Health
Mental Health
Mental Health
Essential Questions:
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What is the relationship between stress and
stressors?
What is the difference between distress and eustress?
How does the body respond to stress?
What are the physical signs of stress and depression?
What are the steps of the decision making process?
Where do you seek help when a person is in danger of suicide?
What are the warning signs of depression and suicide?
What are sources of help for people with depression, suicidal thoughts, etc.?
Why is good self esteem and self concept important?
What are ways to handle anger, conflict, and peer pressure?
How can you model ways of handling peer pressure situations?
What are the steps of Maslow's Hierarchy of Needs?
Do you feel that overall the world operates in a mentally healthy way? Lack of self
esteem, poor decision-making skills, lack of assertiveness, overwhelming amounts of
stress that people don't handle healthily, mismanagement of anger, conflict irresolution,
lack of violence prevention efforts, depression, and suicide are just some of the many
mental health-related issues in today's society. By the end of this unit, you will be
equipped with the knowledge of how to improve your own mental health, and hopefully
use this new knowledge to make this world a better place to live. Wouldn't it be
wonderful if good mental health could become contagious?
To view the standards for this unit, please download the handout from the sidebar.
Mental Health Vocabulary
Please review the following vocabulary terms.
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Mental health- the way people think about and respond to events in their daily
lives
Emotion- a feeling produced in response to a life event
Emotional health- the way a person experiences and deals with feelings
Hormones- chemicals that help control how the body grows and functions
Trigger- situations, people, and events that cause a person to feel an emotion
Body language- expressing emotions with the face, hands, and posture
Active listening- not only hearing but also showing that you understand what a
person is saying
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Self-esteem- a measure of how much you value, respect, and feel confident
about yourself
Positive self-talk- thinking about the good parts of a bad situation
Defensive mechanism- automatic behaviors used to reduce uncomfortable
stress
Mental illness- a disorder that affects a person's thoughts, emotions, and
behaviors
Anxiety disorder- an illness that causes usually strong nervousness, worry, or
panic
Mood disorder- an illness in which people have uncontrollable mood changes
Depression- a mood disorder in which a person feels extremely sad and
hopeless for at least two weeks
Suicidal thinking- the desire to take one's own life
Teen hotline- a phone number that teens can call to talk privately and
anonymously about their problems
Counselor- a professional who helps people work through difficult problems by
talking
Psychologist- a person who tries to change thoughts, feeling, and actions by
finding the reasons behind them or by suggesting new ways to manage emotions
Psychiatrist- a medical doctor who specializes in illness of the brain and body
that affect emotions and behavior
Peer pressure- pressure people of similar age or status placed on a person to
behave in certain ways
Empathy- sharing and understanding another person's feelings
Tolerance- the ability to overlook differences and accept people for who they are
Stress management- the ability to handle stress in healthy ways
Stress- the combination of a new or possibly threatening situation and your
body's natural response to a situation
Stressor- anything that causes a stress response
Distress- the negative physical, mental, or emotional strain in response to a
stressor
Positive stress (EUSTRESS)- the stress response that happens when winning,
succeeding, and achieving
Communication skills- methods for expressing your thought and listening to
what others say
Active listening- not only hearing what someone says but also showing that you
understand what the person is communicating
Refusal skills- different ways of saying no to things that you don't want to do
Qualities of People With Good Mental
Health
How would you characterize a person that you think has good mental health? Would you
characterize yourself this way? Maintaining good mental health these days is quite an
achievement. Here are some examples of qualities to describe such people:
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The person is comfortable with themselves: he/she does not question how they
feel about something, their values and beliefs, or their own thoughts and actions.
The person is comfortable with others: he/she does not associate with people
that make them feel uncomfortable, gets them in trouble, or asks them to do
things that they do not agree with and don't feel right participating in. Part of this
is also good hygiene and grooming habits - these two qualities are linked to
better success with potential employment opportunities and in
building relationships.
The person is comfortable with their environment: he/she is able to leave
surroundings that make him/her feel uneasy.
The person is able to meet life's everyday demands: he/she does not put off
things until the last minute but rather accomplishes what each day presents and
possibly plans ahead for tomorrow's potential demands. As you transition from
adolescence to adulthood, you will experience increased responsibility. Are you
prepared to handle these? If so, how?
What other qualities did you come up with? Have you ever given much thought to how
healthy you are mentally?
Self Esteem and Self Concept
Self Esteem:
Self esteem refers to how an individual feels about him/herself.
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How would you characterize a person who has high self-esteem?
o Can they interact with others comfortably and feel optimistic about selfworth and position in life, etc.
How would you characterize a person who has low self-esteem?
o Social isolation, pessimistic outlook about life and self worth, feelings of
worthlessness as a member of society, etc.
Where Does a Person's Self-Esteem Come From?
A person's self-esteem is constantly changing depending on many things: what others
say to this person, how others feel about this person, the person's accomplishments,
where the person is in their life educationally, financially, socially, vocationally, etc., how
is the person doing in achieving his/her goals?
