How do I know if my teenager is depressed?

For many parents, life with a teenager can be a complete roller coaster. Schedules are busy, there is a sudden demand for privacy, and emotional ups and downs are a daily occurrence. Sometimes it can feel like each day is a new challenge. The teen years are the second most important period of development as their bodies, brains and personalities are rapidly undergoing change. Their brains in particular are growing and changing at an incredible rate, and we often don’t give them credit for it! With all these changes comes emotional stress, causing occasional mood swings or emotional dips. You may be wondering, “How can I know if my teen is suffering from more than just mood swings?” or “What if I miss the signs of something more serious because I assume they are ‘just teenagers’?” These are wonderful questions because depression is one of the most common mental illnesses in the United States among teens and adults. My hope is that the following information will give you clarity about what is normal and when to seek professional help.

Some facts:

• About 10-15% of teens will have some symptoms of depression at some point but only about 5% will struggle from a major depressive disorder.

• According to a study done by the National Institute of Mental Illness (2014), an estimated 2.8 million adolescents ages 12 to 17 in the United States had at least one major depressive episode in the past year. This number represented 11.4% of the U.S. population ages 12 to 17.

• Females are more likely than males to suffer from depression and rates of depression increased between the ages of 12-17.

• Teen suicide is the 3rd leading cause of death is those ages 10-24 in the US

• Teenage depression does not have one single cause, but is impacted by multiple psychological, biological, and environmental factors.

Although depression can be a short-term disorder and there are many effective treatments, including medication and therapy, it is important to recognize and diagnose depression before it leads to thoughts of self-harm or suicide. The following information is a guide to noticing the signs of teen depression so you can seek support when needed:

1. Loss of interest in activities: Are they avoiding activities or commitments that used to bring them joy? Are they cancelling plans and preferring to stay at home

2. Withdrawing from friends and family: Are they avoiding friends and social events?

3. Sadness or hopelessness for a majority of the day

4. Changes in patterns of eating or sleeping: Is your teen eating less than normal? Are they sleeping more or less than normal habits?

5. Frequent crying

6. Inability to focus and stay on task: Has school work become more challenging or are they falling behind on their assignments?

7. Increased feelings of worthlessness or guilt: Do they have a lot of negative self-talk? Does their self-esteem seem to be lower than normal?

8. Irritability and anger

9. Low motivation: Are they struggling to take initiative? Is it challenging ortto even get ready for the day?

10. Thoughts about death or suicide

It is important to remember that teen depression can look very different than depression in adults. Many adults make the mistake of assuming their own experience of depression or someone close to them is exactly what their teen might experience. This often is not the case. For example, teens often exhibit more irritability than sadness when depressed. Depressed teens also experience physical pain such as headaches and stomach aches that cannot be explained by any physical ailment. Depressed teens are more sensitive to criticism as they are already feeling increased worthlessness and guilt. And finally, depressed adults often isolate themselves from most people in their life, while depression teens will usually keep in contact with a few close friends.

If you have been noticing any of these symptoms in your teen’s life, the first step is to set up an appointment with their primary care provider and start looking for the right counselor. With the right help, your teen can work through this challenging time and develop the tools to cope with future seasons of sadness or depression.

Credits:

National Institute of Mental Illness: http://www.nimh.nih.gov/health/statistics/prevalence/major-depression-among-adolescents.shtml

Why is mindfulness so important?

You may have heard someone talking about mindfulness recently. Maybe your doctor or therapist suggested some mindfulness practices. And you may have said to yourself, “Isn’t that just for people who do yoga? Or practice Buddhism? Or people who are really Zen?” If so, you are not alone in feeling a little hesitant to start doing new breathing and mental exercises. And although mindfulness does have Buddhist roots, my hope is this brief article will help you understand what mindfulness really is, and why so many people are benefiting from it.

The word mindfulness stems from the Buddhist word “[S]ati” which is an awareness of things in relation to things, and hence an awareness of their relative value. Mindfulness was introduced in the United States by Jon Kabat-Zinn, a professor of Medicine Emeritus at The University of Massachusetts Medical School. Kabat-Zinn defines mindfulness by saying “Mindfulness is the psychological process of bringing one’s attention to the internal and external experiences occurring in the present moment, which can be developed through the practice of meditation and other training.” Kabat-Zinn reports there are seven primary attitudes to mindfulness. These attitudes are non-judging, patience, beginners mind, non-striving, trust, acceptance, and letting go. In a nutshell, mindfulness is the practice of being present and aware of your current state without criticism or judgement. Most of us live in the opposite reality where anxiety and depression creep in when we are living in the past or future. Social media and our fast-paced lives encourage the opposite of mindfulness and invite us to avoid our current situation and strive for more/better. This is why mindfulness has become such an important part of slowing down and addressing the patterns that lead to high anxiety.

