Risk Factors and Mental Health Issues in Adolescence: An Analysis of the Indian Setting

Adolescence in India is marked by heightened vulnerabilities to concerns related to mental health with depression playing an important role as a contributing factor. Recent years have seen an increase in the incidence of depression in Indian adolescents. Despite this the major causes of causes of depression still remain unidentified. The present article aims to provide a detailed examination of the possible risk factors that are becoming increasingly significant in the Indian setting. The primary purpose of the paper is to offer an in -depth understanding of the factors that commonly lead to mental health problems in contemporary Indian youth. It is believed that the article would help create an understanding and awareness among parents, teachers and policy makers about the pressures and challenges youth faces so that relevant interventions can be made at different levels.

Adolescence is a period of substantial physiological, cognitive, and affective growth, which often coincide with an increase in mental health concerns.India exhibits a demographic feature where more than 50% of its population is under the age of 25, with a significant majority, over 65%, being under the age of 35.Having the largest number of youths as a nation, India is expected to benefit immensely from its given demographic structure.The youth demographic is highly dynamic and industrious within a culture.The youth population of a country has a substantial impact on its economic growth potential.The present youth cohorts are undeniably the future leaders in innovation, creation, construction, and leadership.Therefore, it is widely believed that directing resources towards the education, healthcare, and rights of young people in developing countries with a significant youth population might lead to notable progress.Therefore, it has become very important to address challenges faced by young people in their communities, particularly related to fair, inclusive, and progressive opportunities and solutions, is growing.The society can take full advantage of the demographic dividend only if it possesses the capacity to sustain the resulting growth.Adolescence and youth are marked by critical periods of substantial physiological, cognitive, and affective growth accompanied with various changes including hormonal fluctuations, physical growth, social adjustments, and modifications in brain structure and cognitive functions.These hormonal and physiological changes during adolescence often coincide with an increase in mental health concerns.Despite the overall good health most young people experience during this stage of their lives, adolescence is characterized by heightened vulnerabilities to mental health problems.The period of transition from adolescent to adulthood is a crucial stage during which individuals develop core behavioural and cognitive patterns that might impact health-related outcomes (Ibrayeva et.al,2020).Past few years have witnessed a notable rise in the incidences and severity of mental problems observed among youths.Notwithstanding this disconcerting pattern, such matters are often disregarded.The research in the area identifies the prevalence of mental disorders ranging from 9.5 to 102 per 1,000 individuals (Sagar et.al,2020).It is of utmost importance that we place a high priority on the mental well-being of adolescents and undertake efforts to effectively address these difficulties with the necessary gravity and expeditiousness.Depression has been identified as a key contributor to mental health problems among youth with suicide being the fourth major cause of death in them.A person with depression experiences persistent sadness, a loss of pleasure or a diminished level of interest in activities (WHO,2022).Beck and Alford (2009) identified five indicators of this condition: an unhealthy mood (e.g., sadness, loneliness, apathy), a negative self-concept (e.g., self-reproach, self-blame), a lack of interest in activities (e.g., suicidal thoughts, avoidance behaviours), changes in sleeping, eating, and sexual behaviour, and the presence of anxiety.Depression differs from typical fluctuations in mood and ordinary emotions associated with everyday experiences.In addition to heightened physical ailments, depression is associated with difficulties in interpersonal relationships and impairments in overall functioning.It has the potential to affect a number of domains of life, including interpersonal and social relationships.The consequence of this can potentially be detrimental to various aspects of youth's life, including the educational and career prospects.A negative perception of oneself, the world, and the future, often referred to as the cognitive triad, are the chief markers of depression.These factors result in negative emotions, decreased drive, physical problems like disrupted eating and sleeping patterns, and actions that contribute to depressive symptoms.Depression has been found to be associated with suicidal thoughts in a number of instances (Chen, Kang&Lin,2017).Similarly, Pompili (2020) discovered a correlation between substantial psychological distress and an increased vulnerability to suicidal behaviour.Such correlation between depression and suicide among youth presents a significant concern that requires intervention.Depression is increasing and affecting a large number of Indian youth today (Vijaykumar et.al,2022).It is for this reason that scholars, educators, government officials, advocates, and various academic and legal organisations have directed their attention to student suicides in Indian higher education institutions (Pandey, 2017).Thus, there is an urgent need to identify and address the possible causes of mental health issues among Indian youth.

