
to social, economic, technological, and religious aspects of
Difficult challenges in life
the
cultures
(Tanaka-Matsumi, 2001). Social factors that influence
Depression is linked with suicide (Werth, 2004). Following are some
the
development
of adolescent problems include socio-economic
of the factors for committing suicide during adolescence (Cox, Enns
status
and
neighborhood
quality (Brown & Adler, 1998). For
& Clara, 2004):
example, poverty is a factor in the occurrence of delinquency. In one
A sense of hopelessness
recent study, low socio-economic status was linked to the presence
Low self-esteem
of disruptive behavior problems in 9-to-12 year old boys (Barry &
High self-blame
others, 2005).
Impact of Television and Violence: In one longitudinal study, the
Prevention and intervention
amount of violence viewed on television at 8 years of age was
Mental
health professionals believe that depression often goes
significantly related to the seriousness of criminal acts performed as
undiagnosed in adolescence. Normal adolescents show mood
an adult (Huesmann, 1986). In a second longitudinal study,
swings, ruminate in introspective ways, express boredom with life,
childhood exposure to TV violence was linked with aggressive
and indicate a sense of hopelessness. Thus, parents, teachers, and
behavior of young adults. In addition to TV violence, there is
others may see these behaviors as simply transitory and not
increased concern about children and adolescents who play violent
reflecting a mental disorder but rather normal adolescent behaviors
video games, especially those that are highly realistic. One
and thoughts. Follow up studies of depressed adolescents indicate
difference between television and violent video games is that the
that the symptoms of depression experienced in adolescence predict
games can engage children and adolescents so intensely that they
similar problems in adulthood (Lewinsohn & others, 2006). This
experience an altered state of consciousness in which rational
implies that adolescent depression needs to be taken seriously.
thought is suspended and highly arousing aggressive scripts are
increasingly likely to be learned.
The prevention and intervention strategies can be broadly
categorized in two perspectives, viz. reducing health-compromising
Approaches to adolescent problems
behaviors and increasing health-enhancing behaviors.
The major problems encountered during adolescence are:
Reducing Adolescents' Health-compromising Behaviors: Such
Depression, truancy, and drug abuse
behaviors include drug abuse, juvenile delinquency, unprotected
sex, and dangerous driving/ riding. The three leading causes of death
Juvenile delinquency
in adolescence are accidents, homicide and suicide (National Centre
School related problems
for Health Statistics, 2000). More than half of all deaths of 15 to 24
Sexual problems
years of age are due to accidents. Risky driving habits, such as
The two major approaches to these adolescent problems are as
speeding, driving under the influence of alcohol or other drugs may
follows:
be more important risk factors than lack of driving experience for
The Developmental Psychopathology Approach: It focuses on
these accidents. When adolescents are in tempting and dangerous
describing and exploring the developmental pathways of problems.
situations with minimal adult supervision, their inclination to
According to this approach, adolescent problems can be categorized
engage in risk taking behavior make them vulnerable to a host of
as 'internalizing' or 'externalizing'.
negative outcomes.
Internalizing problems occur when individuals turn their
Increasing Adolescents' Health-enhancing Behavior: Such
problems inward (anxiety, depression)
behaviors include exercising, having nutritious food, wearing seatExternalizing problems occur when problems are turned outward
belt/ helmets, getting adequate sleep. Few emerging adults stop to
(arguing, fighting, juvenile delinquency)
think about how their personal life styles will affect their health in
Bio Psycho-Social Approach: It emphasizes that biological, psychotheir later adult lives (Sakamaki & others, 2005). The recommended
logical, and social factors interact to produce the problems that
range of energy intake for adolescents takes into account the needs
adolescents develop. Thus, if an adolescent engages in substance
of different adolescents, their growth rate, level of exercise, age, and
abuse, it may be due to a combination of biological (heredity and
gender (Sizer & Whitney, 2006). Males have higher energy needs
brain processes), psychological (emotional turmoil or relationship
than females. Some adolescents' bodies simply burn energy faster

