Depression in Teenagers

WHAT?WHY?HOW

What is Depression?What is Depression?According to MediLexicon's Medical Dictionary,

depression is "a mental state or chronic mental disorder characterized by feelings of sadness, loneliness, despair, low self-esteem, and self-

reproach.

Identifying CausesIdentifying CausesCauses could be biological or emotional. Any of Causes could be biological or emotional. Any of life’s challenges, major events and activities can life’s challenges, major events and activities can

trigger Depression, i.e., abuse, medications, trigger Depression, i.e., abuse, medications, conflicts, death, serious illness/terminal diseases, conflicts, death, serious illness/terminal diseases, substance abuse, divorce, personal problems and substance abuse, divorce, personal problems and

challenges, and genetics.challenges, and genetics.

Depression has become a prevalent mental disease in our world today. No one is immune from its attack.

It does not discriminate on the basis of race, religion, nationality, age or sex. Millions are affected. Yet, there is

hope.

Although many may already be suffering from depression, a major trigger is our current economic situation . This is what prompted MWwM to launch this bible study series to provide help and hope to the many individuals and families that are

deeply affected by depression.

Ironically, depression is not a new illness; it’s ancient. In fact, it affected persons in the bible long before Christ. We can

learn how to overcome it by the power of God’s word, if you would believe and receive God’s word like a “medicine” into

your mind, body and soul (spirit).

Biblical ExamplesJob, Jonah, Jeremiah, Elijah, David, Judas Iscariot.

Job’s depression was caused by a calamity of events, sickness, death of his children, loss all of his possessions, and friends that

questioned his character (Job 17:1-16).

Jeremiah’s depression is notable in the Book of Lamentation because of his opposition and the rebellion of God’ s people.

Elijah became depressed after his Mt. Carmel victory, which enraged Jezebel and he began feeling all alone and wanted to die

(I Kings 19:1-5)

David- gets depressed because he is overwhelmed by constant harassment from his enemies (Ps. 143).

Affects of DepressionsAffects of Depressions

Depression zaps a person’s energy and take a great deal of time out of one’s life. It’s affects become more intensive as the depression deepens. A person becomes more withdrawn and it becomes more difficult for others to communicate with the individual. Consequently, if the person’s mental state does not change, the person can lose the desire to face reality, or continue living. At this point, the “spirit” of depression has taken full control. But, nothing is impossible for the All-powerful One to overcome.

Symptoms of DepressionSleep: decrease/increase in sleep

Eating: significant loss/gain in weight

Interest: loss of interest in previously enjoyed activities

Fatigue: loss of energy

Concentration: indecisiveness and/or difficulty concentrating and irritability

Self-worth: feelings of worthlessness or guilt

Death: repeated thoughts about death, suicide (with or without a plan) or a suicide attempt

Mood: depressed mood noticed by others

Motor activity: noticeable agitation in activity, including aches and pains

Symptoms of Depression cont’d.The teen experiences five or more of these symptoms in a two-week period

These symptoms are severe enough to impair the teen’s work, school and/or personal life

These symptoms are not due to other factors such as substance abuse or health problems (such as thyroid disease)

Symptoms of Depression cont’d.When moving from childhood to adolescence the teenager will present a lot of changes in behavior. These include eating more, sleeping more, withdrawing from parents for time with peers, etc. These changes are normal and healthy! But when such changes are coupled with others from the symptom list and appear to impair aspects of the teen’s life, the guardian/practitioner should seek consultation.

Causes

Societal Disconnection

• External: Life’s stresses affect serotonin levels

• Examples are trauma, illness, loss and exercise

• In boys depression may be affected by early disconnection

• Shame

• Boy code

• Gender straitjacketing

Relationship related depression

• Also external

• Poor social support

• Tenuous family connections

• rejection

Explanation of organic

( Internal)• A change in electrical

potential between cells

• Dopamine, norepinephrine

• Serotonin

• Transfer between cells and broken down by MAO

• People vary in MAO levels, so some need higher transmitter levels

• Type R

• Alcoholic

• Anxious

• May need need more chemical transmission

Another Theory

• There may be differences in brain receptors and their levels of stimulation required