Factors that contribute to depression in adolescents
Depression is a complex phenomenon, the possible causes of which remain still unidentified.Even the available theories and models have failed to highlight any specific cause of depression because of it's multifaceted nature.Additionally, these theories governed by western frame of reference are not suitable for exploring and addressing the causes of depression in the non-western cultural context.This necessitates developing indigenous conceptualizations for the phenomenon of depression in particular, and mental health in general.The factors that lead to depression among young Indians are complex and varied.Research conducted in India has found that young adults face a heightened risk of suicide.Despite the alarming evidence, these concerns are frequently neglected.The prioritisation of adolescent mental health necessitates an active and efficient action plan to address these concerns with the utmost urgency Depression in India is a major cause of disability and adversity (Murray & Lopez, 1997).Additionally, there is a notable inverse relationship between depression and quality of life (Sonkar & Singh, 2019).Despite this, the prevailing understanding of depression among professionals has been largely shaped by Western, affluent nations, with comparatively little consideration given to individuals from non-Western, non-affluent nations like India (Yakushko, 2019).Many theories of depression development commonly propose that adolescence is a crucial phase of social reorientation, during which several vulnerabilities are believed to arise.Researchers have found that stressful life events, especially those pertaining to interpersonal relationship, can aggravate depression trajectories in young people (Ge et.al, 1994).It is crucial to acknowledge that depression is perceived differently in India compared to Western societies.While the diagnostic construct of depression is commonly used across different cultures, it is imperative to develop culturally grounded conceptualizations and treatments for depression that cater to the needs of individuals from diverse backgrounds.When considering the trajectory of depression, it is vital to highlight its intricate nature as a disorder that arises from the convergence of genetic, biological, environmental, and psychological elements.However, the occurrence of depression in India is commonly associated with a complex interplay of various psychosocial components covering culture, social relations, and economics factors (Kermode, et.al.,2007).While biomedical explanations cannot be ignored, it is crucial to recognize and address the influence of these cultural, social, and economic cause to effectively tackle the problem of depression in the Indian population.Psychosocial risk factors refer to various factors that can pose a risk to a person's mental and emotional well-being.These factors include childhood neglect or abuse, loss of a loved one, relationship stressors, patterns of negative thinking, and feelings of hopelessness.It's important to address and manage these risk factors proactively to promote better mental health and overall well-being.In light of this, the present paper aims to provide an overview of the possible factors that have become leading causes of depression in the contemporary Indian society.
Academic Pressure: Academic pressure, a primary cause of stress among youths, refers to the psychological distress caused by anticipating academic challenges, anticipating failure, or recognition of academic underperformance (Verma & Gupta,1990).The findings of two comprehensive surveys (Cave et al. ,2014) revealed that academic pressure significantly contributes to adolescents' mental well-being.In a comprehensive study of adolescent suicides in the United Kingdom, Rodway et al. (2020) identified academic pressure as a prominent antecedent consistently identified by coroners.Research done in the Indian context also reveals the same (Subramani & Kadhiravan ,2017; Nagel &Sharma,2018).In India, the youth face immense pressure to excel academically, often triggering stress and a sense of inadequacy, especially during critical examination periods like board exams or competitive entrance exams (Deb et.al,2015).The limited number of institutions for tertiary education compared to the large number of college applicants results in a highly competitive admission environment.Additionally, a considerable number of students from senior school specializing in science subjects, are seen to face the stress associated with the competitive exams for engineering, medical, and other specialised professional programmes, leading to significant pressure.Many students experience anxiety during exam preparation, especially those who struggle to perform at their full potential under stressful conditions (Raina et.al,1983).

Parental Expectations:
Research findings show that parental dissatisfaction with children's academic achievement is strongly connected with the prevalence of depression (Ma, Siu & Tse, 2018).Due to the high academic expectations set by both parents and culture, Asian adolescents commonly experience a high level of stress.It is common for Asian parents to have high expectations for their children's academic performance.In a cross-cultural study conducted by Sun (2011), it was found that as compared to their American counterparts, Asian students reported higher levels of parental expectations and lower levels of parental satisfaction regarding their academic achievement.For many parents, ensuring academic excellence is a key objective when it comes to their children's education.With a strong desire for their children to reach their full potential, parents often have high expectations for their academic performance.Indian parents, in general, hold the belief that achieving excellence in education is crucial to success in life.Research suggests that approximately 66.0% of the student participants experience parental pressure to achieve higher levels of academic success in the Indian setting (Deb et.al. ,2015).Due to the rise in educational levels and the growth of middle-class families, parents expect more from their children.In many cases, parents seek fulfilment of their unmet childhood goals through their children.Such expectations can lead to feelings of being overwhelmed and stressed.When expectations are not met, it can result in elevated levels of stress, diminished self-confidence, and a loss of familial respect, ultimately contributing to the development of depression.(Ang & Huan, 2006).These expectations can lead to feelings of being overwhelmed and stressed.When expectations are not met, it can result in elevated levels of stress, diminished self-confidence, and a loss of familial respect, ultimately contributing to the development of depression (Ang & Huan, 2006).

