I Don’t Know Why

The recent media coverage of Bobbi Kristian Brown and the unknown circustmances of her recovery warrants addressing depression in adolescents.  Often discussion of depression often leads to children and teenagers, even some adults, to describe feelings in the context of “I don’t know why I feel this way…” and the sad reality confirms this truth. Struggling with depression doesn’t warrant a cause or explanation, just understanding.  Here are some guidelines that will hopefully help you and/or your adolescent understand.

Low Mood.  Depression in children and adolescents often rears its sad head in the form of irritation that is not usual for your child.  In addition, the teen can be viewed as “copping an attitude,” reports of feeling sad, or quick to cry.  These expression of low mood can be reported by your child or witness by you, as a change in your child.

Losing Interest.  Children and adolescents, suffering from depression, often discontinue engaging in activities that are pleasurable, such as listening to music, an extra-curricular activity, hanging out with friends.  The child may react lethargically when presented with an activity (such as going to the movie) when normally he/she would be excited about it.

Appetite Change.  Loss of appetite can be an indication that your teen is struggling with depressed feelings, while an increase in appetite could warrant the same struggle.  Notice whether your teen is not eating or eating in excess more days than not, where his/her decrease/increase in appetite is not better explained by other medical conditions or concerns.

Trouble Sleeping.  Normal sleep patterns for teens are sometimes difficult to navigate in general, due to working, hanging with friends, or homework.  Having difficulty falling asleep or staying asleep for nearly every day could be a warning sign.  Opposite of that would be observing your child sleeping too much, as if he/she can’t get enough to sleep.

Too Tired.  Is your teen reporting feelings of fatigue or loss of energy every day?  Are you seeing a change in his/her motivation?  This could be indication of depression.

Low Self-Esteem.  Witnessing or hearing your child report feeling worthless or guilty about something in particular nearly every day could be a symptom of depression.

Difficulty Focusing.  Watching your teen’s ability to concentrate, make decisions, or think straight can be a challenge for parents, especially when the teen feels he/she can’t explain the recent diminishment.

Death & Suicide.   Ongoing thoughts of death and dying are scary, and teens have difficulty explaining why he/she has those in the mind.  Suicidal thoughts, whether with or without intent, are immediate cause for alarm and should always be taken seriously.

Feeling sad and unmotivated one day isn’t reason to immediately consider depression. So how will you know if your adolescent is experiencing depression?  Consider what and how many of the symptoms your teen displays and reports.  How long do those symptoms last (an hour, days, weeks)?  Are they severe enough to cause a significant change in his/her personality?  While adults who feel depressed can confidentially go to a counselor, your teen doesn’t always have that option.  A child/adolescent relies on his/her parent, caregiver, teacher, school counselor to notice these changes and take action to address the symptoms, ask questions, and make him/her feel validated.  Ask and offer suggestions of help, including seeking out a mental health professional who can further inform you and the adolescent if his/her behavior should warrant a concern.

The Difficulty of Grief for Teens

Death is hard. Period. Being at teen is hard. Period. But going through grief as a teen is confounding.

The smalltown community I serve was recent devastated with not one, but three teens, who passed away entirely too young, in an auto accident. I was called on, with several other fabulous counselor I work with, to respond in crisis mode to assist with the mounting grief students would experience processing the realism of death.

Hours of being with students of my own and counseling those I’ve never met, until today, brought light to sharing some key elements of teen grief.

The first emotion nearly always seems to be shock; that look of disbelief and turmoil. Floodgates open and emotions flow out so strongly that crashes any amount of sense lingering in their mind: anger, regret, sadness, guilt, blame, confusion.

Normalize the feelings.
Allow that teen to experience that emotion and remind him/her that those emotions are normal. As adults, we’ve learned through many experiences that most of the feelings we have when processes grief are normal. I’m not certain if it is raging hormones, lack of experiences, or the idea of invincible, but teens do not seem to have the same coping skills as adults. Normalize those feelings and assure him/her it is ok to feel and express those feelings. Create a condition in which that is encouraged and welcomed.

“I just wish I had (fill in the blank).”
I have heard this statement so many times. Teens who feel guilty for surviving when a classmate didn’t. Teens who regret not saying something to that person when alive. Survivor’s guilt comes in so many forms, and it can develop from those teens who barely associated with the one who passed. Again, normalize those feelings as a normal reaction in the form of grief. Challenge that teen to create a positive outcome from such devastation; empower him/her to serve using this feeling as a motivation. Suggestions: write a letter to that person, find a way to contribute to something, give blood, or volunteer in some aspect that would make the deceased proud. Be open to that teen sharing good memories of the deceased; validate the teens “I can’t stop thinking about him/her” and remind them it is OK to remember a loved one in a positive way.

