Youth Depression

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Notes

Show Notes

Slide 1 :

Youth Depression Lorna Martin lormartin@gov.mb.ca

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General Symptoms of Youth Depression A feeling of sadness and hopelessness (belief that there’s no way to stop feeling stressed out and sad) Moodiness (irritability, feelings of anger and sadness for weeks at a time) Eating disturbances (eating either too much of too little) Sleep disturbances (nightmares, insomnia, hypersomnia) Changes in social life (depressed teenagers stop spending time with their friends. They often refuse phone calls)

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General Symptoms of Youth Depression Chemical abuse (depressed teenagers attempt to relieve depression, but often the result is addiction. What they don’t realize is that alcohol and drugs are depressants, not mood elevators, and their depression worsens) Loss of interest in pleasurable activities (finding no pleasure in activities they used to enjoy, such as going to movies or concerts, reading, watching TV, listening to music or sports. As well as no involvement in new activities) adapted from www.counsellor.com.au/depression.html

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School-related Symptoms of Youth Depression Poor performance in school, truancy, tardiness Withdrawal from school activities/peer groups Lack of enthusiasm, energy or motivation Globalized anger and rage Overreaction to criticism, increased self-criticism Indecision, lack of concentration or forgetfulness Restlessness and agitation Problems with authority Suicidal thoughts or actions (e.g., cleaning out locker, giving away items)

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A Few More Reasons for Depression Fear of failure social rejection bodily sickness bullying or abuse childhood memories thoughts of a better life separation with family worries about the future

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A Few More Reasons for Depression alcohol/substance/drug abuse pointless work done teasing or low self opinion because of body, accent, clothing imperfection of the work as a whole, as in negative comments from family, friends or peers excerpted from www.counsellor.com.au/depression.html

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Why we misdiagnose youth depression: The Pathology of Puberty Variable performance in school Withdrawal from family, change in peers Lack of motivation, change in sleep patterns Globalized anger and rage, giddiness Overreaction to criticism, increased self-criticism Indecision, lack of concentration or forgetfulness Restlessness and agitation Problems with authority

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Depression, Suicide and School Violence Students experiencing depression and related emotional reactions are often alienated at school, are insecure, and lack the resources to adequately cope with the many daily challenges they face, both at home and at school (Lewinsohn, Rohde, & Seeley, 1993)

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The Web of Behaviour student socially developmentally academically Consistency between home and school Yet to develop Strengths Emerging Peers Siblings Families and friends Self regulating skills Responsibilities Work habits performance Attitudes toward school Expectations for Behaviour

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Treating Youth Depression Psychotherapy - explore events and feelings that are painful or troubling; learn coping skills Cognitive-behavioural therapy - challenges negative thinking and behaving patterns Interpersonal therapy - focuses on developing healthier relationships at home and school Medication - relieves some symptoms of depression and is often prescribed with therapy

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Depression vs. Discouragement When assessment reveals no clinical depression, yet outward symptoms suggest depression is present: Check the environment: at home, at school, with/out peers Check for an underlying incident (historic, present, or upcoming) Check for suicidal ideation

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The Concept of the Circle (the balanced self) GENEROSITY BELONGING MASTERY INDEPEN-DENCE

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Mending the Broken Circle “Discouraged children show their conflict and despair in obvious ways, or they disguise their real feelings with acts of pseudo-courage. The effective teacher or therapist or youth worker learns to read beneath these behaviours.” Brendtro, Brokenleg, Van Bockern, 1990

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Mending the Broken Circle Is this revenge by a child who feels rejection? Is this frustration in response to failure? Is this rebellion to counter powerlessness? Is this exploitation in pursuit of selfish goals? Is this withdrawal in response to abuse, a threat or depression?

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Mending the Broken Circle “One cannot mend the circle of courage without understanding where it is broken.” Brendtro, Brokenleg, Van Bockern, 1990

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Mending the Broken Circle NORMAL attached loving friendly intimate gregarious cooperative trusting DISTORTED gang loyalty craves affection craves acceptance promiscuous clinging cult vulnerable overly dependent ABSENT unattached guarded rejected lonely aloof isolated distrustful NEEDS corrective relationships of trust and intimacy

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Mending the Broken Circle NORMAL achiever successful creative problem-solver motivated persistent competent DISTORTED overachiever arrogant risk seeker cheater workaholic perseverative delinquent skills ABSENT nonachiever failure oriented avoids risks fears challenges unmotivated gives up easily inadequate NEEDS involvement in an environment with abundant opportunities for meaningful achievement mastery

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Mending the Broken Circle NORMAL autonomous confident assertive responsible inner control self-discipline leadership DISTORTED dictatorial reckless/macho bullies others sexual prowess manipulative rebellious defies authority ABSENT submissive lacks confidence inferiority irresponsible helplessness undisciplined easily led NEEDS opportunities to develop the skills and the confidence to assert positive leadership and self-discipline

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Mending the Broken Circle generosity generosity NORMAL altruistic caring sharing loyal empathic pro-social supportive DISTORTED noblesse oblige overinvolved plays martyr co-dependency servitude bondage ABSENT selfish affectionless narcissistic disloyal hardened anti-social exploitative NEEDS experience the joys that accrue from helping others

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Early Family Influences

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CRISIS ONSET POINT HIGH EFFECTIVE INEFFECTIVE TIME days, months, years seconds, minutes days, months MORE EFFECTIVE FUNCTIONING years, lifetime LOW STRESS MOUNTING STRESS LEVEL OF FUNCTIONING Pre-crisis behaviour Adequate coping Line of Stability Continued fragmentation deterioration maladaptive behaviour Need for psychotherapy LOW Point of intervention Use of resources Pre-crisis behaviour Continuing growth The Crisis Cube Greenstone & Leviton, 1993

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Understanding Behaviour Behaviour may be an expression of an underlying condition Behaviour often has a purpose Behaviour is the response of an individual to the environment, either external or internal Many behaviours are learned and, therefore, can be changed Behaviour difficulties can be viewed as a learning opportunity for us (about the child) and for the student (about their community and themselves) Problem behaviour may be maintained by the environment Behaviour may be a way of communicating Survival strategies learned early in life may not be functional in later life

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Assisting Students in the Development of Resiliency Skills Developing supporting relationships with students Maintaining positive and high, but appropriate expectations for all students Providing opportunities for children to participate and contribute Providing growth opportunities for students

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Assisting Students in the Development of Resiliency Skills (cont’d) Ensuring all students have a caring adult in their lives(mentoring) Teaching students they are capable and have strengths Providing opportunities for self-assessment and self-reflection Providing opportunities to work with other students (cooperative learning)

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Assisting Students - Re-entry Postvention Debriefing - involves a teacher, administrator, counsellor, or clinician reviewing a major incident with a child. Review the incident, discuss emotions, and supports in place to smooth re-entry. Planning for re-entry - involves a teacher, administration, teacher, and students upon the the student’s return to school. Building bridges - involves ‘building bridges’ for success between teacher and student after a major incident -- often a contingency plan for minor setbacks and a plan for immediate intervention

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