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Understanding Adolescent Pain


Title: Understanding Your Adolescent Author: David G. Stec Last modified by: David and Beth Created Date: 3/13/2006 2:20:32 PM Document presentation format – PowerPoint PPT presentation

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Title: Understanding Adolescent Pain

Understanding Adolescent Pain
  • Providing essential pieces for dealing with
    issues of an adolescent with depression

Key understandings
  • All kids are good
  • Kids are trying to do the best they can
  • They want to fit in/be accepted
  • They want to be liked and loved
  • They want to please others
  • They are stressed
  • They are scared about the future
  • They dont feel that anyone understands
  • They want to feel secure and in control
  • They want to feel good

They want to be

  • Anger turned inward

What to look for Warning Signs
  • Unexplainable changes in
  • Friends
  • Grades
  • Behavior
  • Habits
  • Hobbies
  • Activities
  • Body appearance

  • At this point, If youre unsure if an adolescent
    in your life is depressed or just being a
    teenager, consider how long the symptoms have
    been present, how severe they are, and how
    different the teen is acting from his or her
    usual self.
  • dramatic, long-lasting changes in personality,
    mood, or behavior are red flags of a deeper
    problem. 2-3 weeks More often than not.
  • Duration-Severity-Real Change

Key Understanding
  • If a teenager can identify the causes of there
    depression then it normally isnt clinical
  • Name it, Claim it, and Tame it!
  • Depression will not just go away
  • Depression needs intervention
  • Depression is hard to understand

Major Depression
  • Considered a Mood Disorder
  • Can be episodic or recurrent
  • Psychological and physical components
  • Highly treatable
  • Often misunderstood and undiagnosed especially in

Major Depression
  • A combination of symptoms that interfere with
    ability to work, study, sleep, eat and enjoy once
    pleasurable activities and which may occur only
    once or several times

Symptoms Depression
  • Major Depressive Disorder requires two or more
    major depressive episodes.
  • Diagnostic criteria
  • Depressed mood and/or loss of interest or
    pleasure in life activities for at least 2 weeks
    and at least five of the following symptoms that
    cause clinically significant impairment in
    social, work, or other important areas of
    functioning almost every day

At least 5
  • 1.Depressed mood most of the day.
  • 2.Diminished interest or pleasure in all or most
    activities. (Quit)
  • 3.Significant unintentional weight loss or gain.
  • 4.Insomnia or sleeping too much.
  • 5.Agitation or psychomotor retardation noticed by
  • 6.Fatigue or loss of energy.
  • 7.Feelings of worthlessness or excessive guilt.
  • 8.Diminished ability to think or concentrate, or
  • 9.Recurrent thoughts of death (APA, 2000, p.

Teen specific
  • The difference between teenage and adult
  • Irritable or angry mood As noted above,
    irritability, rather than sadness, is often the
    predominant mood in depressed teens. A depressed
    teenager may be grumpy, hostile, easily
    frustrated, or prone to angry outbursts.
  • Unexplained aches and pains - Depressed teens
    frequently complain about physical ailments such
    as headaches or stomachaches. If a thorough
    physical exam does not reveal a medical cause,
    these aches and pains may indicate depression.
  • Extreme sensitivity to criticism - Depressed
    teens are plagued by feelings of worthlessness,
    making them extremely vulnerable to criticism,
    rejection, and failure. This is a particular
    problem for over-achievers.
  • Withdrawing from some, but not all people - While
    adults tend to isolate themselves when depressed,
    teenagers usually keep up at least some
    friendships. However, teens with depression may
    socialize less than before, pull away from their
    parents, or start hanging out with a different

Untreated Depression Can Lead to
  • Problems at school -Depression can cause low
    energy and concentration difficulties. At school,
    this may lead to poor attendance, a drop in
    grades, or frustration with schoolwork in a
    formerly good student.
  • Running away - Many depressed teens run away from
    home or talk about running away. Such attempts
    are usually a cry for help.
  • Substance abuse - Teens may use alcohol or drugs
    in an attempt to self-medicate their
    depression. Unfortunately, substance abuse only
    makes things worse.
  • Low self-esteem - Depression can trigger and
    intensify feelings of ugliness, shame, failure,
    and unworthiness.
  • Eating disorders - Anorexia, bulimia, binge
    eating, and yo-yo dieting are often signs of
    unrecognized depression.

  • Internet addiction - Teens may go online to
    escape from their problems. But excessive
    computer use only increases their isolation and
    makes them more depressed. Cyberbullying and
    harrassment. Falsifying identity on Social
    networks like Twitter and Facebook.
  • Self-injury - Cutting, burning, and other kinds
    of self-mutilation are almost always associated
    with depression. (Piercings and Tattoos)
  • Reckless behavior - Depressed teens may engage in
    dangerous or high-risk behaviors, such as
    reckless driving, out-of-control drinking, and
    unsafe sex.
  • Illegal behaviors Shoplifting and Theft
    (Chemical High)
  • Violence - Some depressed teens (usually boys who
    are the victims of bullying) become violent. As
    in the case of the Columbine school massacre,
    self-hatred and a wish to die can erupt into
    violence and homicidal rage.
  • Suicide - Teens who are seriously depressed often
    think, speak, or make "attention-getting"
    attempts at suicide. Suicidal thoughts or
    behaviors should always be taken very seriously.


