Teens and Depression

Some Things to Think About Most teens do not seek help on their own Depression has increased 200% in this age group since 1960 Surveys indicate 1 in 5 teens have depression Third most prevalent cause of death in adolescents, second in 18-24 year olds Other things may obscure depression e.g. learning difficulties, conduct disorder Untreated teen depression puts people at risk for other disorders in adult life Teens may go years before getting help

Who’s at Risk? What would you say?

Who is More at Risk? Family history of depression A learning disability or attentional difficulty Teen girls Youth from marginalised cultural/ethnic groups GLBT youth Stressful life events Chronic Illness Family difficulties, conflict with parents

What Does Depression Look Like in Teens? What do you think you would See?

What Does it Look Like? Poor performance in school Withdrawal from friends and activities Sadness and hopelessness Lack of enthusiasm, energy or motivation Anger and rage Over-reaction to criticism Feelings of being unable to satisfy ideals

What it Looks Like…cont. 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

How to Tell the Difference? Because of the difficulty distinguishing between depression and ‘normal’ adolescent behaviour, think about: Involving parents and/or trusted teachers and the school counsellor Sudden behaviour change Duration of symptoms

Some Questions to Help Make The Distinction (note: examples of content rather than the way these would be asked!) What have you been experiencing? e.g. changes in sleep, thought patterns When did these things start? Did something happen to make you feel bad? How long have the symptoms lasted? How bad are these things (specific e.g. sadness)? Have you experienced things like this before? Did you receive treatment? What treatment was given? (probe for specific) What other things have you found helpful? Does you use alcohol? Drugs? Have other family members had a depressive illness? If they were treated, which strategies were effective? What kind of social support do you have in place? What lifestyle factors (work, diet, exercise, recreation, etc.) may have changed? Have you had thoughts about death or suicide?

How Treatments Compare (why you should be supportive of different options!) After about a month, medications are ahead. They reduce symptoms more quickly and more reliably than therapy does. After a couple of months of treatment, antidepressants and psychotherapy are equal in effectiveness. At 12 weeks, therapy is slightly ahead in effectiveness. Relapse occurs 50 percent more often among patients receiving medication alone than among those receiving both drugs and therapy.

Aboriginal Youth- At Risk for Depression and Suicide Young women 8x the national average Young men 5x the national average 25% of Mi’kmaq youth in N.S. report depression ‘Transgenerational grief’ Sense of isolation, marginalisation from ‘mainstream’ Conflict at home, arguments indicate higher risk Need to recognise: Problems with ‘medicalisation’ of depression: need to embed cultural practices Protective nature of cultural continuity and identity Health Canada: Acting On What We Know: Preventing Youth Suicide in First Nations, 2002

GLBT Youth – At Risk for Depression and Suicide About 25% of gay and lesbian youth have experienced physical violence in their homes due to their orientation About 50% of runaways/homeless youth self-report as GLBT About 30% of youth suicides are GLBT Increased risk for substance abuse

Things That Ward off Depression Tolerance of ambiguity Critical thinking Clear (as opposed to general) goals Being able to distinguish between what you feel about something and how it is Relationship skills: 1) establishing closeness and 2) setting boundaries Physical exercise Increasing pleasant activities Relaxation skills Increasing problem-solving skills Social skills

Protective Factors Mentoring relationships Community connections (increased social capitol) Involvement in social and volunteer activities Building connections with the family/a family member and the school Supporting an ethno-cultural connection

What Can You Help Others to Do? Cultivate curiosity Reframe youth behaviour Take symptoms seriously Advocate for a troubled youth Find ways to show youth they are valued and included Encourage others to participate in programmes you develop Foster youth-adult partnerships

Resources www.youthproject.ns.ca http://www.gov.ns.ca/health/mhs/depression/Depression%20booklet%20Web%20N30.pdf http://www.genderandhealth.ca/en/modules/sexandsexuality/gss-social-issues-03.jsp http://www.hc-sc.gc.ca/fnih-spni/pubs/suicide/prev_youth-jeunes/index_e.html