H. S. Dhavale (Nair Hospital, Mumbai)
The term adolescence comes from the Latin word meaning to grow to maturity. As it is used today, the term adolescence has a broader meaning, it includes mental, emotional and social maturity. While all periods in the lifespan are important, some are more important because of their immediate effects on attitude and behavior, whereas others are significant due to their long term effects. Adolescence is one of the periods when both immediate and long–term effects are important.

Similarly, some periods are important for their physical and others for their psychological effects. Adolescence is important for both. This period is described by different names such as ‘Critical period’ ‘Awkward age’ or ‘Transitional age’. In fact adolescence is an “In–between” transitional stage. The person is no longer a dependent, biologically immature, socially inept and psychologically weak child. He or she is also not yet independent, mature, resolute, and strong young adult.

The adolescent is really both part adult and part child, and hence it is difficult to describe him or her extremely accurately. Because of this confusion, many mental health professionals also freely used the word ‘Adolescent turmoil’ to describe both disturbed adolescents and the process of normal development. They face more difficult problems and pressures than did youth a decade ago. For example unhealthy competition, parental pressure, peer pressure and the influence of Western Culture through the media have all contributed to this.

Common factors which can affect mental health of an adolescent girl
Dependence
Independence conflict: There is conflict between the desire to grow up and to remain a child. They want to prove themselves as their ‘Own boss’. To prove this, they become more argumentative, reluctant to follow the family or social norms like staying out late, drinking, spending money, hair style, dress code etc. They like their parents to be less restrictive and less old fashioned.

Family V/S peer conflict
Youngsters gradually come to spend more time with their friends than they do with their family. Girls in particular invest and expect a great deal of trust and loyalty in same sex friendships. They also seem to have more intimate friendships with emotional disclosure and sharing of personal thoughts and feelings. They definitely place a great deal of emphasis on conformity with their group in dress, hairstyle, music etc, as that provides mental support. Social support in family and peer groups may operate as a risk factor or a protective factor depending on other risk factors at this age.

Sexuality
Implications of pubertal change on mental health seems to be related to two aspects of puberty–pubertal timing and pubertal status. Early maturation is sometimes an advantage and sometimes a disadvantage. Personality adjustment tends to be most satisfactory in those girls who mature around their average time, whereas early and late matures fare badly. There are mixed feelings towards menstruation. They are happy to become a ‘Real woman’ capable of reproduction but on the other hand get upset about the inconvenience, discomfort and embarrassment. The negative attitude towards menses usually depends on the mother’s attitude. Early puberty tends to be associated with both earlier and greater sexual experience, which in turn, are associated with and increased risk of premarital pregnancies. This is a new problem for India.

Career
Because of parental pressure and unhealthy competition, career choosing is becoming a real problem. Many parents try to force a career on their children even if they don’t have aptitude for the same, which may disturb their mental health. Specially for girls there may be more problems because parents are more reluctant to send them away from the home which may interfere in their career. Nowadays, more and more girls are joining lengthy professional courses which delay their marriage and may indirectly interfere with their sexuality and mental health. According to Blance & Way (1998) almost universally in Sub Saharan Africa and in the majority of developing countries, the gap between age at first sexual intercourse and age at first marriage has increased across age cohorts. The role differentiation becomes more marked in adolescence with girls facing greater conflict in choices between career and domesticity.