Self Concept:
Self-concept refers to what an individual knows about him/herself.
Where Does a Person's Self Concept Come From?
A person's self concept begins developing from birth and continually develops
throughout his/her life. Self concept is what makes a person who they are based on past
experiences and experiences they have yet to endure. For example, a child loses his/her
mother to cancer at age 5. How do you think this child's self concept is going to change?
Possibly he/she will be hesitant about getting close to other mother-like figures, maybe
he/she will constantly fear cancer, and what about if the father gets remarried…?
So, which experiences in your life have made you who you are today? And what
experiences in your future do you feel may change your self-concept?
If you have time, check out the following short films (less than a minute each)
from Dove's Self Esteem Film Gallery.
Assignment - Why Are You Who You Are?
Click here for the "Why Are You Who You Are?" Assignment.
Your instructor will inform you on how to submit this assignment.
Stressed Out?
Stress, Eustress, Distress, Stress Management and Defense
Mechanisms
I think it's safe to say that we all have experienced stress- some more than others.
Stress is the body's response to change. Stressors are the things that actually cause
the stress: family problems (divorce), relationships, injury, drugs, moving to a new
home/community, failing a class (grades), being suspended from school, getting
glasses, discrimination, trying out for a sports team, money (lack of most likely), fatigue,
etc. Stress and stressors
- can be
physical,
mental,
emotional, or
social.
There are two
different kinds
of stress:
1. Eustress: This is good or positive stress and you react to it in a positive manner
o Example:You are getting married, but there's so much involved in
planning a wedding that it is a very tiresome, but you will finally get to
marry the man/woman that you want to spend the rest of your life with!
2. Distress: This is bad or negative stress and you react to it in a negative manner
o Example: The death of a loved one or pet
Excessive stress can affect your physical, mental/emotional, and social health. Think
back to the last time that you were under a lot of stress. Did you mentally function at
your best? Did you easily become angry, confused, pessimistic, etc.? We will discuss
the physical effects of stress on the body in the next topic.
Stress Management: The Ability to Handle Stress in a Healthy
Way
Since there's little we can do to completely avoid stress, the best thing we can do is to
manage it in a healthy way. What do you do when you are under a lot of stress? Here
are a few ways to deal productively with stress:
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Don't sweat the small stuff!
Improve your level of fitness…take a walk to clear your mind
Eat right
Participate in physical activity
Manage your time wisely (get a planner/calendar)
Maintain a positive outlook
Laugh
Develop positive coping strategies
Listen to your favorite relaxing music
Write down your thoughts about the stressor
Talk to someone
Example: Read the case study below to see how Jason uses stress management skills
to help him relieve stress.
Jason has a very busy schedule. He works on the school news crew (morning
announcements) and plays on two sports teams (football and baseball). Lately, Jason
has been having trouble sleeping. His teacher, Mr. Martin, explained that Jason's hectic
schedule could be causing his stress. He showed Jason a strategy for managing his
stress.
1. Identify the sources of the stress: In addition to his normally packed schedule,
Jason was feeling anxious about his performing in the school play.
2. Set priorities: First, he decided which after school activities were the most
important to him. She decided to eliminate one of the after school sports.
3. Manage your time wisely: After reducing his activities, Jason made a day
planner to help him stay organized.
The plan Mr. Martin suggested worked! Before long, Jason found himself falling asleep
the minute his head hit the pillow and was well rested for the next day!
Defense Mechanisms: An Automatic, Short-Term Behavior to
Cope with Distress
Some people turn to defense mechanisms when trying to manage their stress. Overall,
this is definitely not the best thing to do, although some of them are pretty harmless. The
table below shows the most common defense mechanisms and an example of each.
Defense
Mechanism
Denial
Escape /
Fantasy
Meaning
Example
Refusal to accept
reality
Fifteen-year-old David had his pet dog
since he was five years old. At 7:00
every night, David always took Boomer
for a walk. Boomer died suddenly but
David still goes to get Boomer's leash
to take him for a walk each night.
Running away from a
problem through
daydreams, books,
excessive sleep, etc.
Ever since Jennifer found out that her
best friend has leukemia, she sits in
her room listening to her radio while
mindlessly staring out the window.
Rationalization An attempt to justify
one's actions with an
excuse rather than
admitting one's
failure or mistake
Jamal says he failed his world history
test because he was absent the day
before the test when they reviewed the
test material, not because he didn't do
the work.
Projection
An attempt to protect Jamal says he failed his world history
one's self-esteem by test because his teacher doesn't know
blaming unpleasant how to teach.
feelings or
inappropriate actions
on others
Repression
Blocking out
thoughts about
unpleasant things or
experiences"forgetting on
purpose"
Maria's parents have asked her to mop
the floor. It is absolutely gorgeous
weather outside but Maria doesn't
want to waste such a beautiful
afternoon: she would rather be out and
soaking up the rays so she doesn't
think about what her parents asked her
to do.
