Adolescent Depression

Sophia was concerned about her son.

Danny, normally an out-going and energetic sixteen-year-old, had been down in the dumps since he and his girlfriend Lucy broke up just over two weeks ago. Since then he stopped seeing his friends and hardly left his room. At meal times he hardly ate anything and was visibly losing weight. His sleep was erratic and he seemed to lack the energy or interest to do anything – even those things he was usually passionate about.

Recently the school called, also expressing concern. It seemed that Dan was getting behind in his school work and had stopped submitting assignments. He was having trouble staying focused in class and the self-imposed isolation Sophia saw at home also seemed to be occurring at school.

Sophia knew that it was time to get help, but other than the family doctor who was booked up for the next two weeks, she had no idea where else to go. Instinctively she knew she had to act immediately.

Sophia herself felt both desperate and helpless – her son was withering in front of her very eyes and it seemed that there was nothing she could do to help him.

Who is Most Affected by Depression?
While depression has been described as being equivalent to the common cold of mental health (almost everyone has been “depressed” at one time or another), clinically significant depression can range in severity from minimal to severe, with adolescence being an especially difficult time in terms of mental health concern.

“According to the 2012 Canadian Community Health Survey – Mental Health, 15 – to 24-year-olds had the highest rates of mood and anxiety disorders of all age groups. About 7% of them were identified as having had depression in the past 12 months, compared with 5% of people aged 25 to 64 and 2% of those aged 65 or older.

Severe depression is associated with suicidal behaviour, which is often conceptualized along a continuum from thoughts to plans to attempts/deaths. As many as one in five teens report suicidal ideation in the past year. Suicide is the second leading cause of death among young Canadians, accounting for almost one quarter of all deaths at ages 15 – 24.

Adolescence and early adulthood are critical periods in the development of mental health. Risk and protective factors may differentially influence this age group, and rates of depression peak during these ages.”

(health reports: Depression and suicidal ideation among Canadians aged 15-24 https://www.statcan.gc.ca/pub/82-003-x/2017001/article/14697-eng.htm)

What Does Depression Look Like?
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM 5), the following are criteria for the diagnosis of depression:
5 or more symptoms present during a 2 week period;

Depressed or irritable mood (outside being frustrated) and/or loss of interest or pleasure, plus any three of the following:
1.  Significant weight loss or decrease in appetite (more than 5 percent of body weight in a month or failure to meet expect4ed weight gains).
2.  Insomnia or hypersomnia
3.  Psychomotor agitation or retardation
4.  Fatigue or lack of energy
5.  Feelings of worthlessness or guilt
6.  Decreased concentration or indecisiveness
7.  Recurrent thoughts of death or suicide
In addition to the above DSM-5 criteria, children and adolescents may also have some of the following symptoms:
–  Persistent sad or irritable mood
–  Frequent vague, non-specific physical complaints
–  Frequent absences from school or poor performance in school
–  Being bored
–  Alcohol or substance abuse
–  Increased irritability, anger or hostility
– Reckless behaviour

(DSM-5 Criteria – as cited by MD Wise – Clinical Care Guidelines for: Major Depression in Children and Adolescents – http://www.mdwise.org/MediaLibraries/MDwise/Files/…/gl-depressioninchildrend.pdf )

What Causes Depression?
A number of factors can cause depression – genetic predisposition, severe life circumstances, substances and certain medical conditions can all affect brain chemistry and thus the moods we experience.

What Should I Do if I Think My Child is Depressed?
Start with your doctor. It is important to rule out any other underlying physical causes or conditions that resemble symptoms of depression – (Bipolar Mood Disorder, Hypothyroidism, Diabetes and Chronic Fatigue Syndrome all share symptoms which can resemble depression).

www.psychologytoday.com/us/blog/the-truisms-wellness/201609/4-conditions-resemble-depression-arent

Once having ruled other possible causes for your child’s depressive symptoms, there are a number of services available to provide support.

Listed below are a list of strategies that have often been found helpful in managing feelings of depression, followed by links to a number of mental health services.

What is important to remember is that depression, while common, can be a serious health concern. If you see that your child is experiencing a number of symptoms listed above, and especially if they express suicidal thoughts or display self-destructive behaviour, it is better to err on the side of caution and have your child see a health care professional immediately.

