Dental hypersensitivity is an oral condition characterized by a sharp pain in the affected tooth or teeth. It occurs when the dentin is exposed to any stimuli. It is reported more in females than males. It majorly impacted canines, premolars of both arches. Its prevalence peaks among the age group of 20 to 40 years.

Causes of Dental Hypersensitivity:

Dentin exposure progresses in phases, initially starting as a local lesion with the erosion of enamel, and then further progressing to exposure of dentin tubules. Major factors leading to this are:

1. Gingival recession: Gingival recession is the exposure of dentin in the roots of the teeth from loss of gum tissue over the root of the teeth. It usually occurs in people with poor oral hygiene and happens due to improper tooth brushing or excessive brushing.
2. Tooth wear and tear:

•       Tooth abrasion – Tooth loses its enamel if exposed to vigorous brushing, or consumption of low pH oral fluids.
•       Tooth attrition – Tooth to tooth contact during excessive teeth grinding or jaw clenching causes damage to the tooth enamel.
•       Tooth erosion – Repeated exposure of teeth to anaerobic chemical processes or acids whether by consumption of acidic foods or by regurgitation

3. Age: With increasing age, primary dentin starts wearing off but secondary dentin is deposited and restored throughout life.

Risk factors of dental hypersensitivity:

• People who have heavy acidic diets or drinks or have frequent munching habits are at high risk.
• Consuming large amounts of beverages in the form of carbonated drinks, canned juices, beer, flavored waters, machine prepared tea or coffee, energy drinks, sour candies, are at high risk.

•  People with a history of gastroesophageal reflux disease, gastritis, pregnant women, and people on chemotherapy are at high risk.
•  Dry mouth disorder, that is people with inadequate saliva formation are at high risk

Diagnosis of Dental Hypersensitivity:

Diagnosis depends on a thorough clinical examination.

• Response to pain upon tapping the teeth to rule out inflammation of the dental pulp
•  Response to pain on biting a hard surface, like a wooden stick to rule out a fracture
•  Dental X-ray  diagnoses fractures of the tooth
•   The affected area is exposed to a jet of air to examine if there is any pain.

Treatment for Dental Hypersensitivity:

If it is in the initial stages, the doctor would recommend some self-care measures like:

•  Many over the counter toothpaste available in the market are the most cost-effective way of dealing with dental hypersensitivity.

•   Brushing is an important part of oral hygiene, great attention needs to be given to the correct way of brushing the teeth.
• Teeth need to be brushed twice a day with a soft bristled brush.
• The size and the shape of the brush are very important as it should fit in the mouth properly.
• A toothbrush needs to be changed every three or four months. If the bristles of the toothbrush are frayed, it needs to be changed immediately.
• Dental Associations recommend only fluoride toothpaste should be used.
• The toothbrush should be placed at an angle of 45-degree to the gums and brushing needs to be done back and forth in short strokes in a smooth way.
• The entire mouth needs to be brushed, the outer, inner and chewing surfaces of the teeth.
• Do not put excessive pressure while brushing.
• Use toothpaste containing sodium fluoride and calcium phosphates. The most recommended ones are the toothpaste containing potassium nitrate.
• Use mouthwash containing potassium or sodium salts to gurgle following any food intake.
• Reduce the quantity of acidic and high carbonated food intake.
• Avoid brushing teeth following intake acidic food or drinks.
• Keep a gap between food intake, and after every meal rinse your mouth with water.

The dentist may recommend the application of desensitizing agents or nerve desensitization therapies to reduce the pain such as

•         Occlusive therapy
•         Laser therapy
•         Ozone therapy
•         Application of resin-based materials
•         Use of oxalates
•         Gingival Grafts

-Dr.Surampally Bhavani Sagar

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3010026/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927677/

There is a time when I felt that I am about to die as my heart was pounding. I felt like I am paralyzed and I am unable to take a breath, there is nothing I could do to avoid this feeling. Some of you may have experienced similar feelings. 

Yes, I am talking about the panic attacks which many people might have experienced at least once in their lifetime.

I am sharing some facts in this article which many people are not aware of and are useful for people to deal with panic attacks. 