Displacement Expressing feelings
towards someone or
something not
associated with the
source of feelings
Regression
Retreating to an
earlier time that
seems less
threatening and
requires less
responsibility
Ling has had a horrible day: he forgot
to do his math homework, he missed
his school bus in the afternoon, and
when he got home his dog had gotten
out of the fence and so he had to
spend all afternoon hunting for it.
When Ling's mom got home from
work, she innocently asked him how
his day was. Ling yelled at his mom
and said some things he later
regretted, taking out his bad day on his
mom.
Heather has her senior term paper due
in two days. She has been working
day and night for the last week trying
to get it done. On Saturday morning
when she planned to type her final
draft of her paper, she turns the
television on to cartoons and
remembers back to when life used to
be all about playing with toys and
watching cartoons.
Compensation An attempt to make Tony is not very good at science, but
up for something one he excels in his English classes to
did not have or did
make up for it.
not receive
Sublimation
Transforming
unacceptable
behaviors into
acceptable ones
Jeremy is a naturally aggressive
person. He seems to get into a lot of
fights at school because people make
him mad very easily. Jeremy joins the
wrestling team at his high school so he
can direct his aggression in a more
appropriate way.
work-stress1.jpg image from www3.whig.com
General Adaptation Syndrome
Stress (in general) can be defined as "the body's nonspecific response to any demand
made upon it. The term nonspecific implies that the whole body is affected by the
stress, not just certain parts of the body. For example, some people always develop a
headache when they are under a lot of stress, but actually the headache is just one
effect and there are many other physiological changes in the body as well due to the
stress.
A man named Hans Selye studied the physiological effects of stress on the human body
and developed the General Adaptation Syndrome (GAS). He divided this "syndrome"
into three stages:*refer to the linked worksheet to gain a better understanding of
GAS…imagine a line drawn down the middle of the man's body and everything to
the left of the line represents physiological changes during the "alarm" stage and
everything to the right of the line represents those changes that occur during the
"resistance" stage.
Stage One: ALARM
The body enters the alarm stage when it is first introduced to the stressor.
The sympathetic nervous system is activated during this stage to help the body
meet the demands of the stressor. Refer to the linked worksheet to see the many
physiological changes that occur during this stage.
Stage Two: RESISTANCE
A person enters the resistance stage when he/she manages their stress in a healthy,
productive way. The parasympathetic nervous system is activated to help bring the
body back to homeostasis (normal functioning levels). When you look at the linked
worksheet, you should notice that all of the physiological effects that occur during the
resistance stage.
Stage Three: EXHAUSTION
A person enters the exhaustion stage when he/she does not manage their stress very
well and/or is under a lot of stress for an extended amount of time. During this stage,
the body physiologically stays somewhat in the alarm stage…and therefore can
eventually cause major health problems. Such health problems can range anywhere
from decreasing your immunity so you catch a cold to having a massive heart attack!
Think back …have you ever gotten sick when you were under a lot of stress?
Assignment- How Do You Deal With Stress?
Click Here for the "How Do You Deal With Stress?" Assignment.
Your instructor will inform you on how to submit this assignment.
The Decision Making Process:
Assertiveness
Think back to a decision that you made recently. Were you pleased with your final
decision and its outcome? What steps did you take when making this decision?
Doesn't some of the stress we experience come from decisions that we make? For
example, if a person decides to be sexually active and becomes pregnant, she may
have to drop out of high school in order to care for her child. What can we do to make
better decisions in our lives? The five-step process listed below is a great strategy to use
when making decisions, whether they are big or small.
1.
2.
3.
4.
5.
State the problem
List the possible choices
Consider the consequences and your values
Make a decision and act on it
Evaluate your decision
Step
State the
problem
Meaning
Why am I in this situation?
Who is involved? How much
time do I have to decide?
Example
The decision to be made is whether or
not to have sex with my boyfriend. I'm
in this situation because we've been
talking about taking our relationship to
the next level and we both love each
other. At first I thought my boyfriend
and I were the only people involved in
this decision, but when I sat down and
really thought about it our parents are
involved (in case I get pregnant or get
an STD), my friends are involved (will
this make me want to spend more
time with my boyfriend and less time
with my friends), my siblings (in case I
get pregnant or get an STD), etc.
Ultimately I have a lot of time to
decide but my boyfriend and I keep
getting ourselves in the situation
where I think it's "just going to
happen" before too long.
List the possible
choices
Consider the
consequences
and your values
1. choice 1
2. choice 2
3. choice 3
What are potential
consequences to all of the
above possible choices? What
are my personal values,
family's values, religious
values, morals, and legal
values?
1. Tell my boyfriend I love him
but I don't want to have sex
with him because there are too
many things to worry about
2. Have sex with my boyfriend
without using any form of
protection
3. Have sex with my boyfriend
using contraception (and then
what type of contraception???)
