Get Psyched- Teachers

Get Psyched Teachers -
Vol. 1 Issue 2

Recognizing and treating clinical depression changes outcome for our kids
Untreated mental illnesses add a burden to teaching and learning so imagine a system that recognizes disorders before the dysfunction seems too complicated and too difficult to solve. Clinical depression happens more often to teens than most know, or want to know, but recognizing and treating this serious disorder can alter and improve futures.

When kids are clinically depressed, they are wrapped in hopelessness and helplessness. They cannot imagine how to escape from this overwhelming emptiness nor do they have the energy-or ability-to try. Gradually, they withdraw. They stop going to after school activities, talking to family members, walking in the hallways with friends. You can usually find them alone in their rooms. And if they are still doing their homework, they're struggling more because it's harder to concentrate -sleep is not restful anymore. The difference between clinical depression and temporary upset is a matter of degree: Depression is more intense. Depression lasts longer. Depression is more serious and can lead to suicide.

Relationship to other illnesses
Some clinically depressed teens turn to alcohol or illegal drugs to "soothe" themselves. But eventually, the pain returns and often it is worse. Teachers and other adults working with youth need to realize that some teens who are at risk for future addictions have a diagnosable mental illness -clinical depression. And, among those who become "dual disordered", an average of four and a half years passed before they used alcohol and/or drugs to deal with their pain. 1 What's happened in those four years? Perhaps the symptoms were slow to reveal themselves; perhaps they were misread and ignored or dealt with as a behavioral issue; perhaps someone tried helping, but the school year ended. As is the case with all disabling conditions, early detection and intervention can positively re-route a teens pathway to the future.

Depression is also associated with eating disorders. Studies reveal that people with eating disorders suffer 50 per cent higher rates of other psychiatric disorders-including depression, anxiety disorders and substance abuse.2 Psychological factors can predispose a person to an eating disorder. People with anorexia are often perfectionists. They might be involved with sports which stress body image or live in a family that over-stresses dieting and weight. Take these factors, add being raised in a competitive environment, being teased about physical appearance, a diminished self-esteem and then mix it with a culture which equates personal power and beauty with unnaturally low body weight, and you have a candidate for an eating disorder.

Adults working within our school system can make a huge difference in a child's future by knowing more about the warning signs of these illnesses, talking to teens when they see these signs and alerting school counselors that a mental health problem may exist.

1 "When Nothing Matters Anymore: A Survival Guide for Depressed Teens", Beverly Cobain.
2 APA HelpCenter: Get the Facts: Eating Disorders, http://helping.apa.org

Help break the cycle
While traveling on the road to escape emotional pain, some teens can find themselves falling in a deep hole-one which can cause greater pain in the long run.

Early intervention and mental health treatment can help break this cycle and put kids back on track sooner. Schools can play a huge part in this process.

Some facts to help you

o Abusing drugs and/or alcohol and eating disorders can worsen depression or cause the symptoms of depression.

o Teens are most likely to experience Major depression, Dysthymia and Bi-polar disorder

o Depressed teens can feel awful for a long time before realizing something's seriously wrong.

o Depression comes in over 20 types, each varying in symptoms and severity.

o At age fourteen, twice as many girls as boys suffer from major depression.

o 50% of patients with eating disorders have had a depressive episode or anxiety attack prior to the onset of their disorder.

These are just a few of the concepts explored in the book "When Nothing Matters Anymore: A Survival Guide for Depressed Teens" by Beverly Cobain

What causes clinical depression?
Painful situations and multiple stresses will always be a part of life. People have different abilities to cope with the events that bombard our beings, but under the right combination of circumstances no one is immune. A few stressors influencing a teen's life are family problems, school pressures, boyfriend or girlfriend experiences, problems with friends or other conflict-producing events.

Don't be fooled
Depression in teens can be hidden by what appears right-outstanding grades, school leadership, and "ideal behavior". Other depressed teens who don't fit within the "popular" or "brainy" crowds hide their condition by trying NOT to attract attention. A recent comprehensive depression screening of high school students found that half of those who qualified for referral and treatment were NOT KNOWN to school psychologists or school social workers as being in need of help. 1

Observe closely
Depression comes in many types, degrees and symptoms. Because people often mistake clinical depression with other issues, recognition and treatment are delayed. Depression can be detected by talking to the teenager and closely watching behavior patterns. A talk with the family can help too because many of the symptoms will occur while home.

