Dr. Val Farmer
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Rural Mental Health & Family Relationships

How To Help A Depressed Teenager

March 22, 2004

Facts about teen depression. Seven to 14 percent of children will experience a major depression before age 18. Depression among high school students is 8 percent - about the same rate that occurs among adults. Among "normal" teenagers, about 15 percent have problems with physical and social withdrawal, communications, and high conflict relationships with parents. With depression, these types of problems are two or three times more likely to occur.

The most vulnerable ages for suicide are 16 to 22, with the peak being the senior year of high school and the first two years of college. Impulsiveness is a key factor in suicide among junior high school and younger age high school students.

A large percentage of children and adolescents diagnosed with learning disabilities, hyperactivity, conduct disorders and school phobias are depressed. The depression is often undiagnosed and untreated. When an elementary school age child is depressed, it is a common finding that other family members are also depressed.

There are minimal differences between urban and rural youth on depression and suicide.

Media coverage and dramatization of teenage suicide increase suicide among teenagers. The undue notoriety and memorialization of youth suicide victims glamorizes a suicidal option for other vulnerable youth. Media can show restraint by reporting the death in the obituary column only.

School administrators should treat a suicidal death like death from other causes. Special group work should be done for close friends and others who feel the need to know more and to talk about their feelings.

Further attempts at suicide are reduced by 50 percent if teens attend more than two counseling sessions.

Here is a list of the most common problems reported by teenagers:

- Peer relationship problems such as romantic breakups and conflict with close friends, loss of a friend, social isolation, rejection, and humiliation.

- Family problems such as alcoholism, abuse, divorce, finances, and conflict with parents or siblings.

- School problems such as failing grades, clashing with a teacher, moving to a new school, and not meeting personal expectations.

- Grief responses to losses of friends and relatives through death or to incapacitating injury or illness.

The most common indicators of depression in teenagers are the following:

- Lack of concentration, indecision, drop-off in academic performance, and truancy problems

- Withdrawal from friends and social activities.

- Not responding to pleasurable activities, overeating, oversleeping, not caring about appearance, and withdrawing into listless listening to music or TV viewing. Lack of enthusiasm or motivation.

- Increase in somatic complaints.

- Frequent anger, irritability, defiance and rage responses, increased arguments, feelings of restlessness and agitation, problems with authority, overreaction to criticism.

- Use of street drugs and alcohol as a way of self-medicating depression.

- Having excessive and delusional guilt, thinking in "black and white" terms, rewriting history with the use of "always" and "never," and the narrowing of ability to consider options or alternatives. Low self-esteem.

- Sadness and hopelessness. Disappointment in meeting ideals. Suicidal thoughts or actions. Talking about not wanting to live. Obsession with death.

Depression distorts the thinking process and the way situations are perceived. A prolonged negative mood starts a downward spiral that leads to decreased behavior and negative thinking. This leads to an even more negative mood.

Here are some "do's" and "don'ts" for parents, teachers and young people.

- For parents. Don't avoid the topic. Help your children identify feelings and how to communicate about them. Talk out problems. Show love. Accept the child as he or she is. Keep your expectations realistic. Provide comfort and support. Teach them how to soothe or reward themselves.

Help them deal with stress and frustration. Help them be the judge of their own value, successes and failures. Be patient. Offer suggestions on what to do. Take suicidal threats seriously. Alert key adults in their lives. Get professional help if necessary. Few teens seek help on their own. Medications will aid the process of recovery.

- For teachers and friends. Listen calmly. Take problems seriously. Be supportive. Ask directly about thoughts of suicide. Do something tangible to assist with the situation. Avoid showing shock or embarrassment, arguing, trying to joke or humor them out of their troubles or pointing out how others will feel.

Saftey is more important than privacy. Keep confidences but do not guarantee secrecy or confidentiality when you suspect a threat of suicide. Don't try to counsel alone. Too many young people have found too late that they should have notified a parent or an adult about their concerns for their friend.

- For a teenager with depression. Try to understand the problem. Get your feelings out. Talk them out. Write them down. Exercise. Do something physical. Get sleep. Do one thing every day that you enjoy. Give yourself praise for something you are good at. Look your best.

Most important, get out of the house and do something. Be with others. Make new friends if you are feeling alone or abandoned by old friends. Join an organization. Ask for help from a trusted adult. Go to counseling.

Depression is a temporary condition. With time and a little help, there is hope.