4. Show my boyfriend I love him
in other ways than having sex
5. Stop seeing my boyfriend
altogether
Potential consequences of having sex
with my boyfriend are that I get
pregnant (and then I'm less likely to
finish my education, get a good
paying job, etc. I get an STD or even
worse HIV, I lose respect for myself, I
isolate myself from my friends, my
boyfriend doesn't respect me as
much, etc. Consideration of personal,
family, and religious values, as well as
associated morals and legal issues
must also be considered.
Make a
decision and
act on it
A final decision is made at this n/a
point based on all of the
considerations above…did you
ever think so much should go
into the decision of whether or
not to be sexually active?
Evaluate your
decision
*This is the most important
step of all five because if you're
pleased with your decision you
will probably repeat this
decision in the future or if
you're not pleased you will
rethink some of the above
What was the final outcome? Did my
decision affect others? Did my
decision affect my self esteem?
Would I make the same decision
again?
information and make a
different choice if ever faced
with this decision again!
Assertiveness:
It is important to be assertive when making decisions. Assertiveness means:
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That you're bold and confident in the decisions that you make.
That you don't question how other people feel about your decisions.
That you don't let what others think alter your decisions in any way.
Teenagers are faced with a lot of new decisions that can be very difficult to make. If
more people made decisions about drugs, alcohol, sex, and such before they are
confronted with them, they might make good decisions more often!
Assignment- Decision Making
Click Here for the "Decision Making" Assignment.
Your instructor will inform you on how to submit this assignment.
Anger Management &
Conflict Resolution/Violence
Prevention
We have discussed personal stress a good bit. What happens when there is
interpersonal stress (between two or more people)? Sometimes, tempers flare up, words
are spoken that are not really meant, and actions are taken that you wish you could take
back. Can't the decision-making process be applied and smarter decisions ultimately be
made? Aren't many forms of violence simply interpersonal conflict that is not resolved in
a healthy way at all? What can we do about this problem? It seems that most of what we
hear on the news is murders, rapes, muggings, injuries, or other acts of violence.
Again I ask, WHAT CAN WE DO ABOUT THIS PROBLEM?
Peer Pressure Strategies
Sometimes peers try to influence your decisions. Peer pressure is defined as pressure
people of similar age or status place on a person to behave in certain ways. This
pressure can be positive (study for a test, practice for an upcoming concert, wear your
helmet/seat belts, etc.) or negative (to try tobacco, alcohol, or other drugs; have
premarital sex; steal; vandalize; etc.). There are many strategies (a plan of action) you
can use in a negative peer pressure situation. Here are a few examples:
Strategy
Meaning
Steering clear is avoiding a
situation completely,
because nothing good can
come from it
Steer
Clear
Example
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Say "No, thanks", "No Way",
"Nope, Not Interested"
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Example: Lori and Katie were shopping
at the local mall when Lori saw
a necklace she liked. She said, " I want
that necklace, but I don't have enough
money on me. I'll talk to the sales clerk
(distract her) and when she's not
looking, put it in your purse." Lori said,
"No way".
Think of a safe place to go
and start walking. Leave the
situation within thirty
seconds
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Example: Todd had some chewing
tobacco at baseball practice. He said,
"Hey Brad, want some?" Brad looked at
Todd stunned, turned around and
walked out of the dugout.
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Example: Chris wanted to copy
Ashley's answers on the History test,
but her answers were covered. He kept
trying to get her attention so she would
move her cover sheet, but she didn't
Say No
Walk
Away
Ignore
Example: You are invited to party on
Friday night. The host is bragging that
there will be alcohol at the party. If you
attend the party, you may be pressured
to drink alcohol, so you decide not to
go.
Example: Josh and Jason were invited
to a party. They heard that the parents
were out of town and someone was
bringing alcohol. They decided not to go
to the party.
Continue with what you were
doing before the pressure
started. Don't make eye
contact with the person
pressuring you
seem to notice.
Repeat the same thing over
and over. If you say it
enough, the person
pressuring you will
eventually stop.
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Broken
Record
Say, "Wait, I have a better
idea. Let's
go...______________."
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A Better
Idea
Don't lie, but think of a real
reason not to go along with
your friends.
Make an
Excuse
Reverse
the
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Say, "Why are you
pressuring me?" or "If you
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Example: "I don't smoke." "I don't
smoke." "I told you I don't smoke."
Example: Alan: Let's sneak out tonight;
Bill: Find someone else; Alan: What's
wrong, you scared? ; Bill: Just find
someone else; Alan: You ARE scared;
Bill: I said find someone else.
Example: Sally was at Jane's house.
Jane's parents were not home. Sally
wanted Jane to smoke a cigarette
(Jane's mom kept an extra pack in her
closet). Jane said, "I don't want to."
Sally said, "Come on! Jane. Your
parents will never know." Jane said, "I
don't want to." Then Sally said, "You
are such a baby." Jane said, " I just
don't want to do that".
Example(s): Shoot hoops, play video
games, go to the mall, etc. The
possibilities for this one are endless.
Example: Dana and Kim were invited
to a friend's house. They heard that the
parents were out of town and someone
was bringing beer. Dana said, "I have a
better idea. Let's go to the mall
instead."
