Youth Depression - PowerPoint by january

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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 little)  Sleep disturbances (nightmares, insomnia, hypersomnia)

 Changes in social life (depressed teenagers stop spending time with their friends. They often refuse phone calls)

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

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-

criticism  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 Families and friends

Yet to develop



Self regulating skills

Work habits

Attitudes toward school

Consistency between home and school
Expectations for Behaviour Responsibilities

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)




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

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?

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



•attached •loving •friendly •intimate

•guarded •rejected •lonely

•corrective relationships of trust and intimacy

•gang loyalty
•craves affection •craves acceptance •promiscuous

•cooperative •trusting

•cult vulnerable •overly dependent

•isolated •distrustful

Mending the Broken Circle
•successful •creative •problem-solver

•arrogant •risk seeker •cheater

•failure oriented •avoids risks •fears challenges

•involvement in an environment with abundant opportunities for meaningful achievement

•persistent •competent

•perseverative •delinquent skills

•gives up easily •inadequate

Mending the Broken Circle



•confident •assertive •responsible

•reckless/macho •bullies others •sexual prowess

•lacks confidence •inferiority •irresponsible

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

•inner control
•self-discipline •leadership

•rebellious •defies authority

•undisciplined •easily led

Mending the Broken Circle


•selfish •affectionless •narcissistic •disloyal

•altruistic •caring •sharing •loyal •noblesse oblige •overinvolved •plays martyr •co-dependency

•experience the joys that accrue from helping others

•pro-social •supportive


•anti-social •exploitative

Early Family Influences
ATTACHMENT HISTORY Insecure attachment PSYCHOLOGICAL RESPONSE Separation anxiety Failure Alternative attachments Persistent anxiety Depression ATTACHMENT BEHAVIOUR Protest Despair Detachment Object hunger Anxious attachment Emotional detachment Relationship difficulties Marital dysfunction Suicidal threats Suicide attempts Repeated suicide attempts ASSOCIATED BEHAVIOUR Antisocial behaviour Behaviour disorder School phobia Illness behaviour Personality disorder Alcohol & drug abuse Alcoholic binge Promiscuity Phobic stages Major affective disorder Chronic alcoholism

Impaired capacity to form attachments

Loneliness Low self-esteem Depression Abandonment anxiety Suicidal ideation Chronic anxiety Severe depression Persistent suicidal ideation Hopelessness Depair

Threatened attachments Recurrent attachment failure

Social isolation


Adam, K.S., Early family influences on suicidal behaviour

The Crisis Cube
MORE EFFECTIVE FUNCTIONING Pre-crisis behaviour Adequate coping Line of Stability CRISIS ONSET POINT

Pre-crisis behaviour

Point of intervention

Continued fragmentation Need for psychotherapy deterioration maladaptive behaviour

days, months, years

seconds, minutes days, months


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 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

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

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

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