Exercise – especially cardio, helps to release endorphins, the body’s own built-in feel good drug.
Change your self talk – be mindful of what you tell yourself. Negative self-talk tends to create negative feelings, while positive realistic self-talk tends to diminish negative feelings while promoting optimism
Use positive distraction – changing your focus, especially when very upset, can help to restore a sense of calm which can in turn lead to a more realistic evaluation of one’s current situation. Deciding anything important when upset and caught in the “fight or flight” response is seldom a good idea.
Sleep – getting enough sleep is so important to good mental and emotional health that it is often the starting place for many mental health practitioners. It is amazing to see how often a number of mental health issues improve with simply getting consistent sleep.
Watch your diet – as the saying goes “you are what you eat”. We wouldn’t expect to get optimum performance when putting bad gas into a vehicle. How can we expect to get positive results when our food choices are unhealthy?
Express your feelings –  expressing one’s emotions, whether talking, writing or even creating art, helps to release tension. Not expressing ones’ feelings tends to result in our reacting to those feelings in unhealthy ways (i.e. aggression, withdrawal, or even substance use to numb them).
Keep a mood log – tracking one’s moods and the circumstances in which they occur can help us to recognize and better respond to our triggers. It is hard to change in an effective way what we do not consistently pay attention to. The following is a link to a mood log form and an example of how to complete the mood log – http://www.burdenbearersdv.com/documents/Daily_Mood_with)example.pdf
Take action – do what you would normally enjoy doing, even if you don’t feel like it – often the enjoyment follows the effort, despite what we may think before we start.
Structure your time – planning one’s time and then following through with the plan can create a sense of satisfaction and control when the rest of life may feel out of control.
Get into nature – something about getting out into nature often refreshes our spirit.
Read, meditate, pray – numerous studies have shown the mental, emotional and physical benefits of meditation and prayer.
Listen to Positive Music – music can help to change our mood – for good or bad. “Good stuff in/good stuff out”.
Spend time with a pet – the unconditional love our pets give us can really help to elevate our mood.
Talk to someone “Face-to-Face” – overuse of technology has the tendency to divide and cut us off from each other. Making time to hang out with friends is in many ways therapeutic – we were made to be social.
Practice hope – consciously think about what you are thankful for and what you are looking forward to.. What we focus on becomes most real for us.

Support Services  

Child and Youth Resources – Fraser Health: http://www.fraserhealth.ca/health-info/mental-health…use/…/child-youth-resources/

Depression – Fraser Health: www.fraserhealth.com …. Health Topics A-Z > School Health> Mental Wellness

Short Term, Assessment, Response, Treatment Team – Fraser Health: https://www.fraserhealth.ca/…/short-term-assessment-response-treatment-team/

Rapid Access Clinic – Fraser Health: https://www.fraserheatlh.ca/health-info/mental-health…use/…/rapid-access-clinic

Bounce Back: For adults and youth| CMHA British Columbia: https://www.cmha.bc.ca/programs-services/bounce-back/

Adolescent Depression
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Don Lasell is a Registered Clinical Counsellor and is a member of the British Columbia Association of Clinical Counsellors. Don specializes in working with families having children with special needs and anxiety. His areas of special interest include anxiety, depression, stress, self-esteem, couple and family issues. Don utilizes Cognitive Behavioural Therapy (CBT) as well as Eye Movement and Reprocessing (EMDR) in his counselling work. In addition to counselling, Don also offers presentations and workshops on a variety of issues related to children, marriage and family.

Don obtained his Masters in Marital and Family Counselling in 1994 through the Adler School of Professional Psychology in Chicago. Don is also a former teacher who has taught in an integrated classroom setting, has been a high school counsellor as well as the Director of Clinical Services for a large not-for-profit agency in the lower mainland. In addition to his work in private practice, Don is also a former peer reviewer for the Council on Accreditation.

Don is married to Tanya with whom he is the parent of seven children, two of which are diagnosed with Autism Spectrum Disorder.

Posted in Depression, Family & Parenting, General, Stress & Anxiety