What are the benefits?

Mindfulness has an ever growing list of benefits for those struggling with severe mental illness or someone simply looking for a way to slow down and be more present. It is shown to decrease symptoms of depression and anxiety, improve your ability to fight illness, and enhance your general well-being. In 2012 there were over 500 studies published demonstrating the positive impact of mindfulness practices when recovering from mental health disorders, addiction, and physical diseases. Mindfulness allows us to be increasingly gentle and patient with ourselves throughout the day, leading to less stress and self-criticism. Some other benefits include:

-          Reduced rumination

-          Increase in working memory

-          Less emotionally reactive

-          Increased mental flexibility

-          Higher relationship satisfaction

A Harvard study showed that practicing mindfulness increased the brains ability to create new gray matter. Increased gray matter in the hippocampus is beneficial for learning, memory, self-awareness, introspection, and compassion. “It is fascinating to see the brain’s plasticity and that, by practicing meditation, we can play an active role in changing the brain and can increase our well-being and quality of life,” says Britta Hölzel, first author of the paper and a research fellow at MGH and Giessen University in Germany. “Other studies in different patient populations have shown that meditation can make significant improvements in a variety of symptoms.”

So how do I get started?

You can begin mindfulness by simple being aware of your surroundings. For example, find a moment to sit quietly and use your five senses to take in your environment… maybe you notice a new sound in your living room, the smell of clean laundry, rain on the window, or the stiffness of your chair. You can get even simpler by just focusing on your breath. Purely noticing without judgement as your chest rises and falls. Being able to stay focused on the current moment takes lots of practice! Without fail, your thoughts will drift to the day’s tasks or worries about the future. This is where acceptance becomes important, because we need to accept our own ability to be mindful and the process of improving. You can also find hundreds of resources online, including audio recordings of mindfulness exercises. Mindfulness can also be done in counseling to compliment the work you are doing with a therapist. Whether practicing on your own, with a professional, or in a group, mindfulness is an incredible tool that can benefit people of all ages and stages of life.

How long does counseling last?

One of the most common questions I get when talking with a new client is: “How many sessions will this take?” Almost all potential clients are curious about the commitment they will need to make in order for counseling to have positive benefits on their life. Unfortunately, there is no exact prescription for how long counseling will last because each client enters the room with unique experiences and needs. So….the true and probably annoying answer is: everyone is different. With that said, I thought it might be helpful to address the life cycle of the counseling relationship from my perspective, hoping it might dispel some of the fears someone might have around starting the counseling process.

I always like to mention to potential clients that they have the right to choose a counselor who is a good fit for them. You may need to do a few different initial sessions or phone consultations before you find the right professional. Every counselor has a unique style and perspective, and you can find the one that is right for you. But it’s also important to mention that a good counselor will challenge you and encourage you to grow, so don’t mistake hard work for being with the wrong therapist!

With that said, once you find a counselor you trust and can connect with, the rest of the process can look many different ways. Some clients come in with situations or challenges that only require short term counseling. These clients usually come with a specific goal they are wanting to work towards such as processing a break-up, working through a recent trauma, or getting tools to have a hard conversation. In these cases counseling might last anywhere from two to six sessions and often takes a brief/ solution focused therapeutic approach.

I have also seen clients on a more seasonal basis. They come to counseling for a period of time, take a break, and then return when they have more to work through. This is often the case during the Winter months when more people are struggling with symptoms of depression or Seasonal Affective Disorder. I have worked with clients for several months, we decide together to end therapy, and then they reach out again when another challenging life event comes their way. For example, I worked with one young man for 6 months processing events from his childhood. After six months we both agreed he had met his goals and was ready to stop coming to counseling. About a year later he reached out because he was engaged and ready to do some pre-marital work. It was a joy to hear from him again and be able to walk with them through a new season. All of these situations are considered normal in the therapeutic process. 

Counseling can also be a longer process. For struggles such as depression, anxiety, eating disorders, ongoing trauma and struggles with low self-worth, they can be life long battles and clients may benefit from ongoing support. Some people have no other place in their lives where they can speak openly and take a honest look at the things they battle with daily. In these situations, I have seen clients anywhere from six to twelves months, sometimes even years. Sessions may not be weekly, but we maintain a therapeutic relationship that continues to support their growth and changing needs. This is some of the most rewarding work I have done as a counselor as I get to join clients on their journey and walk with them through many ups and downs.

Whether you are considering counseling with one specific goal in mind, or you are ready to tackle a long standing battle in your life, know that reaching out for help is a courageous first step towards healing and living a full life.