This page created 5th April, 2008

Jaimee was having a hard time. She has always been good at her school work, but recently she has not been handing anything in. It was not because she did not want to, it was just that she was not able to organise herself to do it. For hours at night-time she would just lie in bed thinking about nothing in particular and not be able to get to sleep. Her parents were becoming upset with her because she had trouble getting up in the mornings and she told them she wanted to quit gymnastics after being a part of it for nearly 10 years. She stopped her singing lessons too, she just did not have the energy.

Kyle started getting into trouble at school. When the teachers asked him questions in class, he would usually not respond or just look down at the ground. His friends were starting to move away from him too because he was using a lot of sarcasm or would simply not want to socialise with them. It was obvious that he was not showering very often, and sometimes the other students could smell alcohol and cigarettes on him even before school.

Brianna had always had a lot of friends, but recently she had stopped going out with them as much. They noticed that she had stopped smiling as often as she used to. Inside, Brianna was feeling “numb”. She did not feel either happy or sad, she just did not seem to feel anything. But she wanted to feel something, so she started cutting herself. It made her feel pain which she thought was better than feeling nothing at all. She liked to watch the blood drip down her leg. But still she did not feel happy. She did not know what else to do…

Often teens experience a range of symptoms of depression. It is often different to adult depression, so some of the signs are below. Remember, it does not necessarily mean that you have depression if you have a number of these symptoms, but you may have depression even if you do not have many symptoms.

Emotional Signs (Feelings) – Sadness, loss of pleasure/interest, anxiety, turmoil, irritability, guilt, indecisiveness, worthlessness

Cognitive Signs (Thoughts) – Difficulty organising thoughts, negative view, helplessness, hopelessness, isolation, suicidal thoughts

Physical Signs – Headaches/stomach aches, changes in appetite or weight, sleep disturbances, sluggishness, fidgety/restlessness, poor concentration

Behavioural Signs – Avoidance, withdrawal from close friends & family (but not necessarily all), frequent absences from school, clingy, demanding, activities in excess, self-harm, alcohol and drugs

The adolescents in the first section each had difficulties which interfered with their every day lives.

Jaimee’s work was affected, which meant that she was getting into trouble at school and her parents were upset with her. She was not sleeping well, and was finding it hard to get up in the mornings. She started hating herself because she felt guilty about letting everyone down.

Kyle was not happy with his life, so he began “self-medicating” using cigarettes and alcohol. His friends were being pushed away so he was very much alone. So he used more drugs because he did not want to feel so lonely. It was a never-ending cycle.

Brianna did not feel anything, so started hurting herself physically because her world seemed pointless. The things that had given her pleasure before no longer meant anything to her. She did not know how to feel her feelings.

In all three of these situations, they were bright and productive young teens before the depression overwhelmed them. They had not known how to identify the symptoms, so the illness was taking over every part of their lives. But as soon as their problems were identified, with some help they were well on the road to recovery. Decision-making is hard with depression (the chemicals in the brain change, so the connections do not work as well as they are supposed to). It was not their fault, and as soon as they realised that it was like any other illness, they were able to find the help that they needed.

Child and adolescent depression is common. Around 1 in 8-10 teenagers (approximately 1 in 5 adults) suffer from this illness, but most of them feel that they are the only ones. You cannot tell that someone has depression by looking at them. They can still smile and pretend that everything is OK, but inside they may be feeling sad, angry or empty. In a typical classroom there might be 3 students with depression, but many do not recognise it and do not get help. Depression is like any other illness – if it is short and mild then it may well go away by itself in time. However, if you get some help, you can learn how to manage it yourself, help your body heal, and reduce the chance of getting it again. And you can be shown ways of preventing a relapse in the future. As with any illness, the earlier you get help, the easier it is to treat. Adolescents (and adults) who have recovered from depression talk about their “dark” or “foggy” times, and how they did not really believe that they could find happiness again. With a bit of support and guidance, you can find your way back to enjoying life again!

While there is evidence that suggests that you can inherit a disposition towards depression, this does not mean that you will get it even if both of your parents have it. There are other factors involved, such as the experiences you have had in your life. It depends on the way that you deal with the situations you face (eg. Do you usually look for the positives? Do you accept that you are not perfect? Do you discuss your issues with trusted people? Do you worry excessively?). These are all “learned behaviours” and therefore can be changed.

No one is to blame for having depression (and we now know that the amount of people with it is very high), and we need to concentrate on treating it.

There are a variety of treatments available for depression which will be described using 3 broad categories.

TALKING THERAPIES

One of the more widely researched treatments is CBT (Cognitive Behavioural Therapy). This is where the psychologist (or other health professional) teaches the adolescent new ways of “thinking” about situations that they face, or how to change their behaviour to make themselves happier. An example is: Is getting a B on a maths exam good or bad? The answer depends on the way that you think about it. If you had studied but said to yourself that the test was difficult and you tried hard and got a B, you would probably be excited. If you had studied and said to yourself that despite the test being hard, you should have done better, then you might feel like a failure. If you did not like the subject and did not care about the marks, then you would not worry about what you got. Here are 3 ways of looking at the same situation, but with different thoughts in your head which leads to very different feelings.

