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ADOLESCENT DEPRESSION

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Types of Depression Facts About Depression Major depression has been estimated at 1% to 3% in young children and between 3% and 9% in adolescents. – PowerPoint PPT presentation

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Title: ADOLESCENT DEPRESSION


1
ADOLESCENT DEPRESSION
2
Types of Depression
1.Dysthymia is chronic ongoing mild
depression and occurs when a child feels a little
down most of the time for a
year or more. 2. Major depression
is an illness in which a person has a severely
depressed mood and no longer
enjoys his life. 3. Depression associated with
bi-polar disorder (also called manic-depressive
disorder) have moods with extreme ups
and downs.
Government of South Australia website. Teenage
Depression. http//www.cyh.com/HealthTopics/Healt
hTopicDetails.aspx?p114np141id1751
3
Facts About Depression
  • Major depression has been estimated at 1 to 3
    in young children and between 3 and 9 in
    adolescents. These estimates are higher when
    young people with minor depression are included.

http//www.bchealthguide.org/kbase/topic/major/ty4
640/course.htm
4
Symptoms of Dysthymia
  • A person with dysthymia may
  • gradually lose interest in things they have
    enjoyed doing and appear to be more down most
    of the time
  • have less energy and find it difficult to
    concentrate
  • have trouble with eating and sleeping patterns
  • the most common factor is feeling bad about
    themselves and having less confidence and
    enjoyment in their lives
  • Dysthymia is more serious than just a depressed
    mood alone and may need professional assessment

Government of South Australia Teenage
Depression http//www.cyh.com/HealthTopics/Health
TopicDetails.aspx?p114np141id1751
5
Symptoms of Major DepressionAdolescents with
depression may display some of the following signs
  • being angry or irritable a lot of the time
  • temper tantrums and shortness of temper
  • negative attitude a lot of the time
  • overreaction to criticism, irritability
  • excessive worry about physical health
  • unexplained aches and pains, such as headaches or
    stomach pain
  • difficulty thinking and making decisions
  • problems with sleeping or sleeping too much
  • changes in eating habits that lead to weight gain
    or loss or not making expected weight gains
  • low self-esteem
  • feelings of guilt and hopelessness
  • constant tiredness or lack of energy
  • feeling that nothing is worth the effort
  • social withdrawal, such as lack of interest in
    friends and not wanting to go out
  • loss of interest or enjoyment in his usual
    activities quitting favorite activities
  • poor concentration with school work or other
    things
  • missed school, poor school performance and/or a
    sudden decline in grades
  • being sad or tearful
  • anxious worrying and intrusive upsetting thoughts
  • feeling guilty and to blame for things going
    wrong
  • increasing drug and alcohol use
  • not taking care of how he looks or of hygiene
  • pains
  • carelessness about physical safety
  • behaviour problems and delinquency
  • having thoughts about being better off dead or
    that life is not worth living
  • preoccupation with death and suicide.

Compiled from 1) Help Guide.org Teen
Depression 2)
Government of South Australia Teenage
Depression 3)
Psychology Information Online Depression in
Teenagers
6
Causes of Depression in Teens
  • Stress
  • Loss
  • Major disappointment
  • Chemical imbalance
  • Genetic disposition
  • Some medications (i.e. narcotics, steroids) may
    trigger depression
  • Traumatic events (violence, abuse, neglect)
  • Social problems
  • Unresolved family conflict

http//www.bchealthguide.org/kbase/topic/major/ty
4640/course.htm
7
Diagnosis
  • If a child or teen has mild or moderate
    depression, he or she may be diagnosed and
    treated by your family doctor, general
    practitioner, or pediatrician and a therapist or
    psychologist. A doctor who specializes in the
    diagnosis and treatment of mental health problems
    (psychiatrist) may be helpful for severe
    depression or other mental health problems that
    occur with depression.
  • Sometimes a stay in the hospital may be needed if
    the child or teen has suicidal thoughts and is
    likely to act on them or has other health
    conditions, such as a long-term disease, an
    eating disorder, or another mood disorder.