Impact of Globalisation:
The impact of globalisation on the mental well-being of Indian youth has been varied.Social media has provided young people with opportunities to interact with individuals from different cultures, expanding their global perspective and fostering tolerance and acceptance, ultimately contributing to improved mental well-being.However, it has also led to heightened stress levels and mental health issues among youth due to increased competition and pressure for success.Furthermore, the impact of Western media and consumerism has generated unrealistic expectations and feelings of inadequacy, resulting in adverse effects on individuals' mental well-being and self-perception.Understanding the negative impacts of globalisation while providing support is essential for promoting the mental well-being of youth.Globalisation and new technologies are impacting the lifestyle, attitudes, and choices of adolescents in most countries (Gielen, 2016;Rao et al., 2013).According to Bhugra and Mastrogianni (2004), globalisation is a gradual and ongoing phenomenon that involves the fading away of traditional cultural boundaries.As a result of globalization, intercultural connectivity has increased, resulting in dynamic and complex sociocultural contexts that have a significant impact on individual psychological processes.In turn, these challenges one's sense of self, identity and belonging (Ozer, 2019).A significant proportion of young people, especially in developing countries, suffer from increased feelings of alienation as a result of this phenomenon.In developing societies like India, globalization provides young people with exposure to and adaptation to a wide range of cultural influences through media, tourism, and migration to globalised cities. Mental health disorders that can be influenced by these factors include suicide, substance abuse, antisocial behaviour, anxiety, and depression.As noted, mental health of youth is influenced by globalization in several ways, including altering perceptions of identity, introducing new economic disparities, and shaping the dissemination of information.
Technology and social media: Today's youth have unprecedented access to digital content via cell phones, tablets, computers, laptops, and gaming consoles.The media ecosystem is more diverse and sophisticated than ever, and social media platforms are vital.Social media includes any digital tool or program that allows social interaction (Moreno & Kota,2014).Social media is distinct from traditional media like TV since people may generate and consume content.A frequent and prolonged use of social media, particularly in the late hours, can disrupt sleep patterns and aggravate depression symptoms.It is important to note that social media use can displace activities that positively impact mental health, such as getting enough sleep (Stiglic &Viner et.al,2019).Furthermore, it can expose individuals to harmful digital experiences like cyberbullying, which can directly lead to changes in mood and mental state.Although social media use may not have a direct link to overall well-being, it is crucial to be aware of its potential impact on mental health.Social media platforms offer an exceptional amount of information regarding targets that are comparable to one another, thereby creating an environment that is conducive to social comparisons.Additionally, because users of social networking sites are more frequently exposed to the achievements rather than the failures of their virtual peers, upward social comparisons are particularly probable.Research on social comparison on social networking sites indicates that such comparisons generally lead to reduced subjective well-being (Verduyn et.al,2021).The usage of social networking sites among Indian youth is significantly higher compared to other countries, leading to a large portion of the population falling victim to cyberbullying.Contemporary youth encounter the additional obstacle of online platforms, which enable swift and extensive information sharing, thereby facilitating and supporting this form of bullying.Cyberbullying, according to Patchin and Hinduja (2012), involves the use of technology, such as cell phones, computers, tablets, and other electronic devices, for bullying purposes.Research indicates strong links between experiencing cyberbullying and internalising issues, such as depression and suicidal thoughts.Studies have shown that a significant portion of the Indian youth population lacks awareness about cyberbullying.Consequently, it is recommended that the government arrange seminars and awareness camps targeting parents, teachers, and minors to address this issue.

Conclusion
Youth mental health concerns are increasing at the present time, but there is a paucity of research examining the efficacy of interventions for this issue.Policy makers have not sufficiently recognised the prevalence of mental health issues among adolescents.As a result, there are still significant gaps in the development of programmes, policy making, data collection, and provision of social services for children and adolescents in developing countries.Depression is caused by a complex interplay of genetic, biological, environmental, and psychological factors.The intricate nature of the subject requires a comprehensive approach in both diagnosis and treatment.Understanding the complex interplay of these factors is crucial for designing interventions that successfully address the root causes of depression.Collaboration between healthcare professionals and researchers is essential for comprehensive examination and analysis of this condition.The goal should be to create evidence-based treatments and interventions that optimise patient outcomes.As noted, the mental health issues in this population are strongly associated with academic stress, particularly in India.Therefore, there is a pressing need for comprehensive research to assess the extent of academic stress among students, in India.Furthermore, it is important to examine the factors that contribute to stress and its association with mental health issues such as depression and suicidal tendencies.A focus should be placed on implementing stress management workshops, improving the academic environment, and implementing problem-focused and emotion-focused policies.It is believed that maintaining a balanced lifestyle and fostering stronger social bonds may enhance individuals' ability to cope with stress, anxiety, and depression during examination periods (Arusha & Biswas,2020).Psychoeducational family programmes can be highly effective in this context.Research has shown that family education can have an impact on youth depression.For example, psychoeducation sessions have been found to increase knowledge and decrease dysfunctional beliefs about depression (Brent, Poling, McKain, & Baugher, 1993).To advance mental health, societies should uphold and protect basic rights, such as civil, political, and cultural rights.National mental health policies should address not only mental disorders but also the underlying factors that influence mental well-being.Recent years have witnessed an increasing interest in studying the Indian perspectives on depression (Patel, Pereira, & Mann, 1998), which is essential to improve our understanding of depression in different Indian social groups.To effectively address this issue, it is crucial to enhance public health campaigns and treatment strategies.