Suicide warning signs
  • Talking or joking about committing suicide
  • Saying things like, Id be better off dead, I
    wish I could disappear forever, or Theres no
    way out.
  • Speaking positively about death or romanticizing
    dying (If I died, people might love me more)
  • Writing stories and poems about death, dying, or
  • Engaging in reckless behavior or having a lot of
    accidents resulting in injury
  • Giving away prized possessions
  • Saying goodbye to friends and family as if for
    the last time
  • Seeking out weapons, pills, or other ways to kill
  • These are serious issuesthey are scaryany
    serious illness is!

Suicide is a game changer
  • Ask the tough questions?
  • Do you want to kill yourself?
  • How will you do it?
  • Do you have the means?
  • Help before the sun goes down!
  • Get an assessmentCall 911 or ER!
  • Do not leave alone!

Realize this
  • Depression effects 20 of teens
  • 2x as many girls as boys
  • Experts say only one in five depressed
    teens receive help.
  • 1 in 5Why?
  • Very treatable illness
  • take them to a doctor!

If not depression, then what is it?
Terminology is Essential
  • Depression clinical sadness often linked to
    Serotonin and other unknown reasons -DISTRACT or
  • Persistent Depressive Disorder (Dysthemia)
  • Seasonal Affective Disorder
  • General Anxiety Disorder
  • Worrier
  • Grief or Bereavement
  • Sadness
  • Unhappiness
  • Stressed out
  • Blahs

  • What is stress physiological response to a
    psychological or physical stimuli
  • Ultimately, energy to respond
  • Eustress v. Distress
  • Eustress positive energy to respond
  • Distress negative amount of energy

Analogy of the Bucket
  • Puppies must be walkedOR ELSE!
  • The Bucket must be
  • either
  • Emptied or Made Larger

Unhappiness Why?
  • Too High or Too Low of expectations from self or
    others never good enough or always successful
    but no fulfillment
  • Missing or Broken tile syndrome Christmas tree
    lights- one outall out!
  • Comparison to others the Uberperson

Is this what you want?
  • master-photoshopper merging Catherine Zeta-Jones,
    Charlize Theron, Angelina Jolie and Keira

The negative symptoms dart board
  • Adolescence tend to go from one symptom to
    another searching for help and relief
  • Drinking and Drugs
  • Cutting
  • Sex/ bad relationships
  • Stealing
  • Lying
  • Escape Internet and Video gaming
  • Change of behaviors anger and acting out

When to act?
  • When symptoms persist or get worse
  • persistent sad, anxious, or empty mood
  • feelings of hopelessness, pessimism
  • feelings of guilt, worthlessness, helplessness,
  • loss of interest or pleasure in hobbies or
    activities once enjoyed
  • decreased energy, fatigue, being slowed down
  • difficulty concentrating, remembering, making
  • insomnia, early morning awakening or oversleeping
  • appetite and/or weight loss or overeating and
    weight gain
  • thoughts of death or suicide, attempts of suicide
  • restlessness and irritability
  • persistent physical symptoms which do not respond
    to treatment
  • headaches, digestive disorders, chronic pain...

Helping a depressed teenager
  • Talk to your teen
  • Ask the school for guidance
  • Visit your family doctor
  • Call your insurance company
  • Seek out a specialist
  • Explore the treatment options
  • Talk Therapy, Medication, Family support
    services, Educational Classes, Behavior
    Management techniques, as well as Family therapy

  • Offer Support
  • Be gentle but persistent
  • Listen without lecturing
  • Validate feelings

The positive dartboard
  • Given the opportunity and training, teens will
    opt for healthy responses too
  • Exercise and sports
  • Appropriate emotional expression
  • Positive social interactions
  • Prayer
  • Playing
  • Relaxation
  • Talking

What to do
  • The most important thing we can do is have a
    consistent relationship with our children.
  • providing them limits,
  • providing guidance and support in
  • providing them discipline
  • being aware of what's happening in their lives
  • AND
  • Seeking advice and help when needed

  • the peer group is important to young
    adolescents, and theres nothing wrong with that.
    Parents are often just as important, however.
    Dont give up on the idea that you make a

Final Thoughts
  • Step back Put the puzzle together
  • Learn to be aware
  • Once you start seeing these symptoms
  • Talk about it (Saying it doesnt make it)
  • Seek Help (MUCH EASIER EARLY, than LATER)
  • If you suspect that a teenager in your life is
    suffering from depression, speak up right away
    and do something.

(No Transcript)
  • Cuyahoga County Board of Mental Health
  • Helpguide .org
  • National Institute of Mental Health
  • http//www.nimh.nih.gov
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