Government of British Columbia- B.C. Health
Guide Depression in Childhood and
Adolescence http//www.bchealthguide.org/kbase/top
ic/major/ty4640/course.htm
8
  • Automatically, when the disorder depression is
    mentioned normally one directly associates it
    with sorrow. But it is significant to note that
    even if in adults, sorrow characterizes much of
    the depressed experience, in teenagers or those
    younger, depression does not necessarily emerge
    as sorrow. Feelings of anger may actually be
    manifested in hostile or defiant behavior in
    teenagers, as a way of expressing their
    depression. A bad temper may also serve as a sign
    of depression.
  • If your child becomes depressed, he/ she is
    unlikely to talk about it. Your first warning
    signs will probably be changes in behaviour that
    may suggest a troubled and unhappy state of mind.

Parenting Advice for Troubled Teens
Misdiagnosis of Depression http//www.troubledtee
nsinfo.com/Mental_Health_Problems/Teen_Depression/
Misdiagnosis_of_Depression_in_Troubled_Teens/
9
Consider..
  • It was once thought that only adults developed
    depression and that children and teens could not.
  • Symptoms of depression in children and teens can
    be difficult to recognize.
  • Mood swings and other emotional changes caused by
    depression may be overlooked as unimportant or as
    a normal part of growing up.
  • At one time it was a common belief that
    depression is "all in the mind" and that a
    depressed person should be able to snap out of
    it. We now know that depression is an illness
    that requires treatmentnot a character flaw or
    weakness.
  • Prolonged or severe depression can lead to
    problems making and keeping friends, difficulty
    in school, substance abuse, suicidal behaviour,
    and other problems that may carry into adulthood.

Government of British Columbia- B.C. Health
Guide Depression in Childhood and
Adolescence http//www.bchealthguide.org/kbase/top
ic/major/ty4640/course.htm
10
Myths About Depression
  • Myths about depression often prevent people
    from doing the right thing. Some common myths
    are
  • Myth It's normal for teenagers to be moody
    teens dont suffer from real depression. FACT
    Depression is more than just being moody, and it
    can affect people at any age, including
    teenagers.
  • Myth Telling an adult that a friend might be
    depressed is betraying a trust. If someone wants
    help, he or she will get it. FACT Depression,
    which saps energy and self-esteem, interferes
    with a person's ability or wish to get help. It
    is an act of true friendship to share your
    concerns with an adult who can help.
  • Myth Talking about depression only makes it
    worse. FACT Talking through feelings with a good
    friend is often a helpful first step. Friendship,
    concern, and support can provide the
    encouragement to talk to a parent or other
    trusted adult about getting evaluated for
    depression.

Psychology Information Online Depression in
Teenagers http//www.psychologyinfo.com/depressio
n/teens.htmMyths
11
Remember.
  • Having depression doesn't mean that a person is
    weak, or a failure, or isn't really trying...it
    means they need treatment.1
  • By getting to the root of a teens depression the
    likelihood of it resulting in suicide is greatly
    reduced, if not eliminated.2
  • Do not wait and hope that symptoms will go away
    on their own.3
  • Parents need to recognize when their adolescent
    is distressed. They must be careful not to
    disregard real emotional difficulties and
    mistakenly assume that these are due to physical
    changes associated with adolescence.4

Columbine Video
12
How is Teenage Depression Treated?
  • Depression is commonly treated with therapy or
    with therapy and medication. A combination of
    approaches is usually most effective
  • Cognitive-behavioral therapy focuses on the
    causes of the depression and helps change
    negative thought patterns.
  • Group therapy is often very helpful for teens,
    because it breaks down the feelings of isolation
    that many adolescents experience (sometimes it
    helps just to know that "I'm not the only one who
    feels this way").
  • Family therapy as an adjunct to individual
    therapy can address patterns of communication and
    ways the family can restructure itself to support
    each member, and can help the teenager feel like
    others share the responsibility for what happens
    in the family.
  • Physical exercise is helpful in lifting
    depression, as it causes the brain's chemistry to
    create more endorphins and serotonin, which
    change mood.
  • Creative expression through drama, art or music
    is often a positive outlet for the strong
    emotions of adolescents.
  • Volunteer work is sometimes helpful for
    adolescents. Helping someone else whose problems
    are greater than one's own offers a perspective
    and also an opportunity to be helpful, which can
    increase one's sense of purpose and meaning.
  • Medication for depression should be used with
    great caution, and only under careful
    supervision. Recent studies by both the UK
    government and the FDA have led to warnings that
    not all psychiatric drugs may be appropriate for
    teenagers and children. Seek a physician who
    works specifically with teenagers.
  • Hospitalization may be necessary in situations
    where a teen needs constant observation and care
    to prevent self-destructive behavior. Hospital
    adolescent treatment programs usually include
    individual, group and family counseling as well
    as medications.