• This may exist for many types of neuroreceptors

• Some may have small numbers of D2 and D4 dopamine receptors

• Excitement may be needed to increase dopamine levels in low numbered folks

Depression, an indistinct meaning

Dysthymia (mild)

Major depression( more problematic)

Bipolar Depression ( Mania)

Common Symptoms

Most Common:TYPES OF DEPRESSION

Major Depression, also known as clinical depression

Chronic Depression, also know dysthymia

Manic Depression, also known as bipolar (disorder) depression

Seasonal Depression, also known as SAD (Seasonal Affective Disorder)

• Emotional

• Feeling sad and hopeless

• Irritable and anxious

• Loss of interest in what you used to enjoy

• Guilt, and shame

• Death & suicidal thoughts

• Physical

• Headache & Back pain

• Appetite / weight change

• Sleeping problems

• Chest pain & Joint aches

• Digestive problems

Usually Depression diagnosis requires 4 of

followingDepressed mood

Weight loss or gain

Sleep disturbancesAgitationLoss of energyGuiltTrouble concentratingSuicidal thoughts

These criteria are mostly used in women and adults

Types of Depression

Seasonal Affective Disorder

Major Depressive Disorder

Bipolar Depression

Chronic Depression (Dysthymia)

Atypical

Psychotic

Postpartum Depression

Bipolar Disorder

psychiatric diagnosis that describes a category of mood disorders, or mood swings, defined by the presence of one or more episodes of abnormally elevated mood clinically referred to as mania or, if milder, hypomania. Individuals who experience manic episodes also commonly experience depressive episodes or symptoms, or mixed episodes in which features of both mania and depression are present at the same time. These episodes are usually separated by periods of "normal" mood, but in some individuals, depression and mania may rapidly alternate, known as rapid cycling. Extreme manic episodes can sometimes lead to psychotic symptoms such as delusions and hallucinations. The disorder has been subdivided into bipolar I, bipolar II, cyclothymia, and other types, based on the nature and severity of mood episodes experienced; the range is often described as the bipolar spectrum.

Major depression

• mental disorder characterized by a pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. The term "major depressive disorder" was selected by the American Psychiatric Association for this symptom cluster under mood disorders in the 1980 version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) classification, and has become widely used since. The general term depression is often used to describe the disorder, but as it is also used to describe a depressed mood, more precise terminology is preferred in clinical and research use. Major depression is a disabling condition which adversely affects a person's family, work or school life, sleeping and eating habits, and general health. In the United States, approximately 3.4% of people with major depression commit suicide, and up to 60% of all people who commit suicide have depression or another mood disorder.

Dysthymia chronic mood disorder that falls within the

depression spectrum. It is considered a chronic depression, but with less severity than major depressive disorder. This disorder tends to be a chronic, long-lasting illness.[1] Dysthymia is a type of low-grade depression. Harvard Health Publications states that, “the Greek word dysthymia means ‘bad state of mind’ or ‘ill humor’. As one of the two chief forms of clinical depression, it usually has fewer or less serious symptoms than major depression but lasts longer.” Harvard Health Publications says, “at least three-quarters of patients with dysthymia also have a chronic physical illness or another

psychiatric disorder such as one of the anxiety disorders, drug addiction, or

alcoholism”. The Primary Care Journal says that dysthymia “affects approximately 3% of the population and is associated with significant functional impairment”. Harvard health Publications says: "The rate of depression in the families of people with dysthymia is as high as 50% for the early-onset form of the disorder." "Most people with dysthymia can't tell for sure when they first became depressed

Treat the symptoms- Not the label!!!

Biblical Methods to Help Overcome Depression

Talk it Out” – being able to talk to yourself, God, or someone else (preferably a counselor).

Journal it Out- writing can be a form of expression and therapeutic for depression before it intensifies. I

encourage people to journal.Pray it Through – Seek the Lord’s help by talking to God, believing and trusting that He hears you and will

intervene by rescuing your soul from the “spirit” of depression. Pour out your soul to Him! Read the Gospels

how Jesus prayed as it was time to be crucified; depression was upon him (Matt. 26:36-38)

Praise & Worship- David was a praiser and a worshiper. Praise is what he did. So when nothing

worked; he praised; he song; he played his harp. (READ THE BOOK OF PSALMS)

***In no way are these meant to be substitutes for professional counseling and care. ***

Review and Discussion1.  Meditate on Psalms 41:1-13; 42:1-11.

