CRIS

 Depression
       Defined
       Symptoms
       Suicide

Adolescent Depression

What to do When a Friend is depressed:  A Student Guide
 Offers information on depression and its symptoms and suggests things a young person can do to guide a depressed friend in finding help. Especially good for health fairs, health clinics, and school health units.

WHAT TO DO WHEN A FRIEND IS DEPRESSED
You know that these school years can be complicated and demanding. Deep down, you are not quite sure of whom you are, what you want to be, or whether the choices you make from day to day are the best decisions. 

Sometimes the many changes and pressures you are facing threaten to overwhelm you. So, it isn't surprising that from time to time you or one of your friends feels "down" or discouraged. 

But what about those times when a friend's activity and outlook on life stay "down" for weeks and begin to affect your relationship? If you know someone like this, your friend might be suffering from depression. As a friend, you can help. 

FIND OUT MORE ABOUT DEPRESSION 
Q. What is depression? 

 A. Depression is more than the blues or the blahs; it is more than the normal, everyday ups and downs. When that "down" mood, along with other symptoms, lasts for more than a couple of weeks, the condition may be clinical depression. Clinical depression is a serious health problem that affects the total person. In addition to feelings, it can change behavior, physical health and appearance, academic performance, social activity and the ability to handle everyday decisions and pressures.

Q. What causes clinical depression? 

A.  We do not yet know all the causes of depression, but there seem to be biological and emotional factors that may increase the likelihood that an individual will develop a depressive disorder. Research over the past decade strongly suggests a genetic link to depressive disorders; depression can run in families. Bad life experiences and certain personality patterns such as difficulty handling stress, low self-esteem, or extreme pessimism about the future can increase the chances of becoming depressed. 

Q. How common is it? 

 Clinical depression is a lot more common than most people think. It will affect more than 19 million Americans this year. One-fourth of all women and one-eighth of all men will suffer at least one episode or occurrence of depression during their lifetimes. Depression affects people of all ages but is less common for teenagers than for adults. Approximately 3 to 5 percent of the teen population experiences clinical depression every year. That means among 100 friends, 4 could be clinically depressed. 

Q. Is it serious? 

A. Depression can be very serious. It has been linked to poor school performance, truancy, alcohol and drug abuse, running away, and feelings of worthlessness and hopelessness. In the last 25 years, the rate of suicide among teenagers and young adults has increased dramatically. Suicide is often linked to depression. 

Q. Are all depressive disorders alike? 

A. There are various forms or types of depression. Some people experience only one episode of depression in their whole life, but many have several recurrences. Some depressive episodes begin suddenly for no apparent reason; while others can be associated with a life situation or stress. Sometimes people who are depressed cannot perform even the simplest daily activities -- like getting out of bed or getting dressed, others go through the motions, but it is clear they are not acting or thinking as usual. Some people suffer from bipolar depression in which their moods cycle between two extremes -- from the depths of desperation to frenzied talking or activity or grandiose ideas about their own competence. 

Q. Can it be treated?

A.  Yes, depression is treatable. Between 80 and 90 percent of people with depression -- even the most serious forms --- can be helped. Symptoms can be relieved quickly with psychological therapies, medications, or a combination of both. The most important step toward overcoming depression -- and sometimes the most difficult -- is asking for help. 

Q. Why don't people get the help they need? 

A.  Often people don't know they are depressed, so they don't ask for or get the right help. Teenagers and adults share a problem --- they often fail to recognize the symptoms of depression in themselves or in people they care about.  

BE ABLE TO TELL FACT FROM FICTION. 
Myths about depression often separate people from the effective treatments now available. Friends need to know the facts. Some of the most common myths are these:   

Myth: It's normal for teenagers to be moody; Teens don't suffer from "real"` depression.   Fact: Depression can affect people at any age or of any race ethnic, or economic group. 

Myth: Teens who claim to be depressed are weak and just need to pull themselves together. There's nothing anyone else can do to help. 

Fact: Depression is not a weakness, but a serious health disorder. Both young people and adults who are depressed need professional treatment. A trained therapist or counselor can help them learn more positive ways to think about themselves, change behavior, cope with problems, or handle relationships. A physician can prescribe medications to help relieve the symptoms of depression. For many people, a combination of psychological therapy and medication is beneficial. 

Myth: Talking about depression only makes it worse. 

 Fact: Talking through feelings may help a friend recognize the need for professional help. By showing friendship and concern and giving uncritical support, you can encourage your friend to talk to his or her parents or another trusted adult, like a teacher or coach, about getting treatment. If your friend is reluctant to ask for help, you can talk to an adult --- that's what a real friend will do. 

Myth: People who talk about suicide don't commit suicide. 