Helpguide.org Teen Depression http//www.helpgu
ide.org/mental/depression_teen.htmsymptoms
13
  • Special schools, wilderness challenges, or "boot
    camps" are sometimes recommended for troubled
    teens. These alternatives are intended to help
    adolescents learn coping skills, develop
    confidence, learn to trust and work with others,
    improve academics and/or deal with negative
    behaviors. Whether or not they are good options
    largely depends on the staff running the program.
    In many cases, they are not trained mental health
    professionals and may use confrontation,
    humiliation and punitive measures designed to
    break down resistance rather than build up
    internal strengths. Sometimes these programs do
    more harm than good, and can even result in worse
    outcomes for adolescents. Before considering such
    alternatives, do careful research on their
    philosophy, methods, and the background of their
    employees.

Helpguide.org Teen Depression http//www.helpgu
ide.org/mental/depression_teen.htmsymptoms
14
What parents can do for their teen
  • Respond with love, kindness, and support.
  • Repeatedly let your child know that you are
    there, whenever she or he needs you
  • Be gentle but persistent if your adolescent shuts
    you out (depressed teenagers do not want to feel
    patronized or crowded). Do not ask a lot of
    questions, but make known your concern and your
    willingness to listen.
  • Do not criticize or pass judgment once the
    adolescent begins to talk (the important thing is
    that he or she is talking and communicating
    feelings).
  • Encourage activity and praise efforts to
    socialize and be active.
  • Seek help from a doctor or mental health
    professional if the adolescent's depressed
    feeling doesn't pass with time. Be prepared to
    list behaviors, note how long and how often they
    have been occurring, and how severe they seem.
  • Do not wait and hope that symptoms will go away
    on their own. When depression is severeif
    adolescents are thinking about hurting themselves
    or about suicideseek professional help as soon
    as possible.

Helpguide.org Teen Depression http//www.helpgui
de.org/mental/depression_teen.htmsymptoms
15
  • Never treat depression as if it is simply teenage
    'blues' - always take
  • it seriously.
  • Encourage your child to seek help by providing a
    list of contacts for her to choose from.
  • If your teenager won't go for help and you are
    really worried, go by yourself first and get some
    advice about how to best handle the situation.
  • Show love and concern - this doesn't mean that
    you have to agree with everything your child does
    or wants to do, but young people need to know
    that you still love them no matter who they are
    or what they do.
  • Take time to listen when your teenager wants to
    talk about her feelings.
  • Show her that you are available without being
    'pushy'.
  • Encourage her to do things you know she enjoys.
  • Notice the little things she does that you
    approve of.
  • Make sure that you do not keep a gun in your home
    or shed. (Farmers need to be very careful about
    where they store guns because this is the method
    often used in youth suicides in country areas.)
  • Take seriously any talk about suicide and actions
    such as giving away special things. Do whatever
    is needed to protect your child's safety - even
    if it is against her wishes.

Government of South Australia Teenage
Depression http//www.cyh.com/HealthTopics/Health
TopicDetails.aspx?p114np141id1751
16
More helpful actions.
  • The first thing to do is to help your teenager
    set realistic short-term goals. Ask him for
    suggestions on how he would like to improve his
    life. Then help him identify some simple steps he
    can take to achieve these goals. Remember not to
    set goals, which are unattainable, as this will
    just reinforce his belief that he is a failure.
    On the other hand, do not aim for things that are
    easily attainable. The whole idea is that your
    teenager must feel that he has been equal to the
    challenge. 
  • Make sure that you encourage him at every step
    and help him in every way possible without
    actually doing his work for him. For instance, if
    he wants to audition for a play, help him
    rehearse and boost his confidence without giving
    him false hope.
  • If he fails to reach his set goals, do not try to
    sweep it under the carpet and smooth it over with
    inanities like "you'll do better next time."
    Acknowledge his failure and discuss why it
    happened. Maybe he gave up too easily or didn't
    study hard enough or had a panic attack. It's
    important to get this out in the open so that you
    know what your teenager attributes his failure to
    and correct any misconceptions that he may have.

