Youth Depression

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					Youth Depression

     Lorna Martin
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
 Sleep disturbances (nightmares, insomnia,
 Changes in social life (depressed teenagers stop
  spending time with their friends. They often refuse phone
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
                              adapted from
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)
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
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
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-
 Indecision, lack of concentration or forgetfulness
 Restlessness and agitation
 Problems with authority
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)
The Web of Behaviour
   Emerging                  Strengths         Peers         Siblings

         developmentally                                           Families
                                                socially              and
         Yet to
                               student                           Self
         academically                     Consistency between
                          Attitudes       home and school
habits                    toward school
            performance                   Expectations     Responsibilities
                                          for Behaviour
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
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
The Concept of the Circle
(the balanced self)

INDEPEN-                        BELONGING

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

 “One cannot mend the circle of
  courage without understanding
  where it is broken.”

              Brendtro, Brokenleg, Van Bockern, 1990
Mending the Broken Circle
     belonging             belonging               •corrective
                                                   relationships of
                                                   trust and
NORMAL DISTORTED                    ABSENT         intimacy

•attached      •gang loyalty        •unattached
•loving        •craves affection    •guarded
•friendly      •craves acceptance   •rejected
•intimate      •promiscuous         •lonely
•gregarious    •clinging            •aloof
•cooperative   •cult vulnerable     •isolated
•trusting      •overly dependent    •distrustful
Mending the Broken Circle
    mastery              mastery                           •involvement in
                                                           an environment
                                                           with abundant
                                                           opportunities for
•achiever         •overachiever        •nonachiever        achievement
•successful       •arrogant            •failure oriented
•creative         •risk seeker         •avoids risks
•problem-solver   •cheater             •fears challenges
•motivated        •workaholic          •unmotivated
•persistent       •perseverative       •gives up easily
•competent        •delinquent skills   •inadequate
Mending the Broken Circle
   independence             independence                   •opportunities to
                                                           develop the skills
                                                           and the
                                                           confidence to
                                                           assert positive
•autonomous        •dictatorial        •submissive         leadership and
•confident         •reckless/macho     •lacks confidence
•assertive         •bullies others     •inferiority
•responsible       •sexual prowess     •irresponsible
•inner control     •manipulative       •helplessness
•self-discipline   •rebellious         •undisciplined
•leadership        •defies authority   •easily led
Mending the Broken Circle
         generosity              generosity             •experience the
                                                        joys that accrue
                                                        from helping
NORMAL DISTORTED                     ABSENT
•altruistic      •noblesse oblige      •selfish
•caring          •overinvolved         •affectionless
•sharing         •plays martyr         •narcissistic
•loyal           •co-dependency        •disloyal
•empathic        •servitude            •hardened
•pro-social      •bondage              •anti-social
•supportive                            •exploitative
Early Family Influences
  ATTACHMENT                   PSYCHOLOGICAL                 ATTACHMENT           ASSOCIATED
    HISTORY                        RESPONSE                    BEHAVIOUR          BEHAVIOUR
 Insecure attachment           Separation anxiety            Protest
 Failure                       Persistent anxiety            Object hunger      Antisocial
 Alternative                   Depression                    Anxious            behaviour
 attachments                                                 attachment         Behaviour disorder
                                                             Emotional          School phobia
                                                             detachment         Illness behaviour
 Impaired capacity             Loneliness                    Relationship       Personality disorder
 to form attachments           Low self-esteem               difficulties       Alcohol & drug
                               Depression                    Marital            abuse
 Threatened                    Abandonment anxiety           Suicidal threats   Alcoholic binge
 attachments                   Suicidal ideation             Suicide attempts   Promiscuity
                                                                                Phobic stages
 Recurrent                     Chronic anxiety               Repeated           Major affective
 attachment failure            Severe depression             suicide attempts   disorder
                               Persistent suicidal                              Chronic alcoholism
 Social isolation              Hopelessness                  Suicide
 Adam, K.S., Early family influences on suicidal behaviour
The Crisis Cube

                                                       MORE EFFECTIVE FUNCTIONING

              Pre-crisis behaviour
              Adequate coping                   ONSET                    Pre-crisis behaviour
              Line of Stability
                                                                    Point of

                                                                Continued fragmentation
                                     Need for
                                     psychotherapy              maladaptive behaviour

INEFFECTIVE                                           LOW
                 days, months, years                 seconds, minutes           days, months

                                           TIME                                                 Greenstone & Leviton, 1993
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
   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
Assisting Students in the Development
          of Resiliency Skills

 Developing supporting relationships with
 Maintaining positive and high, but
  appropriate expectations for all students
 Providing opportunities for children to
  participate and contribute
 Providing growth opportunities for students
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)
             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