Download Understanding Your Adolescent

Understanding Adolescent Pain
Providing essential pieces for dealing with issues
of an adolescent with depression
Key understandings
All kids are good
 Kids are trying to do the best they can
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They
 They
 They
 They
 They
 They
 They
 They
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want to fit in/be accepted
want to be liked and loved
want to please others
are stressed
are scared about the future
don’t feel that anyone understands
want to feel secure and in control
want to feel good
They want to be…
 LOVED
 UNDERSTOOD
 ACCEPTED
DEPRESSION
Anger turned inward
What to look for: Warning Signs
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Unexplainable changes in…
Friends
 Grades
 Behavior
 Habits
 Hobbies
 Activities
 Body appearance
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Unsure?
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At this point, If you’re unsure if an adolescent in
your life is depressed or just “being a teenager,”
consider how long the symptoms have been
present, how severe they are, and how
different the teen is acting from his or her
usual self.
dramatic, long-lasting changes in personality,
mood, or behavior are red flags of a deeper
problem. 2-3 weeks… More often than not.
Duration-Severity-Real Change
Key Understanding
If a teenager can identify the causes of
there depression then it normally isn’t
clinical depression
 Name it, Claim it, and Tame it!
 Depression will not just go away
 Depression needs intervention
 Depression is hard to understand
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Major Depression
Considered a Mood Disorder
 Can be episodic or recurrent
 Psychological and physical components
 Highly treatable
 Often misunderstood and undiagnosed
especially in teenagers
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Major Depression
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A combination of symptoms that
interfere with ability to work, study,
sleep, eat and enjoy once pleasurable
activities and which may occur only
once or several times
Symptoms:
Depression
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Major Depressive Disorder requires two or more
major depressive episodes.
Diagnostic criteria:
 Depressed mood and/or loss of interest or pleasure
in life activities for at least 2 weeks and at least five
of the following symptoms that cause clinically
significant impairment in social, work, or other
important areas of functioning almost every day
At least 5…
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1.Depressed mood most of the day.
2.Diminished interest or pleasure in all or
most activities. (Quit)
3.Significant unintentional weight loss or gain.
4.Insomnia or sleeping too much.
5.Agitation or psychomotor retardation
noticed by others.
6.Fatigue or loss of energy.
7.Feelings of worthlessness or excessive guilt.
8.Diminished ability to think or concentrate,
or indecisiveness.
9.Recurrent thoughts of death (APA, 2000, p. 356).
Teen specific…
The difference between teenage and adult depression
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Irritable or angry mood
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Unexplained aches and pains
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Extreme sensitivity to criticism
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Withdrawing from some, but not all people
– As noted above, irritability, rather than
sadness, is often the predominant mood in depressed teens. A depressed teenager
may be grumpy, hostile, easily frustrated, or prone to angry outbursts.
- Depressed teens frequently complain
about physical ailments such as headaches or stomachaches. If a thorough physical
exam does not reveal a medical cause, these aches and pains may indicate
depression.
- Depressed teens are plagued by
feelings of worthlessness, making them extremely vulnerable to criticism, rejection,
and failure. This is a particular problem for “over-achievers.”
- While adults tend to
isolate themselves when depressed, teenagers usually keep up at least some
friendships. However, teens with depression may socialize less than before, pull
away from their parents, or start hanging out with a different crowd.
Untreated Depression Can
Lead to…
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Problems at school -Depression can cause low energy and
concentration difficulties. At school, this may lead to poor attendance,
a drop in grades, or frustration with schoolwork in a formerly good
student.
Running away - Many depressed teens run away from home or talk
about running away. Such attempts are usually a cry for help.
Substance abuse - Teens may use alcohol or drugs in an attempt to
“self-medicate” their depression. Unfortunately, substance abuse only
makes things worse.
Low self-esteem - Depression can trigger and intensify feelings of
ugliness, shame, failure, and unworthiness.
Eating disorders - Anorexia, bulimia, binge eating, and yo-yo dieting
are often signs of unrecognized depression.
Cont.
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Internet addiction - Teens may go online to escape from their
problems. But excessive computer use only increases their isolation
and makes them more depressed. Cyberbullying and harrassment.
Falsifying identity on Social networks like Twitter and Facebook.
Self-injury - Cutting, burning, and other kinds of self-mutilation are
almost always associated with depression. (Piercings and Tattoos)
Reckless behavior - Depressed teens may engage in dangerous or
high-risk behaviors, such as reckless driving, out-of-control drinking,
and unsafe sex.
Illegal behaviors – Shoplifting and Theft (Chemical High)
Violence - Some depressed teens (usually boys who are the victims
of bullying) become violent. As in the case of the Columbine school
massacre, self-hatred and a wish to die can erupt into violence and
homicidal rage.
