Youth Depression Lorna Martin [email protected].

Youth Depression

Lorna Martin

[email protected]

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 www.counsellor.com.au/depression.html

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 www.counsellor.com.au/depression.html

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

student

sociallydevelopmentally

academically Consistency between home and school

Yet to develop

StrengthsEmerging Peers Siblings

Families and

friends

Self regulating skills

Responsibilities

Work habits

performance

Attitudes toward school

Expectations 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)

GENEROSITY

BELONGING

MASTERY

INDEPEN-DENCE

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


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?


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

Brendtro, Brokenleg, Van Bockern, 1990


belonging belonging

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

NEEDS•corrective

relationships of trust and intimacy


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

NEEDS•involvement in

an environment with abundant opportunities for meaningful achievement

mastery


independence independence

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

NEEDS•opportunities

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


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

NEEDS•experience the

joys that accrue from helping others

ATTACHMENTHISTORY

PSYCHOLOGICALRESPONSE

ATTACHMENTBEHAVIOUR

ASSOCIATEDBEHAVIOUR

Insecure attachment Separation anxiety ProtestDespairDetachment

FailureAlternativeattachments

Persistent anxietyDepression

Object hungerAnxiousattachmentEmotionaldetachment

AntisocialbehaviourBehaviour disorderSchool phobiaIllness behaviour

Impaired capacityto form attachments

LonelinessLow self-esteemDepression

RelationshipdifficultiesMaritaldysfunction

Personality disorderAlcohol & drugabuse

Threatenedattachments

Abandonment anxietySuicidal ideation

Suicidal threatsSuicide attempts

Alcoholic bingePromiscuityPhobic stages

Recurrentattachment failure

Chronic anxietySevere depressionPersistent suicidalideation

Repeatedsuicide attempts

Major affectivedisorderChronic alcoholism

Social isolation HopelessnessDepair

Suicide

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

Early Family Influences

CRISIS ONSET POINT

HIGH

EFFECTIVE

INEFFECTIVE

TIME

days, months, years seconds, minutes days, months

MORE EFFECTIVE FUNCTIONING

year

s, lif

etim

e

LOW

STR

ESS

MOUNTIN

G STRESS

LE

VE

L O

F FU

NC

TIO

NIN

G

Pre-crisis behaviour

Adequate coping

Line of Stability

Continued fragmentation

deterioration

maladaptive behaviourNeed for psychotherapy

LOW

Point of intervention

Use of re

sources

Pre-crisis behaviour

Contin

uing

gro

wth

The Crisis Cube

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

Youth Depression Lorna Martin [email protected].

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