Coping with Depression in Young People: A Guide for Parents


Coping with Depression in Young People describes the normal steps parents go through in coming to terms with depression in their children, from first noticing something is wrong to accessing the best professional treatment, to surviving what can be a very emotional time for the whole family. Carol Fitzpatrick and John Sharry both experts in this field, deal with the issues most patents find particularly worrying, such as drug and alcohol use, suicide and self-harm, and other mental health problems. Parents ...
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Coping with Depression in Young People describes the normal steps parents go through in coming to terms with depression in their children, from first noticing something is wrong to accessing the best professional treatment, to surviving what can be a very emotional time for the whole family. Carol Fitzpatrick and John Sharry both experts in this field, deal with the issues most patents find particularly worrying, such as drug and alcohol use, suicide and self-harm, and other mental health problems. Parents reading this book will find guidance on what help and treatments are available for their child, as well as what they can do themselves to help the whole family cope.
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Editorial Reviews

From the Publisher
"…a guide for parents, a book long overdue and one which will be of enormous help…is especially valuable…" (, 19 February 2004)

"...concise ...useful to anyone working with children and young people experiencing depression..." (Child Right, May 2004)

“The strength of the book lies in it accessible style and numerous practical suggestions.” (Child and Adolescent Mental Health, Vol.10, No.2, May 2005)

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Product Details

  • ISBN-13: 9780470857557
  • Publisher: Wiley
  • Publication date: 3/15/2004
  • Series: Family Matters Series , #3
  • Edition number: 1
  • Pages: 160
  • Product dimensions: 5.30 (w) x 8.48 (h) x 0.47 (d)

Table of Contents

About the authors ix
Preface xi
Acknowledgements xiii
1 What is depression? 1
What depression feels like 7
How common is depression in young people? 8
Causes of depression 10
Is depression in young people more common now than in the past? 12
What happens to young people with depression? 12
2 How to recognise depression in young people 15
Which young people are most likely to get depressed? 15
Changes in mood and behaviour 16
3 Depression in young people who already have difficulties 23
Learning difficulties 24
Attention deficit hyperactivity disorder (ADHD) 25
Conduct problems 30
Asperger's syndrome 31
Conclusion 36
4 Could it be due to something else? 39
Is it due to alcohol? 40
Could it be due to drugs? 41
A serious physical illness 42
Sexual abuse 43
Schizophrenia 44
Eating disorders 46
Bipolar affective disorder (manic depressive disorder) 47
5 Getting help 51
Talking to others who know your child 52
Help within the family 52
Finding out what help is available 53
Counselling 54
Child and adolescent mental health services 55
Communicating with your teenager about the need for further help 56
Approaching your depressed child 58
6 Treatment of depression 63
Multiple approaches 64
Therapeutic help for the young person 64
Parent support 66
Family therapy 67
Medication 69
Hospitalisation 71
Day treatment programmes 72
How long does it take? 75
7 What can parents do? 77
Supporting your teenager 77
Dealing with discipline and conflict 84
Keeping yourself going 90
Helping your other children to cope 91
Tackling family problems 92
Conflicting advice from family members/friends 93
What parents can't do 94
8 Suicide and self-harm 97
Some myths about suicide 98
Are there warning signs? 98
What to do if you suspect your young person is suicidal 99
Coping with suicide attempts 100
Dealing with discipline after a suicide attempt 101
Dealing with self-cutting behaviour 104
Suicide and alcohol 105
9 Dealing with common problems 107
Depression and school 107
Depression and exams 108
He won't go for help 110
Sleep problems 111
Anger and aggression 112
Depression and bullying 113
10 Learning from young people who have recovered from depression 115
The Working Things Out study 116
What it felt like when they were depressed 118
What they thought had caused them to feel the way they did 121
What they thought had helped them to get through their difficult times 123
Conclusion 129
Interactive CD-ROM 130
11 Depression--what does the future hold? 131
The statistics 132
'Good effects' of depression? 133
The brain and depression--current research 134
The future and your child 135
Resources 137
Index 143
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First Chapter

Coping with Depression in Young People

A Guide for Parents
By Carol Fitzpatrick John Sharry

John Wiley & Sons

ISBN: 0-470-85755-2

Chapter One

What is depression?

Depression is an emotion we are all familiar with. A bleakness of thought, a feeling of irritation toward those closest to us, a sense of emptiness, a question about what life is for, an inability to feel joy or pleasure - most of us have gone through times in our lives when we have had some or all of these feelings. Mostly they occur when we are tired or overburdened, when we have had a row with someone close to us or when an important relationship is not going smoothly. We usually can explain to ourselves why we feel the way we do and can reassure ourselves that these feelings will pass. This is depression, the feeling, part of the vast range of normal emotion that makes us human and that is as much a part of our ordinary experience as is joy, anger, fear or happiness.