PATNAIK/ MENTAL HEALTH AND PSYCHOLOGICAL WELL-BEING

1130

than others. Basal Metabolism Rate (BMR) is the minimum amount

important, one should create a 'to-do' list which involves listing and
of energy an individual uses in resting state.
setting priorities for daily tasks and activities. One may not avoid
important work because of other urgent tasks. Stress level increases
Benson and others (2006) prescribed 40 developmental assets that
when important activities become urgent. Hence, tasks should be
they believe adolescents need to achieve. Half of these assets are
prioritized and completed in the pre-set order.
external and half are internal. The five major external assets are:
n
Mentoring: Mentors are usually older and more experience
Support
individuals
who are motivated to improve the competence and
Empowerment
character of a younger person (Dubois & Karcher, 2005). The
Boundaries and Expectations
guidance is accomplished through demonstration, instruction,
Positive Peer Influence
challenge, and encouragement on a more or less regular basis over
Time Management
an extended period of time. In the course of this process, the mentor
The five major internal assets include
and the young person develop a special bond of mutual commitment.
Commitment to Learning
n
Mastery Motivation: Closely related to intrinsic motivation is
Positive Values
mastery motivation. Adolescents with a mastery orientation focus
on the task rather than on their ability, have positive affect
Integrity
(suggesting they enjoy the challenge) and generate solutionSocial Competence
oriented strategies that improve performance. In contrast,
Empathy, Friendship Skills, and Positive Identity (High Self
adolescents with a helpless orientation focus on their personal
Esteem)
inadequacies, often attribute their difficulty to a lack of ability, and
Besides the above mentioned assets, there are other factors that
display negative affect (boredom/anxiety). This orientation
enhance the adolescents' mental health. These are
undermines their performance. Mastery- and helpless-oriented
Self-efficacy: Self efficacy is the belief that I can, where as
adolescents may not differ in general ability. However, masteryhelplessness is the belief that I cannot (Stipek, 2002). High self
oriented adolescents believe that their ability can be changed and
efficacy adolescents trust that they can master a situation and
improved; whereas helpless-oriented adolescents believe that
produce favorable outcomes. This trust makes them to persist longer
ability is basically fixed and cannot be changed.
at a learning task and to have confidence in exploring challenging
n
Positive Emotions: Although some aspects of personality are
career options (Betz, 2004). To the extent that one respects oneself,
genetically based, children who grow up with abusive parents in a
have faith in his/her personal values and beliefs, and deals 'straight'
deprived and depressive environment tend to develop unhealthy
with other people, he/she is likely to behave in ways that others
personality and are prone to be affected by risk factors easily.
perceive as authentic (Albrecht, 2006).
Several Studies have been undertaken to analyse the impact of
Expectations: Adolescents' motivation is influenced by the
positive emotions on the wellbeing of adolescents that are
expectations of their parents, teachers and other adults. Some
highlighted in the following paragraphs.
emphasize that providing children
with unconditional regard and
n
Positive Emotion and Physical Health: Positive emotion has
positive feedback promote self esteem. However, raising children
direct, positive consequences on physical health (Charnetski &
simply to feel good about themselves often will not prepare them to
Brennan, 2001). It is related to longevity (Danner, Snowden &
face challenge and take responsibility. Adolescents who are not
Fiesen, 2001). When people experience a positive feeling, their
challenged may develop low standards for themselves and the fragile
immune function improves (Charnetski & Brennan, 2001) and their
self confidence they develop from reaching these low expectations
bodies become more capable of fighting off infections. There is
can be shattered when they encounter more challenging tasks
increasing evidence that positive emotion makes a unique
(Stipek, 2002). In fact, one long-term study of depression indicated
contribution to heart health (McCraty, Atkinson, Tiller, Rein &
that teaching children life skills is the better way to bolster genuine
Watkins, 1995).
self esteem. Further, teaching children to challenge their pessimistic
n
Positive Emotion and Psychological Health: Positive emotions
thoughts can help immunize them against depression (Gillham,
have long been associated with psychological health because they
Reivich, Jaycox & Seligman, 1995).
contribute to positive coping. Some coping models suggest that
Goal-Setting, Planning, and Self-Monitoring: These are
positively coping with life circumstances leads to positive effects
important aspects of adolescent achievement (Boekaerts, 2006).
(Diener & Lucas, 1999). It feels good to successfully resolve a
Goals can be long term or short term. A challenging goal is a
troubling situation, other researchers (Folkman & Moskowitz,
commitment to self improvement. However, goals should be
2000) suggest that experiencing positive emotion is, in itself, a
optimally matched to the adolescent's skill level. If goals are
coping strategy. The positive emotions that result from engagement
unrealistically high, the result will be repeated failures that lower the
in leisure activities have many positive psychological
adolescent's self efficacy. They also need to plan so as to reach their
consequences. The positive experiences can lead to an enhanced
goals (Pintrich, 2003). Being a good planner means managing time
ability to cope with challenges of life. The ability to cope can stave
effectively, setting priorities, and being organized.
off the illnesses of depression and anxiety, which contribute to
Time Management: An important aspect of self regulation is
feelings of competence.
managing time effectively. Timen
management helps in being more
Positive Emotions and Social Health: Positive social engagement
productive and less stressed, provides a balance between work and
can improve one's mental and physical health. The expression of
relaxation. Competent time managers create and monitor time plans
positive energy creates a reciprocal response in the other person and
and set priorities. They decide the most important activities for each
the happiness is perpetuated. Studies indicate that social activities,
day and allocate adequate time for them. To stay focused on what is
volunteering and other altruistic behaviors are strong sources of

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Indian Journal of Health and Wellbeing 2013, 4(5), 1128-1131

positive emotion (Argyle, ). Helping others results in feelings of joy

in the giver. Undoubtedly experiencing pleasure and positive
emotion in the moment is important in day-to-day wellbeing.
Moreover, the adolescents need to develop good communication
skills, creative thinking and positive attitudes for better socialization.

Conclusion
Adults' perception of adolescence emerges from a combination of
personal experience and media portrayals, neither of which produces
an objective picture of how typical adolescents develop (Feldman &
Elliot, 1990). Adults often portray today's adolescents as more
troubled, less respectful, more self-centered, more assertive, and
more adventurous than they were. Several studies on adolescence
have been conducted in the West. However, since there are wide
cultural differences between East and West, their problems and
coping styles also do vary accordingly. Adolescence period has to be
analyzed from biological, psychological and social perspectives
since biological changes interact with psychological characteristics
of the person and the changes in the social environment influence
how 'adolescence' is experienced.

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