Example(s): "I have a lot of homework.
I need to get started." "I have to go
straight home. My mom calls to check
on me." "I have baseball practice till 6.
Then, I have to eat dinner with my
folks."
Example: Mike said, "Let's tag (spray
paint on) the neighbor's house tonight.
He's a grouch." Dawson said, "I can't, I
have cross country practice early in the
morning."
Example: Amber: "Come on, we won't
get caught. No one will ever know we
Pressure were my friend, you wouldn't
push me this way."
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To state the facts, tell your
peer the consequences of
doing what he/she wants to
State the do.
Facts
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took the shirt. Liz: No, I don't want to go
with you. Amber: Hey, it's no big deal.
We'll be back before you know it." Liz:
"Why do you keep pressuring me? I
said no."
Example: Bryna and her boyfriend
Andrew were going to meet at the
movies. Andrew said, "Meet me behind
the theater." When she said no, Andrew
said, "Come on, Bryna. I want to be
alone with you." Bryna said, "Why are
you pressuring me? I told you no."
Example: Smoking can give you bad
breath, yellow teeth, and wrinkles. I
don't think your boy/girlfriend would like
that.
Example: Drinking underage is illegal
and not worth the risk.
** NOTE: When using any of the above peer pressure strategies it is important to pick
one that fits with your personality, values, and beliefs. One that works for your friend
may not be the right choice for you. Can you think of any other peer pressure strategies
to add to this list?
Assignment- Peer Pressure Practice
Click Here for the "Peer Pressure Practice" Assignment.
Your instructor will inform you on how to submit this assignment.
Depression
As with stress, I'm sure we can all
honestly say that we've experienced
depression at some point during our
lives. It is estimated that approximately
3-5% of teenagers suffer from teenage
depression. Some people experience
depression on a daily basis, whereas others get the "blues" only occasionally.
Depression Is Common
Case Study: Lindsay
Lately Lindsay hasn't felt like herself. Her friends have noticed it, too. Kia was surprised
when Lindsay turned down her invitation to go to the mall last Saturday. There was really
no reason not to go, but Lindsay just didn't feel like it. Instead, she spent most of
Saturday sleeping.
Staying in more than usual isn't the only change in Lindsay. She's always been a really
good student. But over the past couple of months her grades have fallen and she has
had trouble concentrating. She forgot to turn in a paper that was due and is having a
hard time getting motivated to study for her finals.
Lindsay feels tired all the time but has difficulty falling asleep. She's gained weight too.
When her mother asks her what's wrong, Lindsay just feels like crying. But she doesn't
know why. Nothing particularly bad has happened. Yet Lindsay feels sad all the time and
can't shake it.
Lindsay may not realize it yet, but she is depressed.
Depression is very common and affects as many as 1 in 8 people in their teen years.
Depression affects people of every color, race, economic status, or age; however, it
does seem to affect more girls than boys.
Why Do People Get Depressed?
There is no single cause for depression. Many factors play a role including genetics,
environment, life events, medical conditions, and the way people react to things that
happen in their lives. The table below shows examples of each factor that may cause
depression.
Genetics
Life Events
Research shows
that depression
runs in families and
that some people
inherit genes that
make it more likely
for them to get
depressed. Not
everyone who has
the genetic makeup
for depression gets
depressed, though.
The death of a
family member,
friend, or pet can
go beyond normal
grief and
sometimes lead to
depression. Other
difficult life events,
such as when
parents divorce,
separate, or
remarry, can trigger
Family and Social
Environments
Medical Conditions
For some teens, a
Certain medical
negative, stressful, or conditions can affect
unhappy family
hormone balance and
atmosphere can
therefore have an
affect their selfeffect on mood. Some
esteem and lead to
conditions, such as
depression. This can
hypothyroidism, are
also include highknown to cause a
stress living situations depressed mood in
such as poverty;
some people. When
homelessness; and
these medical
violence in the family,
conditions are
And many people
depression. Even
relationships, or
who have no family events like moving
community.
history of
or changing
depression have
schools can be
Substance use and
the condition. So
emotionally
abuse also can cause
although genes are challenging enough chemical changes in
one factor, they
that a person
the brain that affect
aren't the single
becomes
mood — alcohol and
cause of
depressed.
some drugs are
depression.
known to have
depressant effects.
The negative social
and personal
consequences of
substance abuse also
can lead to severe
unhappiness and
depression.
diagnosed and treated
by a doctor, the
depression usually
disappears.
For some teens,
undiagnosed learning
disabilities might block
school success,
hormonal changes
might affect mood, or
physical illness might
present challenges or
setbacks.
Human Reactions to Depression
A woman by the name of Elisabeth Kubler-Ross was interested in finding out how
people react when grieving. If you have ever lost a loved one, what emotions did you go
through when you heard the news? Kubler-Ross came up with a process that she felt
described what a lot of people go through when grieving:
1. Stage One: Denial and Isolation: The grieving person refuses to accept the
reality of the death.