Some things to look for are excessive sadness, uncontrolled crying, comments about hopelessness, acting overwhelmed, seeming perpetually tired, withdrawing from friends and school activities-perhaps because "everyone looks down at me", "no one understands me", "I'm different from the other kids", over sensitivity in interpersonal relationships, highly reactive to rejection or criticism, reacting more frequently with anger and irritability or simply not reacting, seeming emotionally flat or sluggish, overreacting to disappointment or failure and taking a long time to recover, paying less attention to appearance, and changing to an "out-of-the-mainstream" peer group or "dropping" friends they "have problems with."

When a combination of these sign are noticed, teachers can either ask more questions to clarify the reasons for these behaviors or seek guidance from the school counselor.

Investigate with questions
You seem tired and distracted in class, how are you sleeping at night? How long have you had trouble sleeping? How's your appetite? You look thinner. How long has it been since you felt really hungry? Are you still interested in __________? Coach tells me you missed the last five practices, etc. How are you feeling inside? Is anything going on at home or in school that upsets you? Do you feel different as though your brain's too foggy and it's hard to understand what's being said during class? Does it seem as though too many things make you angry or upset?

Take action
Talk to a school counselor if you suspect an underlying psychiatric disorder. A Depression Screening tool exists that can easily be administered in the school setting or an outside evaluation can be recommended.

Some of this information is from "Parents & Teachers as Allies, Recognizing Early-onset Mental Illness in Children and Adolescents" a publication of the National Alliance for the Mentally Ill (NAMI). A copy of this publication is part of a LESSON PLAN PACKET being offered by COFAMH to staff who teach about health to upper elementary, middle and high school students. If you would like to receive the packet, "Breaking the Silence-Teaching the next generation about mental illness.
2. The information about the brain and its connection to mental illnesses are explored in the book "When Nothing Matters Anymore: A Survival Guide for Depressed Teens" by Beverly Cobain. Her name may sound familiar. She had a cousin Kurt Cobain, lead singer of the rock band Nirvana. He struggled with depression and drugs-and lost this struggle in 1994 when he took his own life. "When Nothing Matters Anymore" won a Benjamin Franklin Award from the Publishers Marketing Association. A copy is available at the Voices of the Heart Resource Center in Hudson Falls. The Center is a lending library which contains books, videos and articles on a variety of mental health issues and topics. These may be signed out for a month. Call 747-8404 or email Voices of the Heart staff.

When the brain's ability to make bridges is broken

There is a connection between the brain, and the body. In fact, the body relies on the brain's messages to keep a person alive and healthy. Imbalances in this system can lead to mental, emotional and even physical changes.2

Chemicals called Neurotransmitters -norepinephrine, dopamine, serotonin-are produced in the brain and used to transport messages along neurons-specialized nerve cells. The gap between these cells is called a synopse. In order to cross this gap, the transmitting cell releases one of its neurotransmitters (e.g. serotonin) to form a bridge. This process is repeated until the message reaches its destination and the chemical is reabsorbed by the transmitting cell. Insufficient neurotransmitters disrupt the message delivery system and lead to abnormal functioning. This abnormality creates the symptoms of depression.

Sick nerve cells impair abilities
The brain's limbic system includes areas of responsible for different tasks which help regulate emotions and motivations. Some of these are:

THALAMUS
Screens and sorts messages from your senses. If this message isn't delivered, one result might be that foods don't look, taste or smell appealing.

HYPOTHALAMUS
The sources of feelings controls blood pressure, thirst and appetite. If this is impaired, hunger may diminish or increase.

AMYGDALA
Activates aggression or calmness. Over or under stimulation can cause problems with anger and self-control.

HIPPOCAMPUS
Forms and stores new memories. If this isn't working, learning and remembering are difficult.

RETICULAR ACTIVATING SYSTEM (RAS)
Lets your brain know messages are coming from the five senses, filters these messages and regulates sleep. Problems here make it harder to focus and disturb sleep (the number one complaint of depressed people!)

CEREBELLUM
Posture, balance, muscle coordination. A person's ability to play sports or just complete normal activities are effected with impairment
.
CEREBRUM
Problem-solving, making decisions, receiving, storing and retrieving memories which language, numbers and intellectual skills. If the nerve cells are not working properly, thinking, judgment and communication is altered.