drada depression talk #1 - esc13.netadolescent depression what we know, what we look for, and what...
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Curriculum
Overview
Karen L. Swartz, M.D.
Johns Hopkins University
School of Medicine
1
ADAP Student
Curriculum
Day 1 of 3
Pre-Test
Not graded
Do not write your name on the test
Your test number is the last three digits
and can be located on the upper right-hand
corner
• Example: 11 025 = Test # 25
Write your name on the sign-in sheet next
to your number before turning in your test
ADKQ and sign-in sheet
Adolescent Depression
What we know,
what we look for,
and what we currently do
Learning Objectives
To define Depression
To learn the process of diagnosing a
medical illness
To identify the symptoms of
Depression
What do YOU think of when you hear the word Depression?
“Depression”
sad
lonely
confused
exhausted
argumentative
loss of interest
distance
alcohol & drugs – people go to it
Depression: a feeling or an illness?
depression – a feeling of sadness
Depression – a medical illness with
particular symptoms
“Cough” as a symptom exercise
Cough = _____________
Illnesses Step 1 __________
Step 2 __________
Step 3 __________
Symptom
Flu
Bronchitis
Emphysema
Hypochondria
Choking
Congestive heart
failure
Meningitis
Pneumonia
Cancer
Allergies
Ask Questions
How long have you been smoking?
Do you smoke?
Are you coughing up anything?
Exam
Temperature, blood pressure,
pulse, heart rate
What does the patient look
like? (sweating, pale, tired)
Listen to lungs with stethoscope
Tests
Blood tests
Sputum sample
Chest x-ray
Patchy area
= where you
hear
crackling
sounds
diaphragm heart
stomach
lungs
Test results: Patchy area on chest X-ray
Symptoms of Pneumonia
Cough
Fever
Change in appetite
or weight
Fatigue or loss of
energy
Coughing up
green phlegm
Changes in lung
sounds when
listening with a
stethoscope
Symptoms of Depression
Sad, low, or irritable
mood or feeling
nothing
Decreased interest or
pleasure in activities
Change in appetite or
weight
Sleeping more or
less than usual
Feeling restless or
slowed down
Fatigue or loss of
energy
Decreased
concentration
Feelings of guilt or
worthlessness
Recurrent thoughts of
death or suicide
Making the Diagnosis of Major Depression
Major Depression = “D”epression
Five or more symptoms for two or more
weeks
The symptoms cause clinically significant
distress or impairment in functioning:
• Socially, academically, or emotionally
Do you think being diagnosed
with Depression feels the
same as being diagnosed
with Pneumonia?
Review of Day 1
Defined Depression
Learned the process of diagnosing a
medical illness
Identified the symptoms of
Depression
What to do
Tell an adult about your concerns• Parents
• Teachers, coaches, or advisors
• Counselors
• School nurses
Your school contact
17
ADAP Student
Curriculum
Day 2 of 3
Learning Objectives
To review the homework
To see through real life examples that
Depression is a treatable medical illness
• Film: Day for Night: Recognizing Teenage
Depression
To review the film worksheet
To recognize Depression as a treatable
medical illness
Homework Review
Homework Review
A 16 year-old girl, who is a sophomore in high school, says
that she is getting annoyed at the littlest things. She is losing
her temper at her parents. Her friends have also noticed that
she is cranky.
Symptom =
________________________________________________
She says that she is bored all the time and even her favorite
movie doesn’t make her laugh anymore. In fact, she stopped
going out to movies with friends. She typically stays in her
room.
Symptom =
________________________________________________
She returns home from school at 3:30 pm and naps until 7:00
pm, even though she is already getting nine hours of sleep a
night. She often sleeps through dinner and does not feel
hungry.
Symptom =
_________________________&______________________
Even though she is tired, she has still been able to maintain
her B-average grades. She does not have any energy and
recently quit the basketball team. When the coach asked her
why she quit, she said that she felt like a failure and believed
that the basketball team would do better without her. The
coach was concerned about this and called her parents.
Symptom =
__________________________&_____________________
Homework Review
A 16 year-old girl, who is a sophomore in high school, says
that she is getting annoyed at the littlest things. She is losing
her temper at her parents. Her friends have also noticed that
she is cranky.
