1. Teens and Depression

2. Some Things to Think About • Most teens do not seek help on their own • Depression has increased 200% in this age group since 1960 • Surveys indicate 1 in 5 teens have depression • Third most prevalent cause of death in adolescents, second in 18-24 year olds • Other things may obscure depression e.g. learning difficulties, conduct disorder • Untreated teen depression puts people at risk for other disorders in adult life • Teens may go years before getting help

3. Who’s at Risk? What would you say?

4. Who is More at Risk? • Family history of depression • A learning disability or attentional difficulty • Teen girls • Youth from marginalised cultural/ethnic groups • GLBT youth • Stressful life events • Chronic Illness • Family difficulties, conflict with parents

5. What Does Depression Look Like in Teens? What do you think you would See?

6. What Does it Look Like? • Poor performance in school • Withdrawal from friends and activities • Sadness and hopelessness • Lack of enthusiasm, energy or motivation • Anger and rage • Over-reaction to criticism • Feelings of being unable to satisfy ideals

7. What it Looks Like…cont. • Poor self-esteem or guilt • Indecision, lack of concentration or forgetfulness • Restlessness and agitation • Changes in eating or sleeping patterns • Substance abuse • Problems with authority • Suicidal thoughts or actions

8. How to Tell the Difference? Because of the difficulty distinguishing between depression and ‘normal’ adolescent behaviour, think about: • Involving parents and/or trusted teachers and the school counsellor • Sudden behaviour change • Duration of symptoms

9. Some Questions to Help Make The Distinction(note: examples of content rather than the way these would be asked!) • What have you been experiencing? e.g. changes in sleep, thought patterns • When did these things start? • Did something happen to make you feel bad? • How long have the symptoms lasted? • How bad are these things (specific e.g. sadness)? • Have you experienced things like this before? • Did you receive treatment? • What treatment was given? (probe for specific) • What other things have you found helpful? • Does you use alcohol? Drugs? • Have other family members had a depressive illness? • If they were treated, which strategies were effective? • What kind of social support do you have in place? • What lifestyle factors (work, diet, exercise, recreation, etc.) may have changed? • Have you had thoughts about death or suicide?

10. How Treatments Compare(why you should be supportive of different options!) • After about a month, medications are ahead. They reduce symptoms more quickly and more reliably than therapy does. • After a couple of months of treatment, antidepressants and psychotherapy are equal in effectiveness. • At 12 weeks, therapy is slightly ahead in effectiveness. • Relapse occurs 50 percent more often among patients receiving medication alone than among those receiving both drugs and therapy.

11. Aboriginal Youth- At Risk for Depression and Suicide • Young women 8x the national average • Young men 5x the national average • 25% of Mi’kmaq youth in N.S. report depression • ‘Transgenerational grief’ • Sense of isolation, marginalisation from ‘mainstream’ • Conflict at home, arguments indicate higher risk Need to recognise: • Problems with ‘medicalisation’ of depression: need to embed cultural practices • Protective nature of cultural continuity and identity Health Canada: Acting On What We Know: Preventing Youth Suicide in First Nations, 2002

12. GLBT Youth – At Risk for Depression and Suicide • About 25% of gay and lesbian youth have experienced physical violence in their homes due to their orientation • About 50% of runaways/homeless youth self-report as GLBT • About 30% of youth suicides are GLBT • Increased risk for substance abuse

13. Things That Ward off Depression • Tolerance of ambiguity • Critical thinking • Clear (as opposed to general) goals • Being able to distinguish between what you feel about something and how it is • Relationship skills: 1) establishing closeness and 2) setting boundaries • Physical exercise • Increasing pleasant activities • Relaxation skills • Increasing problem-solving skills • Social skills

14. Protective Factors • Mentoring relationships • Community connections (increased social capitol) • Involvement in social and volunteer activities • Building connections with the family/a family member and the school • Supporting an ethno-cultural connection

15. What Can You Help Others to Do? • Cultivate curiosity • Reframe youth behaviour • Take symptoms seriously • Advocate for a troubled youth • Find ways to show youth they are valued and included • Encourage others to participate in programmes you develop • Foster youth-adult partnerships

16. Resources • www.youthproject.ns.ca • http://www.gov.ns.ca/health/mhs/depression/Depression%20booklet%20Web%20N30.pdf • http://www.genderandhealth.ca/en/modules/sexandsexuality/gss-social-issues-03.jsp • http://www.hc-sc.gc.ca/fnih-spni/pubs/suicide/prev_youth-jeunes/index_e.html