2. Stage Two: Anger: The person is continuing to resist reality and to ask, "Why
me? Why not that old person down the street?"
3. Stage Three: Bargaining: The person tries to reverse reality, in various irrational
ways, as in "bargaining with God," promising to do certain good works, etc.
4. Stage Four: Depression: Reflects the person's recognition of reality.
5. Stage Five: Acceptance:The person no longer denies reality, no longer feels
angry about it, no longer tries to bargain it away, no longer feels depressed about
it, but contemplates his/her death with quiet expectation.
It is important to remember that this is just one person's theory; however, I do feel
that she isn't too far off with her stages. Some people may experience all five of
these stages, whereas others may only experience a few if any at all.
What Happens in the Brain When Someone Is Depressed?
Depression involves the brain's delicate chemistry — specifically, it involves chemicals
called neurotransmitters. These chemicals help send messages between nerve cells in
the brain. Certain neurotransmitters regulate mood, and if they run low, people can
become depressed, anxious, and stressed. Stress also can affect the balance of
neurotransmitters and lead to depression.
Sometimes, a person may experience depression without being able to point to any
particular sad or stressful event. People who have a genetic predisposition to depression
may be more prone to the imbalance of neurotransmitter activity that is part of
depression.
Medications that doctors use to treat depression work by helping to restore the proper
balance of neurotransmitters.
Questions for Thought
Why do you feel so many people are depressed in this world? Assuming a person's
depression is not physiologically based, what do you think could help alleviate this
person's depression?
depression.jpg image from www3.whig.com
Types of Depression
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Major depression
Dysthymia
Adjustment disorder with depressed mood
Bipolar disorder
For some people, depression can be intense and occur
in bouts that last for weeks at a time. For others,
depression can be less severe but can linger at a low
level for years.
Doctors who treat depression distinguish between these
two types of depression. They call the more severe,
short-lasting type major depression, and the longerlasting but less severe form dysthymia (pronounced:
diss-thy-me-uh).
A third form of depression that doctors may diagnose is called adjustment disorder
with depressed mood. This diagnosis refers to a depressive reaction to a specific life
event (such as a death, divorce, or other loss), when adjusting to the loss takes longer
than the normally expected timeframe or is more severe than expected and interferes
with the person's daily activities.
Bipolar disorder (also sometimes called manic depressive illness) is another
depressive condition that involves periods of major depression mixed with periods of
mania. Mania is the term for abnormally high mood and extreme bursts of unusual
activity or energy.
What Are the Symptoms of Depression?
Symptoms that people have when they're depressed can include:
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depressed mood or sadness most of the time (for what may seem like no reason)
lack of energy and feeling tired all the time
inability to enjoy things that used to bring pleasure
withdrawal from friends and family
irritability, anger, or anxiety
inability to concentrate
significant weight loss or gain
significant change in sleep patterns (inability to fall asleep, stay asleep, or get up
in the morning)
feelings of guilt or worthlessness
aches and pains (with no known medical cause)
pessimism and indifference (not caring about anything in the present or future)
thoughts of death or suicide
When someone has five or more of these symptoms most of the time for 2 weeks or
longer, that person is probably depressed.
Teens who are depressed may show other warning signs or symptoms, such as lack of
interest or motivation, poor concentration, and low mental energy caused by depression.
They also might have increased problems at school because of skipped classes.
Some teens with depression have other problems too, and these can intensify feelings of
worthlessness or inner pain. For example, people who cut themselves or who have
eating disorders may have an unrecognized depression that needs attention.
Getting Help
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Depression is one of the most common emotional problems in the United States
and around the world. The good news is that it's also one of the most treatable
conditions. Therapists and other professionals can help. In fact, about 80% of
people who get help for their depression have a better quality of life — they feel
better and enjoy themselves in a way that they weren't able to before.
Treatment for depression can include talk therapy, medication, or a combination
of both. Talk therapy with a mental health professional is very effective in treating
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depression. Therapy sessions can help people understand more about why they
feel depressed, and ways to combat it.
Sometimes, doctors prescribe medicine for a person who has depression. When
prescribing medicine, a doctor will carefully monitor patients to make sure they
get the right dose. The doctor will adjust the dose as necessary. It can take a few
weeks before the person feels the medicine working. Because every person's
brain is different, what works well for one person might not be good for another.
Everyone can benefit from mood-boosting activities like exercise, yoga, dance,
writing in a journal, or art. It can also help to keep busy no matter how tired you
feel.
People who are depressed shouldn't wait and hope it will go away on its own
because depression can be effectively treated. Friends or others need to step in
if someone seems severely depressed and isn't getting help.
Many people find that it helps to open up to parents or other adults they trust.
Simply saying, "I've been feeling really down lately and I think I'm depressed,"
can be a good way to begin the discussion. Ask your parent to arrange an
appointment with a therapist. If a parent or family member can't help, turn to your
school counselor, best friend, or a help line to get help.