India Parenting Pvt. Ltd. Helping you Teenager
Overcome Depression http//www.indiaparenting.com
/raisingchild/data/raisingchild058.shtml
17
  • Do not compare your teenager to his peers and
    find him wanting. Don't say things like "why
    can't you be like that?" You will just be
    reinforcing his belief that he's not good enough
    the way he is, even for you. You have to teach
    him that he can admire others without necessarily
    envying them. If he comments in an envious tone
    about another teenager's attributes, admit that
    the other child is good, but point out something
    that your teenager is good at.
  • Depressed teenagers tend to vacillate over every
    decision. This is because they don't trust their
    own judgement and need to be constantly reassured
    that they are doing the 'right thing.' You have
    to help your teenager make decisions in a way
    that he will learn to trust his own judgement. It
    is also important that you insist that once he
    has made a choice, he must go through with it and
    cope with the consequences, whatever they are.
  • Short-term measures like buying your teenager
    tickets to a concert or taking him for a holiday
    are not going to alleviate his depression. You
    are going to have to sit down and talk to him
    about what exactly it is that bothers him and how
    he can overcome it. You have to take steps to
    make him feel empowered so that he feels that he
    can effectively accomplish the things he sets out
    to do.

India Parenting Pvt. Ltd. Helping you Teenager
Overcome Depression http//www.indiaparenting.com
/raisingchild/data/raisingchild058.shtml
18
  • Encourage your child to
  • Get regular exercise, such as swimming, walking,
  • or playing vigorously every day.
  • Avoid alcohol and illegal drugs, non-prescription
    medications, herbal therapies, and medications
    that have not been prescribed (because they may
    interfere with the medications used to treat
    depression).
  • Get enough sleep. If your child has problems
    sleeping, he or she might try
  • Going to bed at the same time every night.
  • Keeping the bedroom dark and quiet.
  • Not exercising after 500 p.m.
  • Eat a balanced diet. If your child lacks an
    appetite, try to get him or her to eat small
    snacks rather than large meals.
  • Be hopeful about feeling better. Positive
    thinking is very important in recovering from
    depression. It is difficult to be hopeful when
    you feel depressed, but remind your child that
    improvement occurs gradually and takes time.

Government of British Columbia- B.C. Health
Guide Depression in Childhood and
Adolescence http//www.bchealthguide.org/kbase/top
ic/major/ty4640/course.htm
19
Parenting a teenager who is under severe stress
or suffering depression can be very stressful.
At times it may seem as if your child is
deliberately not trying or misbehaving. When you
find yourself feeling angry or frustrated (and
you will!)
Government of South Australia Teenage
Depression http//www.cyh.com/HealthTopics/Health
TopicDetails.aspx?p114np141id1751
20
  • Take a step back and think about what is
    happening before you react.
  • Remember to hang in there, your child needs your
    love even if she seems to reject it.
  • Think about your own views
  • Are you wondering "Why should I have to put up
    with this terrible behaviour?" This thinking will
    make the situation worse.
  • Are you thinking "Something must be wrong for my
    child to be behaving like this"? This thinking
    will lead to a search for the cause.
  • Ask people close to you for support.
  • Ask someone the young person is close to (eg
    another relative) to help provide support - but
    make sure your child knows that you're not
    rejecting her.
  • Make sure you do things for yourself - you need
    to take care of your own needs if you're to help
    your child.
  • Get professional help for yourself if you feel
    you are struggling.

Government of South Australia Teenage
Depression http//www.cyh.com/HealthTopics/Health
TopicDetails.aspx?p114np141id1751
21
  • Recognize your own feelings about your child's
    depression. you might find that you are feeling
    guilty or frustrated. Without wanting to, you may
    let your child know this and make him / her feel
    rejected and misunderstood.
  • You should also be honest with brothers and
    sisters, and other family members about your
    depressed child's needs. That way, he / she will
    have several sources of support and
    understanding.

Canadian Mental Health Association Children and
Depression http//www.cmha.ca/bins/content_page.a
sp?cid3-86-87-90lang1
22
Suicide
  • Most people who are depressed do not commit
    suicide. But depression increases the risk for
    suicide or suicide attempts.