When we hear somebody described as being depressed, we imagine that we have an idea of how they are feeling, based on our own experiences. We expect that their feelings of depression are a reaction to something negative that is happening in their lives, and we expect them to try to get over their depression - 'to snap out of it'. This is what most people understand when they hear the term 'depression' being used.

When mental health professionals use the term 'depression', they usually mean a depressivedisorder, something that has some shared features with what is described above, but something that also has important differences. The term 'depressive disorder' implies that the person has a number of symptoms, including depressed mood, as described above, only usually to a much more profound degree, and they have what is called 'functional impairment' - in other words, they are handicapped in their ability to get on with life, to carry out their everyday life's activities. The classification systems used by mental health professionals in diagnosing depressive disorders are shown in Tables 1.1 and 1.2.

Many of the symptoms shown in Tables 1.1 and 1.2 are common in young people and probably in most of us from time to time, and do not mean we are suffering from a depressive disorder. What is important is the combination and severity of the symptoms and their effect on everyday life and the ability to function. In young people, irritability is often particularly marked, leading the young person to be in conflict with family, friends and teachers. This can lead to a vicious cycle of depression [right arrow] conflict [right arrow] further depression.

When depressed young people and those around them get into a vicious cycle like this, things can seem completely stuck. As a parent, you want to help your child, but you may feel angry and beaten back by his hostility or seeming indifference. It can feel as if there is no way forward. But there are ways of helping which can gradually 'unstick' situations like this, and these are dealt with in detail in the chapters ahead.

Classification systems for depressive disorders used by psychiatrists

Diagnosis of major depressive episode

Depressive disorders come in all grades of severity from mild disorders where the person may have the symptoms listed and be less efficient, less affectionate, less spontaneous than they usually are, to very severe disorders where the person may be unable to get out of bed, unable to communicate, unable to eat or drink, all of which may become a medical emergency. There are all sorts of grades between these two extremes. While there is no such thing as a typical case of depressive disorder in a young person, each case being somewhat different just as no two people are the same, the following case history is a good example of a young teenager with a depressive disorder.

Depression in children and adolescents usually has some of the above features but they may not always appear in the classical way described above. The reasons for this are many. Young people, particularly children, often do not have the language to describe how they are feeling. They experience the feelings, but are unable to describe them to others. Older children and adolescents may have the language, but are reluctant to talk about how they are feeling, often believing that others may think they are going mad, a fear they often have themselves. There are no words that can adequately describe some of the feelings experienced by some young people going through a depressive disorder, and it is only when they have recovered that they can describe what they have felt. The next section, 'What depression feels like', gives real life examples of descriptions by young people of how they felt when they were going through a depressive disorder. These examples are shown with the permission of the young people involved.

What depression feels like

Quotes from young people (see also Chapter 10 for further information and quotes on the experiences of young people):

It was like a dread inside, there all the time. When I was with my friends it would go away a bit, but it always came back. Jack, aged 15

I started worrying about everything, even things that never bothered me before. I was so worried about being asked a question in school that I used to feel sick in the mornings. Some days I just could not go to school. Nessa, aged 13

I was angry with everyone, they all annoyed me, particularly my mum who kept asking me what was wrong. Laura, aged 14

I couldn't face anyone, I don't know why. I wanted to be dead, it was in my mind all the time, I couldn't stop thinking about my death and being dead. At least then I would stop feeling like this. Sue, aged 15

Sometimes there'd be this feeling of being trapped, or perhaps overwhelmed. Other times there'd be a feeling of just being completely lost and not knowing what to do, and then the most frequent was probably one of complete and utter apathy for life, the universe and everything. David, aged 16

I got very fatigued. I'd stay in bed for ever really. I just felt absolutely lousy and I got awful stomach pains as well, and awful headaches. So that's how I felt. John, aged 15

How common is depression in young people?

Many research studies have been done which involve interviewing large numbers of ordinary young people and usually their parents as well. The interviews used are in-depth psychiatric interviews that allow a formal psychiatric diagnosis to be made. Studies of this type are fairly consistent in showing that about 5% of adolescents have a depressive disorder. This represents about 25 pupils in a secondary school with 500 pupils. Depression occurs in about 2% of older children and probably occurs in younger children, but accurate figures are not available for this age group. Depression occurs in children from all social backgrounds and is often associated with other emotional and behavioural problems. In childhood, depression seems to occur with equal frequency in boys and girls, but in adolescence it may be more common in girls. We are not sure about this, as adolescent boys are notoriously reticent about discussing their feelings with others and that includes the professionals who carry out research studies. It may be that adolescent boys are just as likely as girls to suffer from depression, but they show it in a different way (e.g., with more anger and impulsive hostility).