When Depression Is Severe
People who are extremely depressed and who may be thinking about hurting
themselves or about suicide need help as soon as possible. When depression is this
severe, it is a very real medical emergency, and an adult must be notified. Most
communities have suicide hotlines where people can get guidance and support in an
emergency.
Although it's important to be supportive, trying to cheer up a friend or reasoning with him
or her probably won't work to help depression or suicidal feelings go away. Depression
can be so strong that it outweighs a person's ability to respond to reason. Even if your
friend has asked you to promise not to tell, severe depression is a situation where telling
can save a life. The most important thing a depressed person can do is to get help. If
you or a friend feels unsafe or out of control, get help now! Tell a trusted adult, call 911,
or go to the emergency room.
suicidehelp.jpg image from ehow.com
Suicide
Suicide is defined as the intentional taking of one's life. It is important to recognize the
warning signs of suicide and seek help if you or someone you know is suffering from
severe depression. Suicide is a permanent solution to a temporary problem!
Case Study: Ethan
Ethan felt like there was no point going on with life. Things had been tough since his
mom died. His dad was working two jobs and seemed frazzled and angry most of the
time. Whenever he and Ethan talked, it usually ended in yelling.
Ethan had just found out he'd failed a math test, and he was afraid of how mad and
disappointed his dad would be. In the past, he always talked things over with his
girlfriend — the only person who seemed to understand. But they'd broken up the
week before, and now Ethan felt he had nowhere to turn.
Ethan knew where his dad kept his guns. But as he was unlocking the cabinet, he
heard his kid sister arriving home from school. He didn't want Grace to be the person
to find him, so he put the gun back and went to watch TV with her instead. Later,
when he realized how close he'd come to ending his life, Ethan was terrified. He
summoned the courage to talk to his dad. After a long conversation, he realized how
much his dad cared. All he could think of was how he'd almost thrown it all away.
Why Do Teens Try to Kill Themselves?
Most teens interviewed after making a suicide attempt say that they did it because they
were trying to escape from a situation that seemed impossible to deal with or to get relief
from really bad thoughts or feelings. Like Ethan, they didn't want to die as much as they
wanted to escape from what was going on and at that particular moment dying seemed
like the only way out.
Some people who end their lives or attempt suicide might be trying to escape feelings of
rejection, hurt, or loss. Others might be angry, ashamed, or guilty about something.
Some people may be worried about disappointing friends or family members, and some
may feel unwanted, unloved, victimized, or like they're a burden to others.
We all feel overwhelmed by difficult emotions or situations sometimes. But most people
get through it or can put their problems in perspective and find a way to carry on with
determination and hope. So why does one person try suicide when another person in the
same tough situation does not? What makes some people more resilient than others?
What makes a person unable to see another way out of a bad situation besides ending
his or her life?
The answer to those questions lies in the fact that most people who commit suicide have
depression.
Suicide Is Not Always Planned
Sometimes a depressed person plans a suicide in advance. Many times, though, suicide
attempts happen impulsively, in a moment of feeling desperately upset. A situation like a
breakup, a big fight with a parent, an unintended pregnancy, or being victimized in any
way can cause someone to feel desperately upset. Often, a situation like this on top of
an existing depression, acts like the final straw.
Some people who attempt suicide mean to die and some aren't completely sure they
want to die. For some, a suicide attempt is a way to express deep emotional pain. They
can't say how they feel, so for them, attempting suicide feels like the only way to get their
message across. Sadly, many people who really didn't mean to kill themselves end up
dead or critically ill.
Warning Signs
There are often signs that someone may be thinking about or planning a suicide attempt.
Here are some of them:
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talking about suicide or death in general
talking about "going away"
referring to things they "won't be needing," and giving away possessions
talking about feeling hopeless or feeling guilty
pulling away from friends or family and losing the desire to go out
having no desire to take part in favorite things or activities
having trouble concentrating or thinking clearly
experiencing changes in eating or sleeping habits
engaging in self-destructive behavior (drinking alcohol, taking drugs, or cutting,
for example)
Questions for Thought
Your friend says, "I wonder who would come to my funeral" one night while you are
chatting on the phone. A few days later he/she drops out of the marching band and
starts giving away their prized positions. What would you do? How could you help? What
organizations could you turn to in order to help your friend - or refer your friend to for
help.
Getting Help
What if This Is You?
If you have been thinking about suicide, get help now. Depression is powerful. You can't
wait and hope that your mood might improve. When a person has been feeling down for
a long time, it's hard to step back and be objective.
Talk to someone you trust as soon as you can. If you can't talk to a parent, talk to a
coach, a relative, a school counselor, a religious leader, or a teacher. Call a suicide
crisis line or your local emergency number (911). These toll-free lines are staffed 24
hours a day, 7 days a week by trained professionals who can help you without ever
knowing your name or seeing your face. All calls are confidential — no one you know will
find out that you've called. They are there to help you figure out how to work through
tough situations.
What if It's Someone You Know?
It is always a good thing to start a conversation with
someone you think may be considering suicide. It
allows you to get help for the person, and just
talking about it may help the person to feel less
alone and more cared about and understood.