Let me mention the symptoms faced by people during a panic attack:

• Pounding heart
• Sweating
• Trembling or shaking
• Shortness of breath
• Feeling of choking
• Chest pain
• Nausea or abdominal distress
• Feeling dizzy, unsteady, lightheaded, or faint
• Unrealistic feelings and being detached from self.
• Fear of losing control or going crazy
• Fear of dying
• Numbness or tingling
• Chills or hot flashes

You may have had a panic attack if you experienced four or more of the symptoms listed above. They usually start abruptly and peak in about 10 minutes.

Facts about panic attacks:

1. Panic attacks are harmless, although they can feel very uncomfortable or scary.
2. Panic attacks are the body’s “fight-flight-freeze” response kicking in. This response gets our body ready to defend itself (for instance, our heart beats faster to pump blood to our muscles so we have the energy to run away or fight off danger). But during panic attacks, body might react even if there is no danger.
3. A panic attack typically lasts only 5 to 10 minutes at peak intensity, although we sometimes feel like they go on forever. Because panic attacks take up a lot of energy in the body, they quickly run out of gas. This is why they don’t last very long. You may also feel exhausted after the episode.
4. Panic attacks are private experiences. Except those very close to you usually cannot tell that you are having a panic attack.

Tips to cope up with panic attacks:

There are few ways to reduce these panic attacks. 

Panic diary: Maintain a panic diary in which you should mention each and every thing related to your panic attack. For example: Date, situation, anxiety symptoms, Catastrophic Misinterpretation (The catastrophe is the terrifying event that you thought was going to happen to you when you panic) and response. The panic diary will help you understand why you had a panic. Now you need to make a habit of generating an alternative response to your catastrophic misinterpretations whenever you panic and to write the response down in the final column of your panic diary.

Distraction techniques: There are many types of distraction techniques, for example, thinking of a holiday; imagine the sand between your toes, the sun on your skin and the sound of the sea or you could picture your favourite place wherever that might be. Distraction techniques work because they break the panic cycle of thinking and bodily sensations. These distraction techniques must be employed for at least 3-4 minutes for them to be effective.

Breathing Retraining Technique: Over breathing can also develop as part of the panic attack and make the symptoms worse. This breathing retraining technique can help you to overcome the problem of over breathing during panic attack.

Practice this basic technique three times a day, every day:

Inhale, with your shoulders relaxed, inhale as slowly and deeply as you can while you count to six. If you can, use your diaphragm to fill your lungs with air. Hold and keep the air in your lungs as you slowly count to four. Exhale, slowly breathe out as you count to six. Repeat it and do the inhale-hold-exhale cycle several times. Each time you do it, exhale for longer counts.

Physical exercise: Some recent studies suggest that exercise can reduce the symptoms of panic attack. In fact, exercise is a useful antidote to stress that also serves to enhance our sense of wellbeing. Regular exercise can make you less vulnerable to future episodes of panic. But, talk to your treating doctor before you start exercising, particularly if it has been a long time since you last exercised.

Medication: Sometimes you will be told to take the medication when you feel anxious, while others need to be taken everyday at around the same time each day.  Some of the anti-depressant / anti-anxiety medication work well to make you less anxious, while the minor tranquilizers are used to reduce anxiety or by suppressing the physical symptoms of anxiety and therefore the panic attacks. These medicines may have some side effects, but these usually pass in time. If you have any problems with your medication, then discuss these with your treating doctor as soon as possible.

References:

https://www.webmd.com/anxiety-panic/default.htm

https://www.healthline.com/health/how-to-stop-a-panic-attack#focus-object

Dr. Y. Alekhya.   

                                          

                                                                                                              

 

Hair transplantation is a surgical procedure that moves individual hair follicles from the back of the scalp called the ‘donor site’ to a balding part of the scalp known as the ‘recipient site’. It is primarily used to treat male pattern baldness.

Hair transplantation is a hair restoration procedure performed on men and women who have significant hair loss, thinning hair, or balding spots with no hair growth.

 In men, hair loss and baldness are most commonly due to genetic factors and hormonal changes. Male pattern baldness is a genetic disease common in men in which the hairline gradually recedes and bald areas appear. Men may also experience a gradual thinning of hair at the crown, or at the top of the skull. In women, hair loss is most commonly due to hormonal changes and is more likely to be a thinning of hair from the top of the head. Hair transplants can also be advised to replace hair loss due to burns, injury, or diseases of the scalp.

