Youth Depression

Lorna Martin
lormartin@gov.mb.ca
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
Emerging Strengths Peers Siblings

developmentally Families
socially and
friends
Yet to
develop
student Self
regulating
skills
academically Consistency between
Attitudes home and school
Work
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)
GENEROSITY

INDEPEN- BELONGING
DENCE

MASTERY
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
NEEDS
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
NEEDS
mastery mastery •involvement in
an environment
with abundant
opportunities for
NORMAL DISTORTED ABSENT
meaningful
•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
NEEDS
independence independence •opportunities
to develop the
skills and the
confidence to
NORMAL DISTORTED ABSENT
assert positive
•autonomous •dictatorial •submissive leadership and
self-discipline
•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
NEEDS
generosity generosity •experience the
joys that accrue
from helping
others
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
Despair
Detachment
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
dysfunction
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
ideation
Social isolation Hopelessness Suicide
Depair
Adam, K.S., Early family influences on suicidal behaviour
The Crisis Cube
HIGH

STRESS

th
ow
gr
uing
tin
EFFECTIVE

n
Co
MORE EFFECTIVE FUNCTIONING

Pre-crisis behaviour
CRISIS
Adequate coping ONSET Pre-crisis behaviour
es
Line of Stability
POINT
o urc
res
LEVEL OF FUNCTIONING

f
eo Point of
Us
SS

intervention
RE
ST
G
IN

LOW
NT
OU

Continued fragmentation
M

deterioration
Need for

e
tim
psychotherapy maladaptive behaviour

e
lif
s,
ar
ye
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 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