Depression Education and Health Promotion Project

1. Depression Education and Health Promotion Project Michelle Slivinsky, MA UCONN Health Center Department of Psychiatry

2. The Myth of the Bad Kid Handout from SAMHSA (Substance Abuse and Mental Health Services) Caring for Every Child’s Mental Health Campaign www.mentalhealth.org/child www.samhsa.gov www.hhs.gov

3. True or False?? • A depressed person can just “snap out of it” • If you are depressed it is your fault • Approximately 2 of every 20 young adults suffer from symptoms of depression at any given time • Depressed people will always be depressed • Depression can put a strain on relationships at home and at school • There is no way to tell if someone is depressed

4. Depression affects a person’s mood, thoughts, and actions • Depression is just a bad mood and goes away in a few days • Many times depression goes unidentified- depressed children, teens, and adults are sometimes inappropriately viewed as “difficult” or “unapproachable” • Depression is just in your mind- it can’t affect your body • People often feel “stressed out”- learning to deal with stress can help you to feel better by coping better • Depression is a treatable illness

5. Ages 6-12 Somatic complaints Schoolwork diminished Negative self-statements—highly sensitive to imperfections Fatigue Crying/whining, irritability/clinging to parents Boredom/Apathy Eating Disturbance Decreased Concentration Anxiety Repeated rejection by other children/refusing to engage with others Problems learning Ages 12-18 Frequent absences from school Suicidal thoughts Low self-esteem/hyper-critical Social Isolation Drug/Alcohol use Sexually acting out Overeating Rage Signs of Depression

6. More about Depression………. • Four types of depression: • Major Depression • Bipolar Disorder • Dysthymia • Seasonal Affective Disorder (SAD)

7. What Depression Can Look Like

8. Contributing Factors • Genetic predisposition to depression • Effects of an abusive childhood or a poor attachment to the mother • Hormonal changes that occur in adolescence • Loss of a loved one • Effects of divorce • Exposed to traumatic events such as 9/11 • Bullying • Kids with attentional, learning, conduct or anxiety disorders are at a higher risk for depression (known as co-morbidity) • STRESS

9. Depression Statistics National Comorbidity Survey- Adolescent Supplement (NCS-A) Lifetime Prevalence: 11.2% of 13 to 18 year olds Lifetime Prevalence of “Severe” Disorder: 3.3% of 13 to 18 year olds www.nimh.nih.gov/statistics/lmdd_child.shtml An estimated 10% of adults report depression http://www.cdc.gov/features/dsdepression Substance Abuse and Mental Health Services Administration (SAMHSA) reports: 1.4 million adolescent girls age 12-17 experienced a major depressive episode Depression rates triple between the ages of 12 and 15 among adolescent girls (from 5.1% to 15.2% respectively. www.samhsa.gov/newsroom/advisories/1207241656.apsx

10. About Co-OccurringDisorders • Mental and substance use conditions often co-occur. In other words, individuals with substance use conditions often have a mental health condition at the same time and vice versa. • Approximately 8.9 million adults have co-occurring disorders; that is they have both a mental and substance use disorder • Only 7.4 percent of individuals receive treatment for both conditions with 55.8 percent receiving no treatment at all.

11. Adults vs. Teens Teens show: • Irritable or angry mood – grumpy, hostile, easily frustrated, or prone to angry outbursts. • Unexplained aches and pains – headaches or stomachaches. • Extreme sensitivity to criticism • Withdrawing from some, but not all people --teenagers usually keep up at least some friendships; less than before, pull away from their parents, or start hanging out with a different crowd.