Technique

It is one of the hair restoration procedures that involves transplantation of your own hair taken out from the back of the scalp. It grows naturally and color of the hair is also the same as the original hair. Hair growth normally starts after 2 to 3 months and recovery takes approximately 8 to 10 months.

Hair transplant technique has advanced significantly. There are different techniques for performing transplant. One method is follicular unit transplant (FUT) in which strip of skin is taken out from the back of the scalp, then follicular unit is divided and replantation is done in required area. Linear scar is seen on the back of the scalp. 

Other advanced surgical technique is Follicular unit extraction (FUE).This is a method in which single hair is extracted and replanted in required area. The results are permanent and excellent. Small tiny dots are seen on the back of the scalp in spite of linear scar which is seen in FUT.

Advantages

• Hair transplants are completely safe and natural.
• No special chemicals or medicines are used in this process that might damage the hair.
• Hair transplant surgery is the most natural amongst other hair growth techniques. 
•  Transplanted hair works like naturally grown hair so no need to apply any special shampoos or chemicals to maintain its density.
•  Person gets back his confidence
• Hair transplant candidates can resume their normal work quickly.

Disadvantages

• The candidate who undergoes a transplant should be in good general health.
• It is mostly recommended in male pattern baldness which is a progressive, irreversible disorder. The person should be aware of it.
• It is an invasive procedure performed under local anesthesia. 
• The success of a transplant largely depends on the quality of the existing donor area.
• Recovery takes 8 to 10 months approximately.

Hair transplant is an excellent long term option for hair growth who suffer from low confidence due to male pattern baldness.

Discuss with your dermatologist regarding the procedure.

-Dr Prerna Gaur

Acknowledgements-

https://emedicine.medscape.com/article/839753-overview

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2825128/

Cracked heels are also known as heel fissures

Cracked heels usually develop when the skin around the rim of the heel is dry and thickened. The skin underneath your feet is often dry, rough and broken. This is because the skin around your heels has a relatively small number of sweat glands. If your skin is particularly dry, then cracked skin appears more easily because of less elasticity 

Causes of cracked heels

1. Lack of vitamins, minerals, and zinc in your diet can adversely affect your heel health.
   2. Spending a long time standing at work or home can stress the skin on your heels.
2. Thick, dry, scaly skin loses its elasticity with age, and as such cracks can have a higher incidence as you become older.
   4. Athlete’s foot, psoriasis, eczema, thyroid disease, diabetes, and some other skin conditions can be the cause of cracked heels.
   5. Being overweight can increase the pressure on the fat pad under the heel. This can cause it to expand sideways and, this leads to cracked heels.
3. Open-back sandals or shoes can allow fat under the heel to expand sideways and increase the possibility of cracks on your heels.
   7. Failing to keep your feet adequately clean can be a further cause of cracked heels.
4. Water on your feet can take away natural oils from the skin and can leave the skin rough and/or dry.
   9. Standing for prolonged periods in damp areas, such as a bathroom, can cause dry and cracked heels.

Tips to avoid cracked heels:

• Wearing shoes or boots with a closed heel can help heal and prevent cracks to the back of the foot.
• Wearing padded socks may protect the soft tissue of the foot.
• Wearing cotton socks with shoes may help reduce friction as well.
• Soak your feet weekly twice and clean using a pumice stone to debride the hard, thickened skin
• Avoid hot water, use warm water instead
• limit time in a bath or shower to 5-10 minutes to avoid more moisture loss
• Gently rub the skin with a towel to dry and apply a moisturizer immediately after the bath 
• Taking care of your feet especially if you’re a diabetic to avoid fungal infection which in turn leads to cracked heels.
• Consuming a balanced, nutrient-rich diet, as well as niacin supplements,  will help.
• Drinking plenty of water and losing weight if you are overweight, help prevent cracked heels too.

By doing above you will be kicking up your well-moisturized heels in no time.

……………………Dr. Krishna Priya

References:

https://www.stylecraze.com/articles/what-causes-cracked-heels/#gref

 

Presbyopia is a gradual loss of eyes’ ability to see near objects that occurs with ageing. It usually becomes noticeable around mid 40’s and continue to worsen till mid 60’s. Most people realise, that with increasing age reading books or newspapers gets difficult and keeping it at arm’s distance gives better clarity of vision and easier reading.

Normally, lens in the eye changes its shape so it can bend the light rays further and focus them on your retina at the back of your eye. However with age, lens become less flexible and hence focussing the light rays on retina gets difficult.

