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
Peers
Strengths
developmentally
Yet to
develop
student
Attitudes
toward school
performance
Families
and
friends
socially
academically
Work
habits
Siblings
Self
regulating
skills
Consistency between
home and school
Expectations
for Behaviour
Responsibilities
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
INDEPENDENCE
BELONGING
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
NORMAL DISTORTED
ABSENT
•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
•corrective
relationships of
trust and
intimacy
Mending the Broken Circle
NEEDS
mastery
NORMAL
mastery
DISTORTED ABSENT
•achiever
•overachiever
•nonachiever
•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
•involvement in
an environment
with abundant
opportunities for
meaningful
achievement
Mending the Broken Circle
NEEDS
independence
independence
NORMAL DISTORTED ABSENT
•autonomous
•dictatorial
•submissive
•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
•opportunities to
develop the skills
and the
confidence to
assert positive
leadership and
self-discipline
Mending the Broken Circle
NEEDS
generosity
generosity
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
•experience the
joys that accrue
from helping
others
Early Family Influences
ATTACHMENT
HISTORY
Insecure attachment
PSYCHOLOGICAL
RESPONSE
Separation anxiety
Failure
Alternative
attachments
Persistent anxiety
Depression
Impaired capacity
to form attachments
Loneliness
Low self-esteem
Depression
Threatened
attachments
Abandonment anxiety
Suicidal ideation
Recurrent
attachment failure
Chronic anxiety
Severe depression
Persistent suicidal
ideation
Hopelessness
Depair
Social isolation
Adam, K.S., Early family influences on suicidal behaviour
ATTACHMENT
BEHAVIOUR
Protest
Despair
Detachment
Object hunger
Anxious
attachment
Emotional
detachment
Relationship
difficulties
Marital
dysfunction
Suicidal threats
Suicide attempts
Repeated
suicide attempts
Suicide
ASSOCIATED
BEHAVIOUR
Antisocial
behaviour
Behaviour disorder
School phobia
Illness behaviour
Personality disorder
Alcohol & drug
abuse
Alcoholic binge
Promiscuity
Phobic stages
Major affective
disorder
Chronic alcoholism
The Crisis Cube
STRESS
HIGH
EFFECTIVE
MORE EFFECTIVE FUNCTIONING
Pre-crisis behaviour
CRISIS
ONSET
POINT
Adequate coping
Line of Stability
Pre-crisis behaviour
Point of
intervention
LOW
Continued fragmentation
deterioration
Need for
psychotherapy
INEFFECTIVE
maladaptive behaviour
LOW
days, months, years
seconds, minutes
TIME
days, months
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