12. In the Classroom • Loss of interest in activities • Lack of energy • Problems concentrating, recall, decision-making • Loss of appetite or eating too much • Thoughts of suicide, cutting, suicide attempts • Aches, pains, headaches, cramps, or digestive problems that do not go away. • http://www.nimh.nih.gov/health/publications/depression-and-high-school-students/depression-and-high-school-students.shtml

13. Behavioral Symptoms • Frequent, unexplained irrational changes in behavior • Decreased concentration, lack of interest • Hyperactivity, restlessness • Impulsiveness and recklessness • Giving away of prized possessions (“a living will”) • Aggressiveness • Lack of energy, lethargy, fatigue • Loss of pleasure in usual activities • Somatic complaints • Social withdrawal

14. Emotional Symptoms • Feelings of loss • Feelings of helplessness, hopelessness • Crying spells, tearfulness, sadness • Low self-esteem, unreal expectations of self • Feelings of powerlessness, out-of-control, outside control • Feelings of isolation, loneliness • Depression • Sudden happiness following depression • Guilt, remorse, self-reproachment • Nervousness • Withdrawl, sulkiness • Pronounced mood swings • Anxiety

15. Warning Signs • 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 good. • Seeking out weapons, pills, or other ways to kill themselves. • www.helpguide.org

16. Anxiety Disorders • Anxiety often co-occurs with Depression • Anxiety disorders affect about 40 million American adults age 18 years and older (about 18%) in a given year, causing them to be filled with fearfulness and uncertainty. • Women are 60% more likely than men to experience an anxiety disorder over their lifetime. Non-Hispanic blacks are 20% less likely, and Hispanics are 30% less likely, than non-Hispanic whites to experience an anxiety disorder during their lifetime. • A large, national survey of adolescent mental health reported that about 8 percent of teens ages 13–18 have an anxiety disorder, with symptoms commonly emerging around age 6. However, of these teens, only 18 percent received mental health care. http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml#part3

17. Anxiety Disorders • generalized anxiety disorder (GAD) • obsessive-compulsive disorder (OCD), • panic disorder, • post-traumatic stress disorder (PTSD), and • social phobia (or social anxiety disorder).

18. EDIT(when you want to make a change to something that already exists) • Educate • De-stigmatize • Identify • Treatment

19. EDUCATE • Workbooks • Informational Brochures for students and parents • Handouts (fact sheets, puzzles, awareness sheets) • DVDs • Open discussions at school, at home, in your parish and your community!

20. DE-STIGMATIZE • Depression is an illness, and should be treated like any other illness. • Depression can affect anyone at any age • Depression is treatable! • Through education, we can help people understand the differences between the facts about depression and the myths surrounding depression

21. IDENTIFYSymptoms of Depression Troubled Thoughts and Feelings • Sadness or Irritability • Inability to enjoy usual activities like work, hobbies, school, friends • Feelings of hopelessness or guilt • Anxiety or restlessness • Trouble concentrating or remembering things • Thoughts of death or suicide Physical Symptoms • Trouble sleeping or sleeping too much • Unexplained headaches, backaches, or stomachaches • Eating too much or too little • Low energy

22. TREATMENT DEPRESSION IS TREATABLE! • Therapy • Interpersonal • Cognitive Behavioral Therapy • Individual • Group • Self Help • Medication • Light Therapy • Hospitalization • Any of these treatments may be used alone or in combination, and treatment may change over time. It is important to follow through with treatment plans with the doctor.

23. Summary • EDIT- Educate, De-stigmatize, Identify, Treatment • Teach people about depression so they can get the help they need, or help a friend get the help they need • Understand the differences between facts and myths surrounding depression • If you or someone you know is depressed, please reach out and talk to someone you trust (parent, teacher, support staff, clergy) so they can get you the help you need • Get help! Depression is an illness- people should not feel ashamed of being depressed and deserve to feel better!

24. Crisis Intervention for Students Call the National Suicide Prevention Lifeline’s toll-free, 24-hour hotline at 1-800-273-TALK (1-800-273-8255) or TTY: 1-800-799-4TTY (1-800-799-4889) to talk to a trained counselor. Call 211 (Info line) Encourage people to talk to parent(s), clergy, teacher(s)/support staff, or other adult(s) who can get them (or the person they are concerned about) the help they need

25. DVD: Not Just a Phase: Understanding Kids and Depression

26. Thank you!!  • Hand outs • Q & A