Grief is a process.
Share with the teen that grief is an ongoing process, not an isolated event, where one wakes up all better tomorrow. Discuss triggers of emotions; a song, a class, an activity associated with the deceased. Encourage the teen to continue normal activities such as school and class, even if he/she doesn’t want to, even if it is going through the motions. Suggest eating healthy foods, and snacks, getting plenty of rest, and keeping a journal to write down feelings. Remind the teen to spend time with those he/she loves, even if it is difficult, spend time with family, friends, and pets. Laugh. It might sound completely out of the question, but recommend to the teen to laugh when he/she can.

Grief is hard. Your grieving, my grieving all looks and feels differently from someone else. Allow the teen to express feelings, and thoughts (in a safe way) during grief that may not necessarily make sense; because it probably doesn’t even make sense to the teen living it.  This photo reminds me not to put anyone or their feelings into boxes; each person’s owns his/her individual set of emotions.

grief

RIP Robin Williams and Attention to Depression

With the recent suicidal death of the talented Robin Williams, (love him or hate him, he’s talented) talks of mental illness spill from every news station, radio show, tabloid magazine, and hashtags on twitter. Rumors, possibly truths, are using words like depression, addiction, suicide, and mental illness. Such discussions on mainstream media are hot topic until the latest sweep of something better breaks the headlines tomorrow morning.

After a discussion with a parent today about my client (her child) being admitted inpatient for thoughts of suicide, and recent media hype about depression, I began to question whether adults are fully informed on recognizing such symptoms in our young people.

But, depression is depression, right? Not exactly, and certainly depression differs when comparing adults to child and adolescents.

So what should we look for?

Look for time. We’ve all experience feeling “depressed,” and that is understandable; but, when those feelings last more than two weeks, become concerned.

It’s not just sadness. Adolescents and children experience “depression” differently, and it can be perceived as irritability, anger and/or moodiness, by adults, parents, and teachers, even peers. Be aware of what is normal, and notice if the child has particular and ongoing irritability.

Big changes. Depression changes the way a person feels and thinks, which influences the way he/she behaves. Adolescents and teenagers are no different. Watch for those changes in behavior. Keep an eye for grades dropping, more trouble at school, changes in eating habits (eating more or eating less). Look for significant changes in sleeping patterns, either sleeping more and having difficulty sleeping. Most adolescents and teens are social creatures; so when they withdraw from friends and family (more than the usual not wanting to hang with mom or dad), or take notice.

The same symptoms. Not all depression symptoms are different between adults and children. There are several that can be very similar. Feelings of worthlessness, sadness, crying are key elements that indicate depression in teens. Listen for self-defeating comments about oneself, crying unexplainably, quick to anger for no apparent reason, genuine moping around that is unusual.

Talk about Suicide. Yes, it is ok to mention the “s” word. I can promise with all the media coverage of suicide from every angle, Robin Williams to stories about teens killing themselves, mentioning suicide doesn’t give teens and adolescent the idea. Open discussion helps address the potential elephant in the room, and while awkward, the conversation could shine light on something serious that is happening.

Depression can be difficult for those feeling it and those watching someone they love experience it. Talk about it. Don’t assume that a teenager or adolescent has or doesn’t have those feelings; be proactive in not allowing that child to feel alone in a room full of people. rw

Man Up

Society is reeking with teen violence; racial, bullying, school shootings.  Why now?  What has changed?  This topic hit me full force when I watched the video below on the way we are raising our children.  Little boys are taught from a young age to “Man up,” “Don’t be a wimp,” “Toughen up,” “Don’t be a girl,” which translates to don’t express anger, don’t talk about feeling depressed, boys aren’t allowed to be sad, emotions are forbidden.  Respect is often attributed to violence among peers who are usually taught from a father, or a father-type figure. 

Can a boy still become a man when he has tears rolling down his eyes?  YES.  He becomes a man who is capable of expressing emotions and allowing his anger to be released.  Anger that is held in and oppressed can bring about a foundation of bitterness and unfortunately an explosion of emotions that deems that child to having a conduct disorder instead of just feeling misunderstood. 

Moms, Dads, Educators and individuals who directly care for little boys…. give the same amount of emotional confidence to those little boys as you do little girls.  Stop pretending these tiny creatures should show no emotion.  Affirm his anger, let him talk about it; tell him it’s ok to cry, comfort  him.  Be comfortable in your own emotions to share the anger, the pain, the hurt. 

Maybe, the violence can be curtailed one little child at a time.