Fact: Many people who commit suicide have given warnings to friends and family. A signal or warning may be a statement such as "I wish I were dead," "I can't take it anymore; I want out," or "My parents would be better off without me". Some people even tell a friend about a plan to kill themselves before they actually do. If a friend talks like this, always take it seriously! Immediately make a responsible adult aware of what your friend has said. A parent, a teacher, a school nurse or counselor can all help. 

Myth: Telling an adult that a friend might be depressed is betraying a trust. If someone wants help, he or she will get it.  

Fact: Depression, which saps energy and self-esteem, interferes with a person's ability or wish to get help. And many parents may not understand the seriousness of depression or of thoughts of death or suicide. It is an act of true friendship to share your concerns with a school guidance counselor, a favorite teacher, your own parents, or another trusted adult. 

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KNOW THE SYMPTOMS
The first step toward defeating depression is to define it. But people who are depressed often have a hard time thinking clearly or recognizing their own symptoms. They may need your help. Check the following boxes if you notice a friend or friends with any of these symptoms persisting longer than two weeks. 

Do they express feelings of

• Sadness or "emptiness"? 
• Hopelessness, pessimism, or guilt?  Helplessness or worthlessness?  

Do they seem  

• Unable to make decisions? 
• Unable to concentrate and remember? 
• To have lost interest or pleasure in ordinary activities -- like sports or band or talking on the phone? 
• To have more problems with school and family? 

Do they complain of 

• Loss of energy and drive -- so they seem "slowed down"? 
• Trouble falling asleep, staying asleep, or getting up? 
• Appetite problems; are they losing or gaining weight? 
• Headaches, stomach aches, or backaches? 
• Chronic aches and pains in joints and muscles? 

Has their behavior changed suddenly so that  

• They are restless or more irritable? 
• They want to be alone most of the time? 
• They've started cutting classes or dropped hobbies and activities? 
• You think they may be drinking heavily or taking drugs? 

Have they talked about 

• Death? 
• Suicide -- or have they attempted suicide? 

FIND SOMEONE WHO CAN HELP
  If you checked several of the boxes, a friend may need help. Don't assume that someone else is taking care of the problem. Negative thinking, inappropriate behavior or physical changes need to be reversed as quickly as possible. Not only does treatment lessen the severity of depression, treatment also may reduce the length of time (duration) your friend is depressed and may prevent additional bouts of depression.

If a friend shows many symptoms of depression, you can listen and encourage him or her to ask a parent or teacher about treatments. If your friend doesn't seek help quickly, talk to an adult you trust and respect-especially it your friend mentions death or suicide. 

There are many places in the community where people with depressive disorders can be diagnosed and treated. Help is available from a family doctors, mental health specialists in community mental health centers or private clinics, and from other health professionals.

Let's Talk About Depression
Designed for teenagers, this document discusses facts about depression, symptoms, treatment, relation to substance abuse, and how to get help.

Let's Talk about Depression 
Sure, everybody feels sad or blue now and then. But if you're sad most of the time, and it's giving you problems with 

• your grades 
• your relationships with your family and friends
• alcohol, drugs, or sex 
• controlling your behavior in other ways 

the problem may be: DEPRESSION 
The good news is that you can get treatment and FEEL BETTER SOON.... Approximately 4 out of 100 teenagers get seriously depressed each year. Clinical Depression is a serious illness that can affect anybody, INCLUDING TEENAGERS. It can affect your thoughts, feelings, behavior, and overall health. 

Most People with Depression can be helped with Treatment 
But a majority of depressed people never get the help they need. And, when depression isn't treated, it can get worse, last longer, and prevent you from getting the most out of this important time in you life.

SO... LISTEN UP:
Here's how to tell if you or a friend might be depressed. 

First, there are two kinds of depressive illness: The sad kind, called major depression, and manic-depression or bipolar illness, when feeling down and depressed alternates with being speeded-up and sometimes reckless. 

YOU'VE GOT TO GET EVALUATED BY A PROFESSIONAL IF YOU'VE HAD FIVE OR MORE OF THE FOLLOWING SYMPTOMS FOR MORE THAN TWO WEEKS OR IF ANY OF THESE SYMPTOMS CAUSE SUCH A BIG CHANGE THAT YOU CAN'T KEEP UP YOUR USUAL ROUTINE.

When You're Depressed.

• You feel sad or cry a lot and it doesn't go away. 

• You feel guilty for no real reason; you feel like you're no good; you've lost your confidence. 

• Life seems meaningless or like nothing good is ever going to happen again. You have a negative attitude a lot of the time, or it seems like you have no feelings. 

• You don't feel like doing a lot of the things you used to like-- like music, sports, being with friends, going out-- and you want to be left alone most of the time.  It's hard to make up your mind. You forget lots of things, and it's hard to concentrate. 