What similarities are there that suggest depression?

2. Consider your life; do you recognize symptoms of depression? If so, how

are you handling?3. Biblical examples show us that even

Christians can get depressed. From the biblical examples, how did they

deal with their depression?4. Who in the New Testament suffered

major depression to the point of suicide? Why?

Treatments

Medication

Psychotherapy (Individual, Group and/or Family)

Cognitive Behavioral Therapy

Residential Programs

Hospitalization

MedicationsSome antidepressants (and antipsychotics- often used for mood stabilization) are approved for use by patients under the age of 18.

Medication alone is significantly less effective for treating depression than combination treatments.

While many medications have been proven to be effective in decreasing symptoms of depression, there are risks and side-effects that teens appear to be particularly susceptible to.

Black Label Warning

Powerful Living Bible Study SeriesPowerful Living Bible Study Series

• Anxiety

• Anger

• Depression

• FearFear

• FrustrationFrustration

• PowerlessnessPowerlessness

Text: God's Power to Help Hurting People, Publisher: Urban Ministries (c)2003; Editor: Dr. Colleen Birchett;

(c)2009 Queen Phillips, Majestic Worldwide Ministries, Inc.

God’s Power is LimitlessGod’s Power is LimitlessTo Help and HealTo Help and Heal

Disclaimer: The lessons, information, and links at this site are intended for biblical teaching and educational purposes and should not be construed as medical advice or instruction. In no way are any of these teachings meant to be a substitute for professional medical care or counseling.

Summary and IntroductionSummary and Introduction

Scriptural Basis & Introduction 

In John 16:33 Jesus said, “I have told you these things, so that in Me you may have [perfect] peace and confidence. In the world you have

tribulation and trials and distress and frustration; but be of good cheer [take courage; be confident, certain, undaunted]! For I have overcome the world. [I have deprived it of power to harm you and have

conquered it for you.]” (AMP)

There’s absolutely nothing that can overtake us if we put our TOTAL trust and confidence in Him and obey the Word.

Consequently, these lessons are designed to teach you how to embrace the power of God that’s available in the Person of the Holy Spirit. He will empower you to handle and overcome anxiety, anger, depression, frustration, and feeling powerless during this economic downturn.The truth is what Jesus told His disciples over 2000 years ago are applicable today. Do you believe it? Do you want help? Would like to experience the compassion of the One who created you in His image and likeness? If so, you’re at a good place to begin the healing process. We’ll focus on six (6) emotions that are most common during stressful and challenging times. It is my prayer that you receive the encouragement for which this series is purposed.

  

ACTIONACTIONPRAYER:PRAYER:

Father, thank you for being concerned about every area of my life because it’s your desire for me to in peace and abundance here on Earth. I need you to help me. I confess that I am subject to becoming depressed; therefore, I’m asking that you give me the strength to overcome it in my life and the life of my family. I refuse to allow the spirit of depression to overtake me or my family in Jesus’ name. I will arise with fresh excitement and a fresh zeal for life. I surrender my all to you, and trust your sovereignty to handle life’s challenges for my good, even when it appears the worst is happening. I will meditate on your word; believe and receive your power and unconditional love, grace and mercy to carry me and my families through any situation. Thank you, Father. In Jesus’ name. Amen

CBT for Depression

• Cognitive behavioral therapy (CBT) is an effective treatment for depression.

• Generally speaking, persons with mild or moderate depression can benefit from CBT, even without taking medication.

• Studies have demonstrated that CBT can be as effective as antidepressants in treating mild and moderate depression.

• Studies have also demonstrated that a combination therapy of antidepressants and CBT can be effective in treating Major Depressive Disorder (MDD).

• CBT theory supports that a person's mood is directly related to their thought patterns. Negative thoughts affect a person's mood, sense of self, behavior, and even physical state.

• The goal of cognitive behavioral therapy is to help a person learn to recognize their negative thought patterns, assess how true they really are, and replace them with healthier ways of thinking.