Symptoms

Presbyopia develops gradually. You may first notice these signs and symptoms after age 40:

• A tendency to hold reading material at a distance for clear vision
• Blurred vision at normal reading distance
• Eyestrain or headaches after reading or doing close-up work

These symptoms are worst in dim light or during stress or tiredness.

Risk factors

You are more prone for presbyopia –

• With increasing age.
• Other medical conditions- Like diabetes, cardiovascular diseases, nerve issues
• Refractive error like farsightedness
• multiple sclerosis, which is an autoimmune disease that affects your spine and brain
• eye trauma or disease
• vascular insufficiency or poor blood flow
• Certain drugs are associated with premature presbyopic symptoms, including antidepressants, antihistamines and diuretics.

Diagnosis

Presbyopia is diagnosed by a simple eye examination.

Your eye doctor likely will put drops in your eyes to dilate your pupils. This may make your eyes more light sensitive for a few hours after the examination. Dilation enables your doctor to more easily view the inside of your eyes.

Treatment

The goal of treatment is to compensate for the inability of your eyes to focus on nearby objects. Treatment options include wearing corrective eyeglasses (spectacle lenses) or contact lenses, undergoing refractive surgery, or getting lens implants for presbyopia.

Prescription reading glasses can be prescribed if you have no eye problems other than presbyopia. Also, bifocals  which have two different types of focus, with a noticeable line between them are prescribed. The upper portion is set for distance while the lower portion is set for reading or close work.

Progressive lenses are similar to bifocal lenses. However, they don’t have a visible line, and they offer a more gradual transition between the distant and close portions of the prescription.

There are surgical options too to treat presbyopia.

Your eyes will continue to gradually lose their ability to focus on close objects as you age. As a result, your prescription will have to be reviewed and changed according to the advice of your eye specialist.

If your presbyopia is undiagnosed or uncorrected, your vision will  deteriorate gradually. It will increasingly affect your lifestyle over time. You may experience a significant visual disability if a correction isn’t made and also risk of headaches and eyestrain increases. Hence timely diagnosis and corrective measures is recommended.

-Dr Prerna Gaur

References

https://emedicine.medscape.com/article/1219573-overview

https://www.webmd.com/eye-health/eye-health-presbyopia-eyes

 

Pic Credits: Internet

 

 

Mouth sores commonly affect people of all age groups at some point in their lives.

They are also known as canker sores or Apthous ulcers.

They are small crater like painful lesions that may develop on any of the soft tissues of your mouth, including your lips, cheeks, gums, tongue, and floor and roof of your mouth.

Majority of them are usually harmless and heal on their own in a couple of weeks even without any treatment.

They often make eating, drinking talking very uncomfortable due to pain.

CAUSES: There are no definite or a fixed causes behind each episode of mouth ulcers. However below are certain factors and triggers that are commonly associated with them-

1. Injury to oral tissues due to vigorous brushing, eating very hard/crunchy foods, braces, accidental bite or sport mishaps.
2. Acidic foods like strawberries, citrus, and pineapples, and other trigger foods like chocolate and coffee may cause ulcers to happen or worsen current ulcers.
3. Lack of essential vitamins, especially Vitamin B12, zinc, folate, and iron
4. Hormonal changes during menstruation
5. Emotional stress or lack of sleep
6. Use of certain things that irritate the oral tissues such as tobacco ,both chewing and smoking, toothpastes and mouth rinses that contain sodium lauryl sulphate
7. Recurrent or long lasting mouth ulcers also can be a sign of conditions that are more serious and require medical treatment, such  as inflammatory bowel disease, as anemia, crohn’s disease, celiac disease,  diabetes mellitus, Behcet’s disease and oral cancers.
8. Certain medications may also cause oral sores/ulcers, therefore if you notice ulcers after starting a medicine recently, it is advisable to talk your doctor about it.

 

Treatment of mouth ulcers–

Treatment is usually not necessary for minor canker sores, which tend to clear on their own in a week or two. But large, persistent, unusually painful  or recurrent sores often need medical care. The treatment includes avoidance of irritating foods and substances, treatment of the cause, and topical treatments.