• You get irritated often. Little things make you lose your temper; you over-react.  Your sleep pattern changes; you start sleeping a lot more or you have trouble falling asleep at night. Or you wake up really early most mornings and can't get back to sleep. 

• Your eating pattern changes; you've lost your appetite or you eat a lot more. 

• You feel restless and tired most of the time. 

• You think about death, or feel like you're dying, or have thoughts about committing suicide 

TALK TO SOMEONE
If you are concerned about depression in yourself or a friend, TALK TO SOMEONE about it. There are people who can help you: 

• a trusted family member 

• your family doctor 

• your clergy 

• a school counselor or nurse 

• a responsible adult 

• a social worker 

• a professional at a mental health center or Mental Health Association 

Or, if you don't know where to turn, the telephone directory or information operator should have phone numbers for a local hotline or mental health services or referrals. 

Depression can affect people of any age, race ethnic, or economic group. 

LET'S GET SERIOUS HERE.
Having depression doesn't mean that a person is weak, or a failure, or isn't really trying...it means they need TREATMENT. 

Most people with depression can be helped with COUNSELING, MEDICINE, or BOTH TOGETHER. 

COUNSELING, or psychotherapy, means talking about feelings with a trained professional who can help you change the relationships, thoughts, or behaviors that contribute to depression. 

MEDICINE is used to treat depression that is severe or disabling. Antidepressant medications are not "uppers" and are not addictive. Sometimes, several types may have to be tried before you and your doctor find the one that works best. 

Treatment can help most depressed people start to feel better in just a few weeks. 

So remember, when your problems seem too big and you're feeling low for too long, 

YOU ARE NOT ALONE. There's help out there and you CAN ask for help. And if you know someone who you think is depressed, YOU CAN HELP: Listen and encourage your friend to ask a parent or responsible adult about treatment. If you friend doesn't ask for help soon, talk to an adult you trust and respect-- especially if your friend mentions suicide. 

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WHAT YOU NEED TO KNOW ABOUT SUICIDE
Most people who are depressed do not commit suicide. But depression increases the risk for suicide or suicide attempts. It is NOT true that people who talk about suicide do not attempt it. Suicidal thoughts, remarks, or attempts are ALWAYS SERIOUS...if any of these happen to you or a friend, you must tell a responsible adult IMMEDIATELY.... it’s better to be safe than sorry.

WHY DO PEOPLE GET DEPRESSED?
Sometimes people get seriously depressed after something like a divorce in the family, major financial problems, someone you love dying, a messed up home life, or breaking up with a boyfriend or girlfriend. Other times-- like with other illnesses-- depression just happens. Often teenagers react to the pain of depression by getting into trouble: trouble with alcohol, drugs, or sex; trouble with school or bad grades; problems with family or friends. This is another reason why it's important to get treatment for depression before it leads to other trouble.

DEPRESSION AND ALCOHOL AND OTHER DRUGS 
A lot of depressed people, especially teenagers, also have problems with alcohol or other drugs. (Alcohol is a drug, too.) Sometimes the depression comes first and people try drugs as a way to escape it. (In the long run, drugs or alcohol just make things worse.) Other times, the alcohol or other drug use comes first, and depression is caused by :

• the drug itself, or 

• withdrawal from it, or 

• the problems that substances use causes. 

And sometimes you can't tell which came first... the important point is that when you have both of these problems, the sooner you get treatment, the better. Either problems can make the other worse and lead to bigger trouble, like addiction or flunking school. You have to be honest about both problems-- first with yourself and then with someone who can help you get into treatment... it's the only way to really get better and stay better.

REMEMBER: 
YOU CAN HELP YOURSELF, OR A FAMILY MEMBER, OR A FRIEND FIND TREATMENT FOR DEPRESSION. DO IT NOW. 

BE ABLE TO TELL FACT FROM FICTION.
Myths about depression often prevent people from doing the right thing. Some common myths are

Myth: It's normal for teenagers to be moody; Teens don't suffer from "real" depression. 

FACT: Depression is more than just being moody. And it can affect people at any age, including teenagers.

Myth: Telling an adult that a friend might be depressed is betraying a trust. If someone wants help, he or she will get it.

FACT: Depression, which saps energy and self-esteem, interferes with a person's ability or wish to get help. It is an act of true friendship to share your concerns with an adult who can help. 

Myth: Talking about depression only makes it worse. 

FACT: Talking through feelings with a good friend is often a helpful first step. Friendship, concern, and support can provide the encouragement to talk to a parent or other trusted adult about getting evaluated for depression.

This information is available courtesy of the NIMH.  It is in the public domain and can be downloaded, reproduced, or copied without permission. For more information go to http://www.nimh.nih.gov

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