In childhood and adolescence, depression is usually unrecognised and untreated. The young person is often regarded as being moody, difficult, troubled or troublesome, but is rarely regarded as being depressed. This is partly because adults find it hard to imagine that children and adolescents could suffer from depression in much the same way as adults do, and partly because young people often express their pain in different ways to adults. Young people rarely complain of feeling depressed; they are more likely to complain of being fed up, bored or lonely. Or they may not complain at all, but instead act out their negative feelings, becoming hostile and aggressive to those who are often trying hardest to help them.

Causes of depression

There have been huge advances in research into the causes of depressive disorders in recent times, but we are still some way from having a clear understanding. There is no single cause for depression, but we know that in many situations there is an interaction between a genetic vulnerability and adverse life events. Many young people have a history in their families of depressive disorders in their parents, aunts, uncles or grandparents. A family history of depression does not necessarily imply a genetic basis. A child who has grown up with a depressed family member may respond to adversity by behaving as they have seen others around them behave and, thus, they are more prone to develop depression as a kind of 'learned behaviour'. However, research has shown that genetic factors play an important role in many types of depression. What seems to be inherited is not a single gene for depression but rather a genetic vulnerability. It is likely that many people carry this vulnerability, but they may never experience significant depression. This may be because they never have a combination of things going wrong for them at a particular time, or because they have, in addition to their genetic vulnerability, one or many protective factors. Protective factors in children include a stable relationship with at least one parent and a positive, confident temperament.

Adverse life events that may predispose young people to develop depression include losses of various kinds, such as loss of a parent through separation or divorce, loss of self-esteem through bullying, abuse or failure. Living in situations of family conflict or where a parent is him or herself struggling with a mental health problem, such as alcoholism or depression, may also predispose a young person to develop depression. Most young people with chronic physical problems, such as cystic fibrosis, chronic renal failure or diabetes, do not develop depression, but some do, particularly in adolescence when for the first time they fully appreciate the nature of their physical problems. Some acute illnesses, such as glandular fever, may precipitate depression in young people, as may some other viral illnesses.

Very conscientious, perfectionistic young people seem to be more prone to develop depression than their more easy-going peers, but depression can occur in young people with any type of personality. There is only very rarely a single cause that can be identified. More commonly, there are a number of adverse factors, some of which may seem trivial to an outsider, that predispose a vulnerable young person to develop depression.

Young people with long-standing behaviour problems, learning difficulties or attention deficit hyperactivity disorder (ADHD) are more prone than usual to depression, probably due in part to the many negative experiences such children have had. These experiences include difficulties with friendships, academic failure and constant criticism. The self-esteem of such children tends to be very low, often hidden under an aggressive, brash exterior. In Chapter 3 we consider these special difficulties in more detail.

Is depression in young people more common now than in the past?

That is a difficult question to answer because we do not know how common depression was in the past. It is only within the past 15 to 20 years that accurate estimates are available about rates of depression in young people. The number of young people being referred to services for treatment of depression seems to be increasing, but that could be due to many factors, including more services being available and families being more willing to seek help.

What happens to young people with depression?

The outlook is good for most young people with depression. The depression tends to lift, whether or not they receive treatment. A recent study of a group of teenagers with depression showed that the depression was no longer present 2 years after the initial diagnosis in 80% of the group. Many young people with depressive disorders do not suffer from depression again, but in others there is a tendency for it to recur, particularly at times of stress or change in their lives, such as when they leave home, have a baby, lose a job or experience a broken relationship. This is by no means inevitable, but it does mean that part of the treatment of depression involves helping the young person and their family to be aware of the early symptoms of depression so that, should it recur, they can take active steps early on to prevent it developing into full-blown depression.

In rare cases the depression recurs at regular intervals or alternates with periods of elevated mood, which is called bipolar or manic depressive disorder. This type of disorder can be greatly helped or even prevented from recurring by particular treatment approaches that are outlined in Chapter 4.

Suicide is the greatest fear of all parents of depressed young people. This is entirely understandable given the stark rise in suicide rates in young people, especially young men, in recent times. But remember, depression is very common while suicide is still rare. It is probably not possible to prevent anyone of any age from killing themselves if they are truly determined to do so, but there are ways of reducing the risk. As a parent there is a lot you can do to deal with the fear of suicide and this is dealt with in Chapter 8.

While most young people with depression recover, it can take a long time. Two years out of the life of a teenager, when so much could be happening for them in terms of friendships, schoolwork, sport and fun, is too long. In many situations, you as a parent can help greatly. You probably cannot make the depression go away, but you can take active steps to ensure that your son/daughter gets all the help they need and that you and the family are there to support them, while getting on with your own life in a way that gives a message of hope to your teenager.


Excerpted from Coping with Depression in Young People by Carol Fitzpatrick John Sharry Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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