Depression

Julia and Laura

Definition:

Presence of sad, empty, or irritable mood, accompanied by

somatic and cognitive changes that significantly affect the
individual’s capacity to function
[there is a cluster of “depressive disorders” but all are characterized by these
symptoms]

(American Psychiatric Association, 2013)

Epidemiology

● 3.2% of children aged 3-17 years (approximately 1.9 million)

have diagnosed depression...statistics vary for specific
depressive disorders
● 3 in 4 children aged 3-17 years with depression also have
anxiety (73.8%) and almost 1 in 2 have behavior problems
(47.2%).
● Prevalence increases with age; for example, 2-3% of children
aged 6-12 present symptoms of serious depression and 6-8%
of teens aged 12-17 present symptoms (Center for Disease
Control, 2019)
Etiology
Biological Factors
● Evidence for some genetic factors
● Neurotransmitter 5-HT, or serotonin
system may be inhibited
● Persons with a first-degree relative
with major depressive disorder are
2.5-3x more likely to develop
depression than others
Environmental Factors
● Stressful or traumatic event may trigger
a depressive episode
● Risk factors: poverty, little social
support, sleep disorders
● Most likely an interaction between
genetic and environmental factors -
meaning some people are more
vulnerable to depression after exposure
to adversity
Diagnostic Criteria (according to the DSM)

5 or more of the following symptoms have been present during the

same 2 week period and represent a change in functioning
1. Depressed mood most of the day, nearly every day.
2. Markedly diminished interest or pleasure in almost all activities
3. Significant weight change (not due to dieting), or loss of appetite
4. Insomnia or hypersomnia nearly every day
5. Feelings of restlessness or lethargy
6. Fatigue or loss of energy nearly every day
7. Feelings of excessive guilt or worthlessness
8. Limited ability to think concretely; indecisiveness
9. Recurrent suicidal ideation or attempts
 Treatment
Psychotherapy- “talk therapy”
● CBT: recognition of negative
thoughts and teaching coping
mechanisms
● IPT: evaluating interactions
and relationships that may
contribute to depressive
symptoms
● Psychodynamic therapy:
recognizing unconscious
processes and negative
behaviors
 Treatment
Medication
● SSRIs: most commonly
prescribed, act on the brain
chemical serotonin
● SNRIs: increase serotonin
and norepinephrine
● NDRIs: increase
norepinephrine and
dopamine (ex: Wellbutrin)
● Mirtazapine: also target
norepinephrine and
serotonin, but associated
with more side effects
 Treatment
Medication (continued)
● SGAs: treat schizophrenia,
bipolar disorder, and
treatment-resistant
depression
● TCAs: similar to SNRIs but
with more side effects,
sometimes used to treat
chronic pain
 Signs of
Depression in
Students
The DSM criteria is important for
psychiatrists and clinicians, but
these five signs of depression can
be easily recognized by school
counselors, parents, and
students’ peers.
School-Based Interventions

Academics Socioemotional

● Break up and give more time ● Frequent check-ins

on assignments ● MTSS
● Assist with setting up ● Individual or group
schedules and teach study counseling
habits ● Outside referrals
Depression in Pop Culture

Are these characters depressed, why or why not?

SADNESS: Inside Out

“Sadness” is a
personified
emotion who
inhabits Riley’s
mind.
 SADNESS:
Inside Out
“Sadness” the character is
depressed.
● She is pessimistic
● She is lethargic
● She often feels guilty for making Riley sad
● Sadness does not understand why she
cannot just be happy, even when she tries

But...Riley is not depressed! The movie teaches us

that a little bit of sadness is necessary to
appreciate joy.
EEYORE: Winnie the Pooh
 Eeyore is depressed.

● He expresses shame/guilt
● Diminished interest in activities
● Pessimistic outlook
● Irritable mood
“One awesome thing about Eeyore is that even
though he is depressed, he still gets invited to
participate in adventures and shenanigans with all
his friends. What is amazing is that they never
expect him to pretend to feel happy, they never
leave him behind, or ask him to change. They just
show him love."
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American
Psychiatric Association.

Center for Disease Control. (2019, April 19). Data and Statistics on Children’s Mental Health. Retrieved from:
https://www.cdc.gov/childrensmentalhealth/data.html

Fendrich, M., Warner, V., & Weissman, M. M. (1990). Family risk factors, parental depression, and psychopathology in offspring.
Developmental Psychology, 26(1), 40-50. http://dx.doi.org/10.1037/0012-1649.26.1.40

Huberty, T. (2010). Depression: Supporting Students at School - nasponline.org. Retrieved from

https://www.nasponline.org/Documents/Resources and Publications/Handouts/Families and
Educators/Depression_Supporting_Students_at_School.pdf.

NAMI. (2017, August). Retrieved from https://www.nami.org/Learn-More/Mental-Health-Conditions/Depression/Treatment.