Talking About Mental Health
April, 2014
“Exercise and hard work!”
Have you ever heard this advice provided to
someone suffering from depression? How about this
one: “What have you got to be sad about? You have
so much going for you - your health, your family –
stop feeling sorry for yourself!” Comments like these
suggest that depression isn’t real, that the sufferer is
lazy, unmotivated, or just not grateful enough. But
we know that depression is very real. And, in
adolescents, depression is often dismissed.
behavioural signs. Often these are first dismissed as
typical adolescent changes. But when adolescents
withdraw from recreational or sports activities, lose
interest in friends, when sleeping and eating are
severely affected, when grades start to suffer, when
they turn to drugs or alcohol to self-medicate against
the pain, or when there is talk of giving up or dying,
we realize that something is very, very wrong.
What causes depression? Like all things related to
with mental health, it is complicated. But we know
that adolescent depression doesn’t develop ‘out of
the blue’. A period of depression is common when
one has experienced an acute, terrible stressor such
as a tragic event or catastrophic loss. Or, it can
develop gradually in response to living
Depression is a serious condition that
with chronic stress (family conflict,
involves severe, chronic feelings of
poverty, neglect, chaos, social isolation,
sadness and loss of interest in life (the
“For
every
loss, trauma, etc.). In the presence of
emotional symptoms). It also has
complex
ongoing, unbearable stress, human
cognitive symptoms such as negative
problem
there
coping becomes compromised and
thoughts and painful beliefs of
is a simply
depression can follow.
unworthiness, helplessness, and
solution
–
that
hopelessness. Depression is different
Adolescents are particularly vulnerable to
doesn’t work “
from the mood swings adolescents can
depression because they experience
experience because of the duration
intense, changeable moods. When this is
-Mark Twain
(can last for weeks at a time) and
compounded by academic, social, or
because the mood does not lighten in
family pressure, uncertainty about the
response to positive events.
future - particularly if other chronic
Depression in teens and younger
stressors have been present – we have reason to be
children is often accompanied by physical
concerned.
symptoms, like headaches, changes in sleep, fatigue,
or joint pain.
How can we help? Mark Twain said, “For every
Together, these symptoms contribute to feeling
unable to think, unable to get motivated, and feeling
unwell. This is different from normal teen lethargy
because it is accompanied by a general sense of
helplessness and hopelessness. The adolescent can
feel overwhelmed and become preoccupied with
thoughts of giving up or dying.
What are the signs we might see, as parents or
educators? Frequent school absences or complaints
of being unwell, social withdrawal, irritability and
shortness with others, and changes in appearance or
loss of interest in self-care are some of the first
complex problem there is a simple solution - that
doesn’t work.” This applies well to depression.
In a quick-fix society we tend to turn first to
medication for relief of depression, but it is not that
simple. Mood stabilizers can lighten the mood
enough to allow a person breathing room, room to
function, to concentrate, to regulate sleep, and start
being slightly more active again. But medication
does not treat the cognitive symptoms - the
thoughts that I am unlovable, unworthy, can’t do
anything, or that my life has no meaning. These are
not helped by medication, and do not go away on
their own, even when mood improves. That is why
so many teens diagnosed with depression and
treated only with medication do well for a while but
soon slide back into depression.
The best treatment for adolescent depression is a
combination of therapy and medication, particularly
when the physical symptoms are severe. The most
effective therapies are cognitive behavioural therapy
(CBT) for the painful negative thoughts. Acceptance
and commitment therapy (ACT) focuses on
rediscovering values and feelings of effectiveness.
Interpersonal therapy (IPT) focuses on strengthening
the self in relationships. Group therapy is often very
successful with adolescents.
There are some excellent interactive self-help
websites for teens, such as mindyourmind.ca, or
teenmentalhealth.org. Information for parents can
be found at such sites as helpguide.org. And
teachers can find classroom support strategies in
Supporting Minds (gov.on.ca), a resource about
student mental health specifically developed for
Ontario educators.
Every one of us within Wellington Catholic can learn
a little more about adolescent depression. We can
learn to identify problems early and how to reach
out to teens who are suffering. As a board are
taking this one step further, undertaking mental
health prevention and promotion initiatives as part
of our 2014-2017 Mental Health & Addiction
Strategy, to be released this May. We believe that
together, families, schools, and the larger
community can provide a network of loving care
around our adolescents at this vulnerable time in
their lives. And we do this by talking about mental
health.
Dr. Brenda Kenyon is the Mental Health Lead for
Wellington Catholic District School Board.