Psychology Information Online Depression in
Teenagers http//www.psychologyinfo.com/depressio
n/teens.htmMyths
23
Myths about Suicide
  • People who talk about suicide won't do it. Almost
    everyone who commits suicide gives some clue or
    warning.
  • Anyone who tries to commit suicide must be
    crazy. It isn't as simple as this. Suicidal
    thinking isn't necessarily a sign of mental
    illness. In young people depression is almost
    always behind suicidal thinking. Often no one has
    realized that the young person was depressed.
  • If people really want to kill themselves nothing
    will stop them. What they usually want is for the
    pain to stop. The feeling of wanting to end it
    all doesn't last forever. In fact, sometimes it
    doesn't last for long at all, particularly if
    things in the person's life change.
  • People who complete suicide don't seek help
    before their death. More than half of the people
    who commit suicide have been to their doctor for
    help in the six months before their death, though
    they may not tell their doctor they are thinking
    of suicide.
  • Talking/asking about suicide may give someone the
    idea. The opposite is true. Discussing suicide
    openly helps people talk about their feelings and
    to look for other ways to stop the pain.

Government of South Australia website. Teenage
Depression. http//www.cyh.com/HealthTopics/Healt
hTopicDetails.aspx?p114np141id1751
24
Facts about Suicide
  • Teens with depression are at particularly high
    risk for suicide and suicide attempts.
  • In Canada, approximately 400 teens commit
    suicide each year.
  • While teen girls attempt suicide almost twice as
    often as teen boys, boys are more likely to
    succeed because girls usually use less lethal
    means and survive the attempt.
  • Suicide attempts in children younger than age 12
    are uncommon.

Government of South Australia Teenage
Depression http//www.cyh.com/HealthTopics/Health
TopicDetails.aspx?p114np141id1751
25
  • Suicide is the leading cause of death among youth
    in British Columbia and the 2nd leading cause of
    death among youth overall (ages 15-24) in Canada
  • Teen/youth suicide rates have tripled since 1970.
  • Approximately one-third of teens who die by
    suicide have made a previous suicide attempt.

The Kelty Patrick Dennehy Foundation http//www.th
ekeltyfoundation.org/index.html
26
  • Nine out of ten suicides take place in the home.
  • For every completed suicide there are an
    estimated 30 to 50 attempts.
  • 70 of suicides occur between the hours of 3
    p.m. to midnight (when they could be saved).
  • Males complete suicide 4 times more often than
    females.
  • Females account for 75 of the attempted suicides
    (mainly with drug overdoses).

The Kelty Patrick Dennehy Foundation http//www.th
ekeltyfoundation.org/index.html
27
  • Approximately one-third of teens who die by
    suicide have made a previous suicide attempt.
  • Males use more violent means, e.g. guns,
    hanging.
  • Only 33 to 50 were identified by their doctors
    as having a mental illness at the time of their
    death and only 15 percent of suicide victims were
    in treatment at the time of their death.

The Kelty Patrick Dennehy Foundation http//www.th
ekeltyfoundation.org/index.html
28
  • Spring and fall are the months of highest risk.
  • An estimated 80 of all those who commit suicide
    give some warning of their intentions or mention
    their feelings to a friend or family member.
  • In 1996, more teenagers and young adults died of
    suicide than from cancer, heart disease, AIDS,
    birth defects, stroke, pneumonia and influenza,
    and chronic lung disease combined.

The Kelty Patrick Dennehy Foundation http//www.th
ekeltyfoundation.org/index.html
29
Risk Factors for Suicide
  • Current suicidal thoughts.
  • Other mental health or disruptive disorders, such
    as conduct disorder.
  • Impulsive or aggressive behaviours.
  • Feelings of hopelessness.
  • A history of past suicide attempts.
  • A family history of suicidal behaviour or mood
    disorders.
  • A history of being exposed to family violence or
    abuse.
  • Access to firearms or other potentially lethal
    means.
  • Social isolation/alienation, including because of
    being gay or being bullied

Government of British Columbia- B.C. Health
Guide Depression in Childhood and
Adolescence http//www.bchealthguide.org/kbase/top
ic/major/ty4640/course.htm
30
  • talk or threats of suicide
  • hints such as "I won't be a problem for you much
    longer"
  • previous attempts - especially if the person was
    alone at the time
  • careless, risk taking, behaviour
  • self-destructive behaviour
  • sad or angry mood that does not go away
  • giving away personal possessions
  • suddenly clearing out belongings and getting them
    in order
  • becoming suddenly cheerful without reason after
    being depressed.

