Youth Depression

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Youth Depression
Lorna Martin lormartin_at_gov.mb.ca
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General Symptoms of Youth Depression

• A feeling of sadness and hopelessness (belief
  that theres 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 dont 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.htm
  l

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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.ht
  ml

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

• NEEDS
• corrective relationships of trust and intimacy

• 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

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Mending the Broken Circle

• NEEDS
• involvement in an environment with abundant
  opportunities for meaningful achievement

mastery

• 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

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Mending the Broken Circle

• NEEDS
• opportunities to develop the skills and the
  confidence to assert positive leadership and
  self-discipline

• 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

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Mending the Broken Circle

• NEEDS
• experience the joys that accrue from helping
  others

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

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

• 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 students 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