Spring 2006

Wellbeing and connectedness

Moving beyond the blue: depression in young people

Students experiencing depression often struggle both academically and socially. Brian Graetz reveals how teachers can recognise when young people are experiencing depression and suggests how to help them fulfil their potential.

When people talk about depression, they tend to describe either a general emotional state, such as feeling sad or depressed, or a mental illness. Not surprisingly, this can cause confusion. Everyone will have times when they feel sad or depressed. This is part of the normal human experience, particularly for young people who are negotiating a period of rapid physical, mental and emotional change. It is estimated that about 40 per cent of adolescents suffer prolonged periods of sadness and unhappiness in any six-month period.

What are the symptoms of depression?

Research in Australia suggests that 2 per cent of children (6–12 years) and 4 per cent of adolescents (13–17 years) have clinical depression at any one time. This translates to approximately 120,000 children and adolescents in Australia today.

Clinical depression is a term health professionals apply to individuals who have multiple symptoms of depression that are severe, ongoing (at least two weeks), and impair their everyday functioning. The symptoms of clinical depression include:

• being unhappy, irritable, tearful or miserable
• losing interest or enjoyment in things or activities previously enjoyed
• experiencing changes to appetite or weight
• having difficulty getting to sleep, or oversleeping
• feeling restless, agitated or slowed-down
• lacking in energy, feeling tired all the time
• having difficulty concentrating, thinking things through or making up one’s mind.
• feeling worthless or guilty about things
• believing that life is not worth living, that there is no future and one would be better off dead.

How do young people experience depression?

While a list of symptoms describing clinical depression provides a useful guideline for assessment, it can give the impression that young people with depression present in a similar manner. In reality, depression can look, and even be experienced, quite differently from one young person to the next. This variation can be seen in how young people have described their depression to ‘beyondblue: the national depression initiative’.

‘For five months I barely slept. I was constantly sick and exhausted. I snapped and snarled at my housemate and spoke to no one else much at all. I worked as little as I could, and cried every day.’

(Tanya)

‘I began cutting myself and using drugs to try and hide the hurt and anguish I was feeling. It was easy to smile in front of them, it was just behind the closed doors and the inside of myself where it was boiling up.’

(Samuel)

‘[Depression’s] more than feeling sad. It’s a lack of motivation to do stuff, a feeling of worthlessness, low self-esteem. You don’t feel like eating or talking. All you want to do is cry. I’ve cried so much my eyes can’t cry anymore.’

(Lisa)

While these young people ascribe different behaviours and feelings to their depression, their descriptions show considerable commonality. All three indicate they withdrew socially. It is also clear that all three were extremely distressed, and that their depression had a profound negative impact on all aspects of their lives.

There is negativity in their thoughts (‘I’m weak and a failure’, ‘It’s all my fault’, ‘I’m worthless’, ‘I’m a bad person’); their feelings (guilt, sorrow, overwhelm, frustration, irritability); their behaviours (drug-taking, avoiding friends and family, self-harming, avoiding school or work); and even their physical health (being tired all the time, lacking appetite, experiencing sleep problems and headaches). It is no wonder that, for some young people with depression, completing what are generally considered mundane everyday tasks such as getting out of bed and going to school becomes a major challenge.

How can we assist young people with depression?

Research in Australia suggests that less than one in three young people with clinical depression seek professional help. In some cases, young people are reticent to discuss their problems. This may be because they fear how others will perceive them, or because they believe no one can help. In other cases, depression goes unrecognised because the symptoms are not obvious or have been interpreted as normal adolescent angst or moodiness.

In general, it is harder to identify depression in young people than adults. Young people are less able to identify and label their feelings and many lack the confidence to communicate these to others. As a result, adults must sometimes ‘second guess’ a young person’s feelings or emotional state by observing behaviours.

Young people who are depressed are far more likely to talk about their difficulties to friends, parents and teachers than to seek help from a medical practitioner or mental health specialist. Knowing the signs and symptoms of depression puts friends, parents and teachers in a better position to recognise when someone close to them is experiencing difficulties and to provide the type of support that will enable the young person to access specialist help if it is needed.

The most important clue that a young person may be depressed is when there has been an abrupt change in their normal functioning. Because teachers spend so much time with their students, they are in a good position to detect when a young person is perhaps not travelling very well.

The sort of changes that should give rise to concern within the school context occur when:

• a more or less happy student becomes increasingly sad
• a normally talkative student becomes much less communicative, starts withdrawing from friends and becomes less interested in usual activities
• a student becomes tearful, irritable and more sensitive than normal
• the quality of a student’s school work drops off
• school attendance becomes less consistent
• a student starts to become a discipline problem.

Of course, such events do not automatically mean a student is depressed or even has a mental health problem—experienced teachers will know that, from time to time, all young people experience setbacks that make them sad or even distressed. However, a teacher noticing such behaviour change should approach the student, particularly one who shows signs of ongoing sadness and distress.

Understandably, students are more likely to respond to teachers they trust and with whom they have a good relationship. In making an approach, it is reasonable for teachers to gently talk about the things they have noticed and to check out if the student is sad, worried or upset. This is not to suggest that teachers need to ‘diagnose’ and provide ‘therapy’. But teachers, like parents and friends, can play an important role in assisting students who are experiencing depression by recognising the signs and symptoms, and initiating conversations to support and possibly assist the students to get professional help.

To support students, teachers need school policies that clearly identify their roles and responsibilities with respect to student mental health, and identify referral pathways and protocols. Teachers also need access to people who can support their mental health and wellbeing.

Ongoing depression can reduce the capacity to find employment and to form supportive relationships. So, the earlier students experiencing difficulties with depression or any other mental health problem get help, the better. With early intervention it is more likely that the young person will be able to control the symptoms, maintain good relationships, stay at school and continue regular activities.

The good news is that 80–90 per cent of young people who experience depression make a good recovery. The most important step a young person can take is to talk to someone about any difficulties. Understandably, the perception that there is someone suitable to talk to at school makes this first step more likely.

Further information

The following websites provide a range of information and fact sheets about mental health and issues that impact upon young people.
www.beyondblue.org.au/ http://bluepages.anu.edu.au/

Brian Graetz is a clinical psychologist and senior program manager at beyondblue: the national depression initiative.

The author owns the copyright in this article. For information related to the reuse of this work in any form please contact the publisher denise.quinn@curriculum.edu.au