Suicide - Teens who are seriously depressed often think, speak, or
make "attention-getting" attempts at suicide. Suicidal thoughts or
behaviors should always be taken very seriously.
Suicide warning signs
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Talking or joking about committing suicide
Saying things like, “I’d be better off dead,” “I wish I could disappear
forever,” or “There’s no way out.”
Speaking positively about death or romanticizing dying (“If I died,
people might love me more”)
Writing stories and poems about death, dying, or suicide
Engaging in reckless behavior or having a lot of accidents resulting
in injury
Giving away prized possessions
Saying goodbye to friends and family as if for the last time
Seeking out weapons, pills, or other ways to kill themselves
These are serious issues…they are scary…any serious illness is!
Suicide is a game changer
 Ask
the tough questions?
 Do
you want to kill yourself?
 How will you do it?
 Do you have the means?
Help before the sun goes down!
Get
an assessment…Call 911 or ER!
Do not leave alone!
Realize this…
Depression effects 20% of teens
2x as many girls as boys
Experts say only one in five
depressed teens receive help.
1 in 5…Why?
Very treatable illness
take them to a doctor!
If not depression, then what is it?
Terminology is Essential
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Depression –
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Persistent Depressive Disorder (Dysthemia)
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Seasonal Affective Disorder
General Anxiety Disorder
Worrier
Grief or Bereavement
Sadness
Unhappiness
Stressed out
Blahs
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clinical sadness often linked to Serotonin and other
unknown reasons -DISTRACT or RUMINATE
Stress
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What is stress: physiological response
to a psychological or physical stimuli
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Ultimately, energy to respond
Eustress v. Distress
Eustress: positive energy to respond
 Distress: negative amount of energy
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Analogy of the Bucket
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Puppies must be walked…OR ELSE!
The Bucket must be
either…
Emptied or Made Larger
Unhappiness: Why?
Too High or Too Low of expectations
from self or others – never good
enough or always successful but no
fulfillment
 Missing or Broken tile syndrome –
Christmas tree lights- one out…all out!
 Comparison to others: the Uberperson
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Is this what you want?
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master-photoshopper merging
Catherine Zeta-Jones, Charlize Theron,
Angelina Jolie and Keira Knightly.
The negative symptoms
dart board
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Adolescence tend to go from one
symptom to another searching for help
and relief
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Drinking and Drugs
Cutting
Sex/ bad relationships
Stealing
Lying
Escape – Internet and Video gaming
Change of behaviors – anger and acting out
When to act?
When symptoms persist or get worse
 persistent sad, anxious, or “empty” mood
 feelings of hopelessness, pessimism
 feelings of guilt, worthlessness, helplessness,
 loss of interest or pleasure in hobbies or activities once enjoyed
 decreased energy, fatigue, being “slowed down”
 difficulty concentrating, remembering, making decisions
 insomnia, early morning awakening or oversleeping
 appetite and/or weight loss or overeating and weight gain
 thoughts of death or suicide, attempts of suicide
 restlessness and irritability
 persistent physical symptoms which do not respond to treatment
 headaches, digestive disorders, chronic pain...
Helping a depressed
teenager
Talk to your teen
 Ask the school for guidance
 Visit your family doctor
 Call your insurance company
 Seek out a specialist
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Explore the treatment options
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Talk Therapy, Medication, Family support services, Educational
Classes, Behavior Management techniques, as well as Family
therapy
TIPS FOR TALKING TO A DEPRESSED TEEN
 Offer
Support
 Be gentle but persistent
 Listen without lecturing
 Validate feelings
The positive dartboard
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Given the opportunity and training, teens
will opt for healthy responses too
Exercise and sports
 Appropriate emotional expression
 Positive social interactions
 Prayer
 Playing
 Relaxation
 Talking
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What to do…
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The most important thing we can do is have a
consistent relationship with our children.
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THIS INCLUDES:
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providing them limits,
providing guidance and support in decision-making,
providing them discipline
being aware of what's happening in their lives daily
AND
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Seeking advice and help when needed
Remember…
 …the
peer group is important to
young adolescents, and there’s
nothing wrong with that. Parents
are often just as important,
however. Don’t give up on the idea
that you make a difference.
Final Thoughts…
Step back; Put the puzzle together
 Learn to be aware
 Once you start seeing these symptoms
 Talk about it (Saying it doesn’t make it)
 Seek Help (MUCH EASIER EARLY, than LATER)
 If you suspect that a teenager in your life
is suffering from depression, speak up
right away and do something.
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resources
Cuyahoga County Board of Mental
Health
 Helpguide .org
 National Institute of Mental Health
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http://www.nimh.nih.gov