Talking things through may also give the person an
opportunity to consider other solutions to problems.
Most of the time, people who are considering
suicide are willing to talk if someone asks them out of concern and care. Because
people who are depressed are not as able to see answers as well as others, it can help
to have someone work with them in coming up with at least one other way out of a bad
situation.
Even if a friend or classmate swears you to secrecy, you must get help as soon as
possible — your friend's life could depend on it. Someone who is seriously thinking
about suicide may have sunk so deeply into an emotional hole that the person could be
unable to recognize that he or she needs help. Tell an adult you trust as soon as
possible.
If necessary, you can also call the toll-free number for a suicide crisis line or a local
emergency number (911). You can find local suicide crisis or hotline numbers listed in
your phone book. These are confidential resources and the people at any of these
places are happy to talk to you to help you figure out what is best to do.
Sometimes, teens who make a suicide attempt — or who die as a result of suicide —
seem to give no clue beforehand. This can leave loved ones feeling not only grief
stricken but guilty and wondering if they missed something. It is important for family
members and friends of those who die by suicide to know that sometimes there is no
warning and they should not blame themselves.
When someone dies by suicide the people left behind can wrestle with a terrible
emotional pain. Teens who have had a recent loss or crisis or who had a family member
or classmate who committed suicide may be especially vulnerable to suicidal thinking
and behavior themselves.
If you've been close to someone who has attempted or committed suicide, it can help to
talk with a therapist or counselor — someone who is trained in dealing with this complex
issue. Or, you could join a group for survivors where you can share your feelings and get
the support of people who have been in the same situation as you.
help.jpg image from moneywise.co.uk
Coping With Problems
Being a teen is not easy. There are many new social, academic, and personal
pressures. And for teens that have additional problems to deal with, such as living in
violent or abusive environments, life can feel even more difficult.
Some teens worry about relationships, wondering if their feelings are normal, or if they
will be loved and accepted. Others struggle with body image and eating problems; trying
to reach an impossible ideal leaves them feeling bad about themselves. Some teens
have learning problems or attention problems that make it hard for them to succeed in
school. They may feel disappointed in themselves or feel they are a disappointment to
others.
These problems can be difficult and draining — and can lead to depression if they go on
too long without relief or support. We all struggle with painful problems and events at
times. How do people get through it without becoming depressed? Part of it is staying
connected to family, friends, school, faith, and other support networks. People are better
able to deal with tough circumstances when they have at least one person who believes
in them, wants the best for them, and in whom they can confide. People also cope better
when they keep in mind that most problems are temporary and can be overcome.
When struggling with problems, it helps to:
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Tell someone you trust what's going on with you.
Be around people who are caring and positive.
Ask someone to help you figure out what to do about a problem you're
facing.
Work with a therapist or counselor if problems are getting you down and
depressed — or if you don't have a strong support network, or feel you
can't cope.
Counselors and therapists can provide emotional support and can help teens build their
own coping skills for dealing with problems. It can also help to join a support network for
people who are going through the same problems — for example, anorexia and body
image issues, living with an alcoholic family member, or sexuality and sexual health
concerns. These groups can help provide a caring environment where you can talk
through problems with people who share your concerns.
Check out your phone book to find local support groups, or ask a school counselor or a
youth group leader to help you find what you need.
In Summary
People often commit suicide impulsively, because they think their pain will not go away,
and even because they know someone who has committed suicide. Did you know
that 50% of people who commit suicide or attempt to commit suicide are under the
influence of alcohol &/or drugs when they kill themselves? So, did these people
really mean to do it or were the drugs or alcohol acting as "liquid courage"? If you or
someone you know has experienced any of the signs/symptoms listed above, please
know that life is definitely worth living and help is available! People who think about or
attempt suicide usually do not want to die. Rather, their actions are a plea for help.
There are many organizations you can go to for help. One is the"Suicide Prevention
Action Network" (SPAN USA). Another is the Nation's Youth Violence Prevention
Resource Center. Both of these resources have a website and telephone hotline to
obtain more information if needed.
Hierarchy of Needs
A man by the name of Abraham Maslow viewed life as a "constant struggle to meet
one's needs." Have you ever thought of life that way? For example: the need to have
money, the need to buy food, the need to have acquaintances and friends, and so forth.
Maslow developed a hierarchy of the category of needs he felt a person had throughout
his/her life. As you view the hierarchy below, keep in mind that the base represents
needs from birth, whereas the top are needs experienced in later life. Not all people will
reach self actualization-some people will only progress to a certain point on Maslow's
Hierarchy and accept this as their stopping point.
Self
Self fulfilled, independent & creative
Actualization
Aesthetic Needs The needs to know, explore & understand
Achievement
The needs to achieve, be recognized
Needs
The needs to belong, love, be loved, be
Safety Needs
safe, secure & out of danger
Physiological
The needs to satisfy hunger, thirst, sleep,
Needs
& to have shelter