DEPRESSION WHAT ARE THE SIGNS AND SYMPTOMS OF DEPRESSION?

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1 DEPRESSION WHAT ARE THE SIGNS AND SYMPTOMS OF DEPRESSION? Common symptoms of depression in children and adolescents are listed below. In major depression, five or more of these symptoms last for over two weeks, and cause difficulty in everyday life. In a less severe but longer lasting condition called dysthymia, two or more of these symptoms are present, more often than not, for a year. Feeling or appearing depressed, sad, tearful or irritable Decreased interest in or pleasure from activities, which may lead to withdrawal from friends or after-school activities Change in appetite, with associated weight Major changes in sleeping patterns, such as sleeping much more or less than normal Appearing to be physically sped up or slowed down Increase in tiredness and fatigue, or decrease in energy Feeling worthless or guilty Difficulty thinking or concentrating, which may correlated with worsening school performance Thoughts or expressions of suicide or self destructive behavior In children it is important to keep in mind that an increase in irritability or even complaints of boredom may be more noticeable than sadness. Children also may have more physical complaints, particularly if the child does not have the habit of talking about how he or she feels. Talk of suicide or not wanting to be alive can be difficult to interpret, so it must be taken seriously and brought immediately to a doctor s attention. WHAT ARE THE CAUSES OF DEPRESSION? Depression has no single cause. Both genetics and the environment play a role, and some children may be more likely to become depressed. Depression in children can be triggered by a medical illness, a stressful situation, or the loss of an important person. Children with behavior problems or anxiety also are more likely to get depressed. Sometimes, it can be hard to identify any triggering event.

2 THE DIFFERENCE BETWEEN TEENAGE AND ADULT DEPRESSION Depression in teens can look very different from depression in adults. The following symptoms of depression are more common in teenagers than in their adult counterparts: Irritable or angry mood As noted above, irritability, rather than sadness, is often the predominant mood in depressed teens. A depressed teenager may be grumpy, hostile, easily frustrated, or prone to angry outbursts. Unexplained aches and pains Depressed teens frequently complain about physical ailments such as headaches or stomachaches. If a thorough physical exam does not reveal a medical cause, these aches and pains may indicate depression. Extreme sensitivity to criticism Depressed teens are plagued by feelings of worthlessness, making them extremely vulnerable to criticism, rejection, and failure. This is a particular problem for over-achievers. Withdrawing from some, but not all people While adults tend to isolate themselves when depressed, teenagers usually keep up at least some friendships. However, teens with depression may socialize less than before, pull away from their parents, or start hanging out with a different crowd. ~Courtesy of The American Academy of Child and Adolescent Psychiatry

3 SIGNS OF SUICIDE Suicides among young people continue to be a serious problem. Each year in the U.S., thousands of teenagers commit suicide. Suicide is the third leading cause of death for 15-to-24-year-olds, and the sixth leading cause of death for 5-to-14-year-olds. Teenagers experience strong feelings of stress, confusion, self-doubt, pressure to succeed, financial uncertainty, and other fears while growing up. For some teenagers, divorce, the formation of a new family with step-parents and step-siblings, or moving to a new community can be very unsettling and can intensify self-doubts. For some teens, suicide may appear to be a solution to their problems and stress. Depression and suicidal feelings are treatable mental disorders. The child or adolescent needs to have his or her illness recognized and diagnosed, and appropriate treatment plans developed. When parents are in doubt whether their child has a serious problem, a psychiatric examination can be very helpful. Many of the signs and symptoms of suicidal feelings are similar to those of depression. Parents should be aware of the following signs of adolescents who may try to kill themselves: change in eating and sleeping habits withdrawal from friends, family, and regular activities violent actions, rebellious behavior, or running away drug and alcohol use unusual neglect of personal appearance marked personality change persistent boredom, difficulty concentrating, or a decline in the quality of schoolwork frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc. loss of interest in pleasurable activities not tolerating praise or rewards

4 A teenager who is planning to commit suicide may also: complain of being a bad person or feeling rotten inside give verbal hints with statements such as: I won't be a problem for you much longer, Nothing matters, It's no use, and I won't see you again put his or her affairs in order, for example, give away favorite possessions, clean his or her room, throw away important belongings, etc. become suddenly cheerful after a period of depression have signs of psychosis (hallucinations or bizarre thoughts) If a child or adolescent says, I want to kill myself or I'm going to commit suicide always take the statement seriously and immediately seek assistance from a qualified mental health professional. People often feel uncomfortable talking about death. However, asking the child or adolescent whether he or she is depressed or thinking about suicide can be helpful. Rather than putting thoughts in the child's head, such a question will provide assurance that somebody cares and will give the young person the chance to talk about problems. SUGGESTED READING LIST: A Relentless Hope: Surviving the Storm of Teen Depression by Gary Nelson I Just Want You to be Happy: Preventing and Tackling Teenage Depression by Rowe Bennett Tonge Rescuing Your Teenager from Depression by Norman T Berlinger When Nothing Matters Anymore: A Survival Guide for Depressed Teens by Bev Cobain

5 SELF-INJURY Self-injury includes anything that someone does to intentionally injure themselves. Some people hurt themselves as a way of dealing with overwhelming painful emotions and thoughts. Some of the ways that self-injury occurs is through cutting, bruising or burning oneself. Self-injury can also present as risky behaviors such as substance use, promiscuity or reckless driving. Myths and Facts about Self-Injury Because cutting and other means of self-injury tend to be taboo subjects, people may harbor serious misconceptions about the motivations and state of mind of someone who does these things MYTH: People who self-injure are trying to get attention. FACT: The painful truth is that people who self-injure generally do so in secret. They aren t trying to manipulate others or draw attention to themselves. In fact, shame and fear can make it very difficult to come forward and ask for help. MYTH: People who self-injure are crazy and/or dangerous. FACT: It is true that many people who self-injure suffer from anxiety, depression or a previous trauma, just like millions of other people in the general population. Self-injury is how they cope. Identifying them as crazy or dangerous isn t accurate or helpful. MYTH: People who self-injure want to die. FACT: Self-injurers usually do not want to die. When they self-injure, they are not trying to kill themselves. They are trying to cope with their pain. In the long-term however, people who self-injure may have a much higher risk of suicide, which is why it is important to seek help. MYTH: If the injuries or behaviors aren t that bad, it s not that serious.

6 FACT: The severity of a person s injuries or behaviors has very little to do with how much he or she may be suffering. Don t assume that because the injuries or behaviors are minor, there s nothing to worry about. ~Courtesy of helpguide.org SUGGESTED READING LIST Helping Teens who Cut: Understanding and Ending Self-Injury by Michael Hollander