Depression

Dr. Cory D. Saunders, C.Psych.

Developmental Neuropsychology
Windsor Regional Children’s Centre
 Muscular Dystrophy: 1/6000

 Cystic Fibrosis 1/4000

 Childhood Cancers 1/500

 Diabetes Mellitus 3/100

 Autistic Disorder 2-3/500

1/88 1/50
 113.54 FTE
 Social Workers
 Child & Youth Workers
 Psychologists
 Psychometrists
 Medical Consultants & Child Psychiatrists

 Number of Children Seen 2011/12: 2725

 Number of Visits 2011/12: 10,145

1800
1700
1600
1500
1400
1300
1200
1100
1000
900
800
700
2006- 2007- 2008- 2009- 2010- 2011- 2012-
07 08 09 10 11 12 13*
 980 Referrals
876 849 855
844
827 841 Closed
786
675
645
589
545

192
181

2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13*

 What are the most common mental health
issues in school aged children?

 Where do they come from?

 Is there a common denominator?

 What is the purpose of the student’s

behavior?
 5 or more symptoms for at least 2 weeks:
 Depressed mood
 Markedly diminished interest or pleasure
 Significant weight loss or gain
 Insomnia or hypersomnia
 Psychomotor agitation or retardation
 Fatigue or loss of energy
 Feelings of worthlessness or inappropriate guilt
 Diminished concentration or indecisiveness
 Recurrent thoughts of death or suicide
 Family history
 An imbalance of chemicals in the brain

 Difficult life events

 Traumatic events in childhood
 abuse
 neglect
 divorce
 family violence
 Gender
 Increased stress
 Chronic illness
 Four different categories: emotional signs,
cognitive signs, physical complaints, and
behavioral changes

 Not every child who is depressed

experiences every symptom
 Typical moods or emotions experienced:
 Sadness
 Loss of pleasure or interest
 Anxiety
 Anger or Irritability
 A depressive mood can bring on negative,
self-defeating thoughts

 The signs to look for are:

 Difficulty organizing thoughts
 Negative view
 Worthlessness and guilt
 Helplessness and hopelessness
 Feelings of isolation
 Suicidal Thoughts
 Depression is not just an illness of the mind
- it also causes physical changes
 Changes in appetite or weight
 Sleep disturbances
 Sluggishness
 Agitation
 These signs will be the most obvious and
easy for your detect
 Avoidance and withdrawal
 Clinging and demanding
 Activities in excess
 Restlessness
 Self-Harm
 Most symptoms are similar to those in adulthood

 Depression can be difficult to diagnose in teens

because adults may expect teens to act moody

 Adolescents do not always understand or express

their feelings well - they may not be aware of the
symptoms and may not seek help
 These symptoms may indicate depression:
 Poor performance in school
 Withdrawal from friends and activities
 Sadness and hopelessness
 Lack of enthusiasm, energy or motivation
 Anger and rage
 Overreaction to criticism
 Feelings of being unable to satisfy ideals
 Poor self-esteem or guilt
 Indecision, lack of concentration or forgetfulness
 Restlessness and agitation
 Changes in eating or sleeping patterns
 Substance abuse
 Problems with authority
 Suicidal thoughts or actions
 Teens may experiment with drugs or alcohol or
become sexually promiscuous to avoid feelings of
depression

 Teens also may express their depression through

hostile, aggressive, and/or risk-taking behavior

 Such behaviors often lead to new problems, deeper

levels of depression, and destroyed relationships
 Four out of five teens who attempt suicide
have given clear warnings:
 Suicide threats, direct and indirect
 Obsession with death
 Poems, essays, and drawings that refer to death
 Giving away belongings
 Dramatic change in personality or appearance
 Irrational, bizarre behavior
 Overwhelming sense of guilt, shame or rejection
 Changed eating or sleeping patterns
 Severe drop in school performance
 ER Visits 444
409
Admissions 388
337
285 300
280

181 195
150 151 164
139 146
116
91
 Children
 Young children –medication with some simple
cognitive behavior therapy if appropriate
 Older children – Cognitive behavior therapy and
medication (SSRI)

 Adolescents
 Cognitive behavior therapy
 Medication (SSRI)
 If SSRI used an initial period of monitoring
 Immediate Risk:
 Proceed to the ED at WRH Met campus

 Urgent Care:
 Walk In Clinic: Monday, Tuesday, Thursday 12-6pm.

 Referrals for Service

 Windsor Regional Children’s Centre (aged 6-18)
 Maryvale Adolescent and Family Services (aged 13-18)
 Coordinated Access
 HelpLink, Intake, Service Coordination
 Children’s Crisis Services
 Walk In Clinic, ERCR
 Children's Treatment Services
 Clinic Services
 Youth Justice Services
 Probation Diversion, Adolescent Sex Offender, Youth Mental Health
Court Worker (pre-charge diversion)
 Intensive Family Services
 Milieu Continuum (Residential through Day Treatment)
 Assessment and Consultation Services
 Developmental Services, Psychological Assessment, Medical Services
 Child and Adolescent Mental Health Beds
 Sexual Assault Domestic Violence Treatment/SAFE Kids