There are a number of other therapies which are similar to CBT (such as REBT, RET, Mindfulness, Acceptance & Commitment Therapy, etc.) that are found to be effective in the treatment of depression.

Other therapies which work well for many people include narrative, psychodynamic, hypnosis and brief solution-focussed.

MEDICATION

Doctors and psychiatrists prescribe medications such as SSRI’s (Selective Serotonin Reuptake Inhibitors) to help balance the chemicals in the brain. However there are mixed views on giving these to children and teens, so many treating professionals will recommend a less invasive treatment first before going down this path. It is important to note that a lot of studies suggest that if someone is given medication, they will do better if they also have some “talking therapy” with the intention of making lifestyle and behavioural changes.

ALTERNATIVE TREATMENTS

Other available treatments include various herbal remedies, vitamins, acupuncture, massage, getting better sleep, etc. Some of these may be very helpful, but some may be damaging, and some may not have any effect whatsoever. Before taking any herbal medications or vitamins, check with your doctor first!

For more information on child and adolescent depression, here are a few websites that you can visit:

• www.beyondblue.org.au
• www.depressionet.com.au
• www.reachout.com.au
• www.psychonline.com.au
• www.ybblue.com.au

A prevention program for children and teens (which helps teach positive “self-talk” skills) is the “Life Strategies Programs” which are run in Melbourne. For more information on these programs, ring Sally-Anne McCormack on (03) 881 22 373 or go to her website at www.psychonline.com.au

The school psychologist is a great person to speak to. He/she will have dealt with many adolescents in a similar position to you, and if they cannot help you, they will know where to find you the best person to meet your needs.

Your family doctor is also a good resource. They will know what to do if you need assistance.

If you have access to a telephone, then here are some numbers that you can ring:

• Kid’s Helpline 1800 55 1800 (free from a landline)
• Lifeline 13 11 14 (local call from a landline)
• Suicide Helpline 1300 651 251 (toll free from a landline)

If you need immediate help, then ring for an ambulance on 000.

DID YOU KNOW :

• In 2003 there were 55,753 Victorians under the age of 20 who were prescribed anti-depressants. This statistic does not take into account those who did not receive medications.
• Before puberty, the risk factors are the same for boys and girls
• After the onset of puberty, the rate of depression is about twice as high in girls.
• Children can experience depression at any age, even shortly after birth!
• A survey in 2004 showed that about 8% of AFL players had sought help for depression (this statistic is likely to be higher now)
• The World Health Organisation estimates that by the year 2020 depression will be the second most debilitating condition in the developed world.
• Martin Seligman (psychologist/author of “The Optimistic Child”) found that 2½ years after 10-year olds have completed a depression prevention program, their rate of moderate to severe depression was less than half the rate of those who have not done a program.

Some famous and successful people who have suffered from depression:

Elle Macpherson… …Supermodel

Ben Stiller… …Actor

Monica Seles… …Pro Tennis Player

Dawn Fraser… …Pro Swimmer / Olympic Gold Medalist

Jim Carrey… …Comedian

Janet Jackson… …Singer

Diana, Princess of Wales… …Royalty

Albert Einstein… …Scientist

Billy Joel… …Musician / Composer

Drew Barrymore… …Actress

Winston Churchill… …British Prime Minister

Cathy Freeman… …Olympic Gold Medalist

Michael Slater… …Former Australian Cricketer

Wayne Schwass… …AFL Football player

Most children and teens respond well to therapy. Some therapies (such as CBT) are designed to be short-term, and many students notice some changes within the first week or two (as long as they do the “homework” tasks they may be asked to do). This type of treatment is where you are taught skills and strategies to help you manage your thinking and feel more positive.

An episode of depression will usually go away over time (even without any help). But you are at risk of having another one unless you make some changes. For those who respond well to therapy (and keep using some of the strategies), it is possible that you will never have another severe episode.

And for those who have not had depression but might be at risk, if you have the opportunity to enrol in a preventative program, you reduce the chances of having depression according to Martin Seligman.

Remember – depression is very common, and there are many people you can turn to for help, and the internet (reputable sites!) can provide a lot of helpful information for you.

Sally-Anne’s top five techniques for adolescent mental health

• CBT
• Having a good sleep routine
• Getting regular exercise
• Eating healthy foods (and drinking water)
• Scheduling “Pleasant Activities” every day

Sally-Anne’s top four Reading and Viewing Materials

• “The Optimistic Child” by Martin Seligman
• Other books by Martin Seligman (eg. Authentic Happiness)
• www.ybblue.com.au
• www.reachout.com.au

Sally-Anne’s top three referral sources

• Resources page on Depressionet
• Resources page on BeyondBlue
• www.reachout.com.au

Sally-Anne’s top two pieces of comforting information

• Depression can be beaten! For most people, it is just making sure that you become aware of you
• feelings, and ask yourself if your self-talk is helpful or not.
• You are not alone! There are probably others in your class who have similar feelings to you.

Sally-Anne’s One top tip for dealing with mental health issues

The most important thing that you can do is to ask for help! If you are never happy, and nothing seems to be going right for you, put up your hand and let a responsible adult know. There IS treatment for mental health issues, and the earlier you get help, the quicker you will get better!