Examples of the Signs of Depression
What Is Depression
Other types of mood disorder
Incidence of Depression
Depression in Young People
Information provided by the Mental Health Foundation of New Zealand
signs of depression
(Rey (1995) outlines the following checklist to help parents of adolescents become aware of possible signs of depression in adolescent children)Your adolescent child probably suffers from Depression if he or she: Has shown a marked change in character, a decline in school work and a changed relationship to family and friends and appears unhappy, tearful, down in the dumps or complains of sadness or emptiness or has lost interest or enjoyment in most activities and pastimes previously enjoyed and at the same time has shown four or more of the following symptoms: 1. Appetite or weight has changed considerably (has lost or gained a substantial amount of weight)
2. a change in sleeping pattern: can't sleep at night or sleeps too much
3. is restless, agitated (pacing, wringing hands) or has slowed down (e.g., spends hours staring in front, finds it hard to move)
4. has lost a lot of energy, complains of feeling tired all the time
5. feels worthless or complains of feeling inappropriately guilty ('everything is my fault', 'I am bad')
6. believes that life is not worth living, there is no future and will be better off dead
of the Signs of Depression
People working closely with adolescents are finding
Rey's checklist a useful guide if they are concerned that a young person's behaviour has
changed significantly. The following signs of depression in young people have been
observed by workers in the community: they may make depression difficult to identify, but
they are very important as they provide early warning signs, and opportunity for early
Changes in character
Irritable; e.g., snapping at people for no apparent reason
Physically aggressive or verbally aggressive
Abandoning favourite hobbies or sports
Passive TV watching
Risk-taking; e.g., dangerous driving
Misuse of drugs and alcohol.
Changes in school behaviours (including training courses and work settings)
Frequent absences from school through 'wagging' & Gets poorer grades for assignments than formerly
Complains of being bored. Becomes disruptive in class
Loses interest in activities which once were fun
Finds it harder to stay on task. Loses concentration
Mentally confused. Finds decisions difficult to make
Cannot remember commitments: doesn't turn up to appointments
Has difficulty staying still or conversely, is lethargic
Projects personal difficulties on to others; e.g., bullying
Sets self up for rejection by peers and/or teachers. Takes on the victim role
Changes in relationship to family and friends
Stops going out with friends; shows no interest in group outings
Increase or decrease in sexual activity
May start associating with a different peer group
Expresses negativity about family
More than normal conflicts with parents and siblings
Changes eating and sleeping habits
Changes in feeling, thinking and perceiving
Expresses inappropriate guilt
Feelings of not being good enough, worthlessness, failure
Expressions of hopelessness: nothing to look forward to
Speaks in a monotonous or monosyllabic manner
Preoccupied with self; withdrawn, shows inner distraction
Cries easily, looks sad, feels alone or isolated
Fears about having to be perfect. Fearful of doing something bad
Incidents of self-injury. Ideas of killing self
Life is full of 'ups and downs', and most people have periods of experiencing the 'blues' or feeling 'down'. Depression is not just 'feeling blue' or 'down in the dumps', and it is more than experiencing normal grief and sadness after a loss.
DEPRESSION IS AN ILLNESS
Severe Depression -is present when a person has nearly all of the signs of depression, and the depression almost always interferes with his or her ability to initiate, enjoy, and perform a range of activities. Severe depression is very debilitating, interfering with daily life and work.
Moderate Depression - is present when a person has some signs of depression which often interfere with the person's life.
Mild Depression -is present when a person has a few signs of depression, requiring a greater effort to function normally.
With adolescents depression often occurs in combination with other disorders. This is
known as 'co-morbidity'.
Chronic Low Grade
Depression. (known as Dysthymia or Dysthymic Disorder).
Precise data relating to the prevalence of depression in the community are unavailable because it often goes unreported. However, even the conservative figures we do know indicate that depression is a major health problem in New Zealand. 'There are about as many people with depression as there are people with asthma.' (What is Depression? National Health Committee, 1996).The following information is generally accepted in the literature:
Depression can affect people of any age, culture, and occupation. About ONE in every SEVEN people.... in New Zealand will develop a Depressive Disorder during their lifetime. (Wells et al. 1989) In any two week period, ONE in TWELVE people will have a Depressive Disorder: 6.4% will have Dysthymic Disorder, and 3.7% will have a Major Depressive Episode. (Oakley-Browne et al. 1989) Depression is one of the three most common mental health problems in young people. (Along with alcohol and drug missuse and addiction and anxiety disorders). The first onset of a major depression often occurs in mid to late adolescence. Adolescents who experience depression are at risk of having a recurring episode of depression. Chronic Low Grade Depression (Dysthymia) often precedes a Major Depressive Disorder. Depression is a significant problem for young people who are in custody or who are shelterless (homeless). Clinical Practice Guidelines:Depression in Young People, Draft Document, September, 1996. NHMRC, Canberra. Comparative data from Canada, Germany, United States, and New Zealand indicate that major depression rates have been increasing. Since 1945 the onset of depression has been occurring at an increasingly earlier age, a trend that has been more marked in recent years, especially among young men born since the 1960s. (Weissman et al. 1977) Studies in New Zealand have found that the prevalence of depression increases with age in adolescence, with a three-fold increase post puberty, and 'about equal prevalence among boys and girls until 15-years, after which there appears to be a greater prevalence in females. '(McGee et al. 1992). Although the incidence of young women being diagnosed with depression is higher than for young men, it is not known whether this indicates a greater willingness to seek help on the part of the women.
in Young People
Adolescence is a period of transition between childhood and adulthood. For the purposes of this resource the term adolescence applies to young people in the approximate age range of 12 to 20 years. Adolescence is a time of adaptation and integration into broader society, including establishing one's own identity. It is a time of major physical, emotional, intellectual and social changes for the young person.
Adolescence is a vulnerable time for depression as it is a period characterised for many young people by: Natural mood swings
Concerns over body image
Precarious self-esteem, dependent on outside circumstances
Relationship problems and break-ups
A future that is beginning to exert fears and pressures
A lot of natural idealism which the day-to-day realities of life constantly threaten
Attempts to establish sexual identity and security
Concerns about sexuality and sexual behaviour
Exposure to peer group pressure
Exposure to alcohol and drugs
Frequent value conflicts with parents
Acute academic pressures
Transition from school to the public arena
(Adapted from Mourant, 1989)
Depression in young people is similar to that in adults in many respects. For example, a young person may have clinical depression if they have had a number of the signs of depression for two weeks or more, as in adults. The key differences are in the manner of presentation. That is: In a young person the signs of depression may be expressed differently than in an adult. This can result in depression in young people going undetected.
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