 

• Avoidance of irritating substances-

 

• Avoid hot, spicy, salty, citrus-containing foods, and foods with high sugar content.
• Avoiding irritation from gum chewing
• Avoiding chewing tobacco/ pan masala and smoking

 

• Involves treatment of the cause-

 

• • Deficiency of vitamins being a very common cause, taking nutritional supplements like folic acid, vitamin B-6, vitamin B-12, and zinc can help but must be discussed with doctor before taking.

 

• For recurrent or long lasting oral ulcers, it is best to get a detailed evaluation from a doctor.

• Topical treatments and home remedies-

 

• Gargle with salt water
• using over-the-counter benzocaine (topical anaesthetic) products
• Damp tea bags are soothing and provide relief form the pain and can be placed on the sores.
• Rinsing your mouth with a salt water or baking soda rinse which can be made by Mixing 1 teaspoon of baking soda per ½ cup water.

Tips to prevent oral ulcers- There are no absolute measures by which canker sores can be prevented, the following measures would help

1. It is best to keep a watch on your diet and avoid very hot foods and drinks
2. Chew slowly to avoid accidental biting.
3. Use a soft toothbrush and practice regular dental hygiene avoid vigorous brushing and it is important to avoid toothpastes and mouth rinses that contain sodium lauryl sulfate.
4. See your dentist if any dental hardware or teeth may be irritating your mouth
5. If your canker sores seem to be related to stress, learn and use stress-reduction techniques, such as meditation
6. Eat a balanced diet take a daily multivitamin eat plenty of fruits, vegetables and whole grains.
7. Drink plenty of water
8. Don’t smoke or use tobacco
9. Avoid or limit alcohol consumption
10. Shade your lips when in the sun, or use SPF 15 lip balm

It is a good idea to visit your doctor for a check-up and discussion if you have been getting oral ulcers too frequently or if they have been staying for long or if they seem to have appeared after you were started on a medication.

                                                                                            ………….Dr.Afroze Fatima

 

https://www.healthline.com/health/mouth-sores

https://www.healthline.com/symptom/mouth-ulcers

https://www.mayoclinic.org/diseases-conditions/canker-sore/symptoms-causes/syc-20370615

https://www.medicinenet.com/canker_sores/article.htm

https://www.msdmanuals.com/home/mouth-and-dental-disorders/symptoms-of-oral-and-dental-disorders/mouth-sores-and-inflammation

https://www.webmd.com/oral-health/guide/canker-sores#1

Pic Credits: Internet                                     

 

Child safety is major health concern and is preventable with correct safety measures. We discussed various safety measures at home or while travelling with the baby in the previous article. In this article, we will deal with how to act and prevent mishaps in an emergency situation.

It is possible that the accident is pretty minor, but preparedness will prevent any major mishap. So, it is important to recognise the risk and severity of a particular situation and take steps in the right direction.

The most important role a parent can play in an emergency situation is to stay calm. Children of all ages can easily pick up on their parent’s fears and anxieties.

Following are the few common scenarios, where correct decision can revert a major mishaps-

1. Bump on the head/fall/injury to head– In case of a minor fall or injury or bump, if the child is playful and active, simply observe the kid and notice for any changes in behaviour.

In case of any loss of consciousness, vomiting, ear and nose bleed, excessive sleep or any other change in behaviour please take him/her to nearby hospital immediately without delay as there could be a probable injury to the brain.

3. Broken bone/injury– In case of minor injury to limbs without swelling or fractures, let the child rest and warm compress can be used to relieve the pain. In cases of fractures or injuries with lot of pain, try to make the child comfortable and make sure the affected area is not moved much. Take the kid to the nearest hospital immediately.
4.  Choking– While playing with smaller objects or eating hard food, these things can land up in the throat causing choking which can make breathing and speech difficult.

In such situations

• Keep talking with the child and if he is able to talk, his airway is clear.
• If he/she is not able to speak do the  Heimlich maneuver:

• Wrap your arms around your child’s waist, make a fist, and place the thumb side of your fist against his upper abdomen (just below his rib cage).

 

Pic Credits: Internet

Depression in teens/adolescents can be different from that in adults. It can be a serious mental issue that may make them sad and lose interest in routine and other activities, studies, etc. by affecting their thinking ability, behavior, emotional state.

Depression may not be just a sad feeling, lows experienced by adolescents, that can get better with willpower, mind deviation, etc. but can be severe and long lasting needing medical attention with treatment, counseling, etc. as it doesn’t get better on it’s own usually.