Symptom =
________________________________________________
She says that she is bored all the time and even her favorite
movie doesn’t make her laugh anymore. In fact, she stopped
going out to movies with friends. She typically stays in her
room.
Symptom =
________________________________________________
She returns home from school at 3:30 pm and naps until 7:00
pm, even though she is already getting nine hours of sleep a
night. She often sleeps through dinner and does not feel
hungry.
Symptom =
_________________________&______________________
Even though she is tired, she has still been able to maintain
her B-average grades. She does not have any energy and
recently quit the basketball team. When the coach asked her
why she quit, she said that she felt like a failure and believed
that the basketball team would do better without her. The
coach was concerned about this and called her parents.
Symptom =
__________________________&_____________________
Irritable mood
Loss of interest or pleasure in activities
Increased sleep Decreased sleep
Decreased energy Feeling worthless
Film
Film Worksheet Review
Day for Night: Recognizing Teenage Depression
Film Assignment
How is Depression Described?
How is Mania Described?
Walking under water
Anvil on your head
Always wanting to sleep
Throw things around
Cup with holes
Extremely energized
Open front door and end up in Canada
Drug and alcohol abuse
How do we know Depression is an illness?
It has a cluster of symptoms
It can affect anyone – no one is
immune
It runs in families
It is treatable
Review of Day 2
Reviewed the homework
Saw through real life examples that
Depression is a treatable illness
Reviewed the film worksheet
Recognized Depression is a
treatable medical illness
What to do
Tell an adult about your concerns• Parents
• Teachers, coaches, or advisors
• Counselors
• School nurses
Your school contact
27
ADAP Student
Curriculum
Day 3 of 3
Learning Objectives
To watch the film Psychiatry 101:
Psychiatry One on One
To identify the symptoms of Mania
To review the treatment for mood
disorders
To work in groups to present information
about Depression
Psychiatry 101: Psychiatry One on One
What should the psychiatrist ask?
What should the psychiatrist ask?
How long?
Are you sleeping well?
Are you eating?
Do you get in & out of
relationships fast?
Are you feeling irritable?
Do you see a change?
How were your grades before?
Psychiatry 101: Psychiatry One on One
Scene 1 & 2
“d”epression vs. “D”epression
Feeling down for one
week
Good sleep and appetite
Doing well in all classes
except Chemistry
Active with friends and
playing soccer
Has different interests
than girlfriend
Hopeful about the future
Sad and irritable for over
two months
Poor sleep
Poor performance in
most classes
Quit soccer and not
seeing friends
Breakup after weeks of
isolating himself
Very self critical
Psychiatry 101: Psychiatry One on One
Scene 3
Symptoms of Mania
Elevated, expansive,
or irritable mood
Inflated self-esteem
or grandiosity
Decreased need for
sleep
More talkative or
pressure to keep
talking
Racing thoughts
Distractibility
Increased activity or
agitation
Excessive
involvement in
pleasurable activities
Risky behaviors
Making the Diagnosis of Bipolar Disorder
Bipolar Disorder = Manic Depression
Two poles
• Depressive episodes
• Manic episodes
Three or more symptoms of mania for
one or more weeks
Impaired functioning
1% of teenagers have Bipolar Disorder
Mood Graph I: 3 Mood States
TimeMiddle
High=
Mania
Low=
Depression
Mood
Treatment of Mood Disorders
Medications – antidepressants or mood
stabilizers
Individual psychotherapy
Education and support
Family therapy
Individual responsibility
Mood Graph II: Effects of Treatment
TimeMiddle
High=
Mania
Low=
Depression
Mood
Mood stabilizers
Mood stabilizers
Antidepressants
Behaviors seen with Mood Disorders
Eating disorders
• Anorexia nervosa
• Bulimia nervosa
Alcohol abuse
Substance abuse
Cutting
Behaviors and Moods
These behaviors can alter moods for brief
periods
These behaviors can destabilize moods
These behaviors can happen with mood
disorders or occur independently
Avoiding these behaviors is essential for
getting well and staying well
Group Activity
Review of Day 3
Watched the film Psychiatry 101:
Psychiatry One on One
Identified the symptoms of Mania
Reviewed the treatments for mood
disorders
Worked in groups to present information
about Depression
What to do
Tell an adult about your concerns• Parents
• Teachers, coaches, or advisors
• Counselors
• School nurses
Your school contact