• In addition, therapists also help their patients change behavior patterns that are directly linked to their negative thinking. Negative thoughts and behaviors make a vulnerable person more susceptible to depression.

• CBT seeks to change patterns of thought and behavior and thus impact mood.

• CBT for depression focuses on:

• Cognitive restructuring (therapist and patient work together to change thinking patterns) and behavioral activation( patients learn to overcome obstacles to participating in enjoyable activities).

• The immediate present- what and how a person thinks more than why a person thinks that way.

• Specific problems- problem behaviors and problem thinking are identified, prioritized, and specifically addressed.

• Goal setting behavior-patients are asked to define goals for each session and long-term goals too.

• Education- the use of structured learning experiences teach patients to monitor and write down their negative thoughts and images. The goal is to recognize how those thoughts and images affect their mood, behavior, and physical condition. Therapists also teach important coping skills, such as problem solving and scheduling pleasurable experiences.

• Homework assignments- patients must take an active role in learning, both in the session and between sessions. Homework is assigned at every session, can be graded in the beginning, and the HW is reviewed reviewed at the start of the next session.

• Using many different techniques, including Socratic questioning, role playing, imagery, guided discovery, and behavioral experiments. 

Cognitive Restructuring

• Cognitive restructuring refers to the process of identifying and changing inaccurate negative thoughts that contribute to the development of depression.

• This is done collaboratively between the patient and therapist, often in the form of a dialogue. EXAMPLE: a college student fails a math quiz and responds "That just proves I'm stupid.” The therapist might ask if that's really what the test means. In order to help the student recognize the inaccuracy of the response, the therapist could ask what the student's overall grade is in math. If the student answers, "It's a B," the therapist can then point out that his answer shows he's not stupid because he couldn't be stupid and get a B. Then together they can explore ways to reframe what the performance on the quiz actually says.

• "I'm stupid” is an example of an automatic thought. Patients with depression may have automatic thoughts in response to certain situations. They're automatic in that they're spontaneous, negatively evaluative, and don't come out of deliberate thinking or logic. These are often underpinned by a negative or dysfunctional assumption that is guiding the way patients view themselves, the situation, or the world around them.

Practitioners should educate parents on data collection. Data should

be collected before, during and after any medication changes!

Psychotherapy

There are many different approaches to therapy. Parents are encouraged to gather research on what type of therapy has been most effective for what their teen is facing.

Psychotherapy may be beneficial if family conflict is lending to the depression. School psychologists may help if the environment at school is influencing the teen’s health.

Cognitive Behavioral Therapy (CBT)

Based on the theory that thoughts and observable behaviors are directly related to mood. If changes are made to patterns of thought and behavior, changes will follow in the mood pattern of the patient.

Focuses on what a person is thinking, as opposed to why they think the way they do.

Goal-oriented and focuses on specific problems.

CBT cont’d.Employs multiple strategies such as role-playing and guided imagery.

Coping skills and problem solving strategies are taught to the patient. CBT is considered educational as well as therapeutic and patients are to take an active role.

Uses behavioral approaches to reinforce activities that were previously enjoyed by and beneficial for the teen.

Continue to take data on any changes in target behaviors to

determine the effectiveness of any treatment.

Residential & Hospitalization

Teens suffering from severe depression may require more supervision and structure.

Suicide is the third leading cause of death for American teens.

Referencinghttp://www.befrienders.org/

http://www.wingofmadness.com/

Multiple books by Dr. Kay Redfield Jamison

http://www.twloha.com

National Hopeline Network 1-800-SUICIDE

(Pollock,W) Variation by age , sex and cultureAccrding to Pollock, 3.5 million children < 19 are depressed

Allison ReidSpalding University

(Disclaimer: These are only resource links for your convenience. I am not affiliated with these organizations or

business entities, and cannot be held liable for their content. The information/content on the websites or books

does not necessarily represent the views or beliefs of Majestic Worldwide Ministries, Inc.

http://health.yahoo.com/depression-videos/what-is-depression/healthination--HNB10281_depression_1.html

http://www.medicalnewstoday.com/articles/8933.php

http://www.hartinstitute.com

http://www.aacc.net