Symptoms

Depression may change the adolescent/teenager’s attitude, behavior leading to changes in emotions, problems in school/college, at home, social life, etc.

A few symptoms are

• Feeling extremely low with outbursts of crying, anger, agitation, irritability for no apparent reason or simple issues.
• Loss of interest in normal and regular activities, hobbies, etc.
• Feeling of worthlessness, guilt, loss of self esteem and self confidence.
• Loss of interest and conflict with family and friends.
• Feeling hopeless, empty, extreme sensitivity to rejection, failure.
• Insomnia or excessive sleep.
• Loss of appetite or food cravings with weight gain.
• Body ache, tiredness, restlessness.
• Difficulty in thinking clearly, focus and concentration.
• Social isolation and a look of negligence on personal appearance or self grooming.
• Excessive use of alcohol, drugs, etc.
• Thoughts of self harm, suicide.

Temporary lows and depression can be very difficult to differentiate. One may be able to handle feeling of low well in a typical situation but may not be able to when depressed. Assessment of this behaviour by parents in the teenage children may help in estimating the risk and chances of depression.

Causes

• Changes in the levels of neurotransmitters (messengers in brain to other parts of body).
• Hereditary factors with family members, parents, siblings with depression, anxiety, bipolar disorder, etc.
• Hormonal changes in the body.
• Emotional trauma in childhood in the form of physical, sexual abuse, etc.
• Evolving self to feel helpless with negative thinking, being submissive to a difficult situation, rather than solving or trying to deal with life’s challenges.

Risk factors

Risk factors which increase chances of depression can be

• Medical conditions such as diabetes, obesity, asthma, etc. that can make one feel low.
• Bullying at school/college, difficulty in coping up with studies.
• Physical, emotional, verbal and sexual abuse.
• Conflict or issues in family, divorce of parents, staying far away from parents and loved ones.
• Family member with serious medical conditions.
• Loss of a person.
• Change in location, new job, etc.
• Physical disability.
• Alcohol, drug abuse.

Management

Diagnosis is made by a psychiatrist after talking for some time to know about one’s feelings, attitude, behavior, approach to life, to estimate probable underlying cause. Tests such as thyroid test may be done to rule out thyroid disorders as a cause. A mental health assessment is done and diagnosis may be made with criteria from DSM-5 (Diagnostic and Statistical Manual for mental disorders).

Treatment

• Medications may help in treating depression, that may be prescribed by the psychiatrist after grading the severity and type of depression.

 

• Psychotherapy or talk therapy or counseling may be done one-on-one, with family members or in a group to help address the symptoms and educate on how to tackle and approach issues better.

 

Education on causes, ways to help get relief from symptoms, changes in lifestyle, etc. may be guided through. Psychotherapy includes cognitive behavioral therapy, interpersonal therapy.

 

• Lifestyle changes with a healthy diet and sleep cycle, regular exercises, working around the ways to control emotions and deal life challenges better.

 

 

• Other options that night help to some extent can be yoga, meditation, laughter therapy, acupuncture, massage therapy, etc.

• Support groups help in coping up better.

FOR PARENTS

 

• Keeping self in the teen’s position to understand the cause, feelings.

• Helping them understand and decide future goals, helping with setting realistic goals.

• Going for walks and spending a lot of time together to help them open up better.

• Avoiding family conflicts at home.

• Making sure prescribed medications are taken regularly.

• Keeping a watch on symptoms and making a note of it, maintaining a journal, etc.

 

Complications

Depression when left untreated or unnoticed or discontinuation of prescribed medications or treatment may lead to complications, that worsens the lifestyle.

• Suicide- It is very important to keep an eye on teens with depression and if you notice any any behaviour that indicates suicidal ideation, seek expert help immediately. Remove all sharp objects, chemicals, etc. around them.
• Alcohol and drug abuse.
• Failure in academics.
• Family conflicts ruining relationships.

 

References:

https://www.mayoclinic.org/diseases-conditions/teen-depression/symptoms-causes/syc-20350985

http://www.mentalhealthamerica.net/conditions/depression-teens

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3488279/

https://www.healthline.com/health/adolescent-depression

https://www.hopkinsmedicine.org/psychiatry/specialty_areas/moods/ADAP/docs/ADAP-Booklet_FINAL.pdf

https://www.webmd.com/depression/guide/teen-depression#1

Pic Credits: Internet