Government of South Australia Teenage
Depression http//www.cyh.com/HealthTopics/Health
TopicDetails.aspx?p114np141id1751
31
Precipitating Events for Teen Suicide
  • Suicidal behavior in adolescents is commonly
    precipitated by events or challenges that the
    teenager finds too difficult to tolerate. Even
    things that seem minor to an adult can be major
    to a young person, who does not have the life
    experience to put them into perspective or the
    coping skills that an adult has honed.

Helpguide.org Teen Depression http//www.helpgu
ide.org/mental/depression_teen.htmsymptoms
32
Some common precipitants of suicidal behavior in
teenagers include
  • death of a family member or close friend
    (particularly if by suicide)
  • loss of a romantic relationship or good
    friendship
  • loss of a parent through divorce or separation
  • loss of a pet, treasured object, job or
    opportunity
  • fear of punishment
  • physical, sexual or psychological abuse
  • unwanted pregnancy
  • poor grades
  • fight or argument with family member or loved one
  • belief one has harmed or brought harm to a family
    member or friend
  • embarrassment or humiliation
  • concerns about sexuality
  • suicide of a friend, acquaintance, or celebrity
    ("copycat" suicide)

Helpguide.org Teen Depression http//www.helpgu
ide.org/mental/depression_teen.htmsymptoms
33
If your child exhibits any warning signs
  • Call 911

34
Crisis Intervention and Suicide Prevention Centre
of British Columbia
  • Greater Vancouver 604-872-3311
  • Toll free - Howe Sound Sunshine Coast
    1-866-661-3311
  • TTY 1-866-872-0113
  • BC-wide1-800-SUICIDE (784-2433)
  • Help for Youth Online www.YouthInBC.com

35
REMEMBER
  • Depression is treatable
  • You are not alone, help is available
  • Dont delay. If you suspect your child is
    depressed, seek help.

36
References
  • Advanced Behavioral Consultants Lets Talk
    About Depression retrieved March 5, 2007
  • http//www.healthsurvey.com/teendepression.htm
  • Canadian Mental Health Association Children and
    Depression retrieved February 15, 2007
  • http//www.cmha.ca/bins/content_page.asp?cid3-86-
    87-90lang1
  • BC Helpguide Depression in Childhood and
    Adolescence retrieved February 15, 2007
  • http//www.bchealthguide.org/kbase/topic/major/ty4
    640/cause.htm

37
Health Canada Attachment to Parents and
Adjstment in Adolescence retrieved April 5,
2007 http//www.phac-aspc.gc.ca/dca-dea/publicati
ons/pdf/attachment_e.pdf Help for Troubled
Teens Misdiagnosis of Depression in Troubled
Teens retrieved March 2, 2007
http//www.troubledteensinfo.com/Mental_Health_Pr
oblems/Teen_Depression/Misdiagnosis_of_Depression_
in_Troubled_Teens/ Helpguide.org Teen
Depression retrieved February 15,
2007 http//www.helpguide.org/mental/depression_t
een.htmparents
38
India Parenting Helping your teenager
Overcome Depression retrieved March 3,
2007 http//www.indiaparenting.com/raisingchild/d
ata/raisingchild058.shtm The Kelty Patrick
Dennehy Foundation Teenage Depression and
Suicide-the Facts retrieved April 8,
2007 http//www.thekeltyfoundation.org/depression-
facts.htm Psychology Information Online
Depression in Teenagers retrieved March 2,
2007 http//www.psychologyinfo.com/depression
/teens.htmsuicide South Australia Government
Children, Youth and Womens Health Service
Teenage Depression retrieved March 2,
2007 http//www.cyh.com/HealthTopics/HealthTopicD
etails.aspx?p114np141id1751
39
  • Crisis Suicide Prevention Centre of British
    Columbia website
  • http//www.crisiscentre.bc.ca/
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