CHILDHOOD DEPRESSION

“The missing piece sat alone waiting for someone

to come along and take it somewhere…”

-Shel Silverstein

SIGNS OF DEPRESSIONOften say things like:

“I wish I was never born.”“I can’t do anything right.”“My mom loves my brother more.”“I’m stupid.”

Have a hard time seeing the good in a situation Blame themselvesLack feelings of empowermentThink things will never get better

GREATER CONCERNS•Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.

• Significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day. In children, consider failure to make expected weight gains.

• Recurrent thoughts of death, recurrent suicidal ideation without a specific plan or suicide attempt or specific plan for committing suicide.

SUICIDE FACTS Suicide takes the lives of nearly 40,000 Americans every year.

There are twice as many deaths due to suicide than HIV/AIDS.

Between 1952 and 1995, suicide in young adults nearly tripled.

Suicide rates in the United States are highest in the spring.

Over half of all suicides are completed with a firearm.

For young people 15-24 years old, suicide is the second leading cause of death.

80% of people that seek treatment for depression are treated successfully.

15% of those who are clinically depressed die by suicide.

There are an estimated 8 to 25 attempted suicides to 1 completion.

Substance abuse is a risk factor for suicide.

The strongest risk factor for suicide is depression.

Suicide is the 10th leading cause of death in the U.S. (homicide is 16th). (CDC)

It is estimated that there are at least 4.5 million survivors in this country. (AAS)

There are four male suicides for every female suicide. (CDC, AAS)

Research has shown medications and therapy to be effective suicide prevention.

There are three female suicide attempts for each male attempt. (CDC, AAS)

According to the Violent Death Reporting System, in 2004 73% of suicides also tested positive for at least one substance (alcohol, cocaine, heroin or marijuana).

The highest suicide rate is among men over 85 years old: 65 per 100,000 persons

INITIAL INTAKES: KIDS

Gather as much background information as possible.

Ask about school performance, friends, outside activities, etc.

Ask about sleep schedules, bed wetting, medications, doctor visits, headaches, stomachaches, etc.

Ask family history, any interventions tried and if they are/aren’t working.

Duration Intensity Frequency

TOOLS FOR KIDS

TOOLS FOR KIDS

GOOD AT JAR

SICK OF EGGS

BAG OF BAD FEELINGS

ALL TANGLED UP

BLANKET TOOL

INITIAL INTAKES: ADOLESCENTSAsk about behavior changes, overall mood at home, what seems to trigger moods. Suicidal ideation?

School performance, school activities, relationships with teachers. Have teachers said anything?

Changes in friends, groups or activitiesFound anything suspicious? Notes? Texts? Facebook posts?

Drugs/Alcohol use. Weekend Activities. Cutting?

INITIAL THINGS TO CONSIDER

Suicidal Ideation Medication or psychological evaluationsSupport systemRelationship with parentsLevel of success in any one areaChange in peer groupsAcademic decline

DEPRESSED ADOLESCENTSIrritability often comes outResistance to change what’s not workingLack of communicationLack of motivationOften don’t know what’s wrongCry easily

WHAT TO PAY ATTENTION TOMusic – what they’re listening toFriends – what their friends are doingMovies – what they’re watching. Pay attention to movies they’re watching obsessively.

TOOLS FOR ADOLESCENT

S

LIST OF BAD THINGSAsk adolescent to write down all of the bad things in his/her life.

Rank them in order from least to greatestWhich ones are able to be changed?What will help with the ones that aren’t able to be changed

WHAT TRIGGERS YOU?Write down all things that trigger negative emotions.

Rank reaction to triggers (1-10).How often do these triggers occur?How long are the after effects?Is there a specific theme to the triggers?

AUTOMATIC NEGATIVE THOUGHTS

Talk about CBT and how we have automatic negative thoughts about certain events.

Identify a difficult event and write the negative thought about the situation.

Choose a positive thought to replace the negative thought.

CUTTINGCutting is an impulse-control disorder. When a person cuts, it calms them down and that registers in the brain as a calming mechanism.

Cutting is calming because the brains releases endorphins, which are the body’s narcotic). Endorphins minimize pain by providing a sense of well being.

Pain switches from being emotional to physical.Cutting is considered a non-suicidal self-injurious behavior.People who cut feel everything intensely and have a hard time addressing emotional discomfort.

THE 3 C’S – A WAY TO ASSESS CUTTING1. Craving for the substance – release of

emotional pain

2. Loss of control once the thought to cut arises

3. Continues cutting in spite of negative consequences

HOW TO TREATRemove sharp objectsTalk about distressing event out loud, even if it’s to yourself.

Draw something positive on place where cutting usually takes place. (i.e. person’s name or symbol)

Use rubber band, hold ice, exercise. Do something that causes discomfort but isn’t as harmful as cutting.