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When sadness won’t go away: depression and related disorders in young people
You know a young person who feels down or worried all the time. They may have stopped doing things they used to enjoy, or become withdrawn and antisocial. Is it just part of growing up, or is it a sign of something else? Could it be drugs? How can you tell? Should you be worried? This factsheet has been written to help you decide if action is needed, and what you can do to find treatment and support.

Like all of us, teenagers can feel a bit down sometimes.

Everyday frustrations, disappointments, problems at school, troubles in the family or any stressful event can cause this feeling. If the sadness or worry go on for more than two weeks and start to affect their daily life, though, this may be a symptom of depression or another disorder, such as anxiety, which needs a medical assessment and treatment.

Can young people really experience depression

Around four in every hundred young people experience depression or an anxiety disorder at some time. The symptoms may go unrecognised by others, however, especially during the teenage years. Untreated depression or anxiety can go on to affect adult life, can result in long-term social and emotional problems, alienation from family and friends, and may lead to more serious depression. The chances of developing depression are higher if there is a history of it in the family.

The feeling of being down may not be a serious problem. It could just be a rough patch and the sadness or lowered mood will pass. But it is important to recognise depression or anxiety early if they are present, so they can be treated, and in case they develop into a long-term problem.

If depression or anxiety are detected early, and help is sought, there is a very good chance that the symptoms can be reduced and overcome. Psychological therapy and medication are the main forms of treatment. Encouraging someone to talk openly about the thoughts and feelings that go with depression and anxiety are an important first step towards overcoming the problem.

The warning signs

A Checklist

These changes may indicate that someone is experiencing depression or a related disorder. The person may:

-be unusually sad or worried for more than two weeks.

-lose interest in doing things, especially activities they usually enjoy.

-withdraw from their social life; spend less time with friends and family.

-change their sleeping patterns; be constantly tired, lack energy, or have troubled sleep or insomnia.

-have a change in appetite; start to eat very little, or eat much more than previously; lose weight; vomit frequently.

-become over-sensitive to criticism or authority.

-experience frequent health complaints such as head or stomach aches, general aches and pains.

-think they are worthless and have low self-esteem.

-have trouble concentrating or making simple decisions.

-become persistently irritable.

-make comments about suicide, talk about feeling hopeless, or say life is not worth living.

-blame themselves unreasonably for things not going right.

-become so anxious they have difficulty breathing, start to sweat or choke, or feel faint and shaky.

-behave aggressively and provoke fights.

-abuse drugs or alcohol.

Seek a medical assessment as soon as possible

If several of these signs are present, the young person may be experiencing depression or a related disorder. If so, it is important to understand that these are symptoms and that they are treatable. A school counsellor, youth worker or close friend may be able to help in encouraging the person to see a doctor.

What about drugs?

Is it possible that use of drugs or alcohol is responsible for strange, withdrawn or aggressive behaviour in the young person you care about? Concerned family members and others often believe that drug use is causing the problem. Sometimes this may be true. Drug and substance abuse among young people is common. Many use drugs with friends for recreation. Some, however, use them as a way of dealing with the distressing symptoms of depression or other disorder. To confuse matters, drugs may add to feelings of depression or anxiety, and even produce symptoms similar to those of a mental illness.

Try to talk to the young person about it when they seem willing to open up. It is important to find out if the drug use points to a serious problem, and this is not easy to assess. Remember, if you are concerned, talk to a doctor about getting specialised help.

What about eating disorders?

Feelings of worthlessness experienced by a depressed or anxious person can sometimes affect how they view their bodies. This may lead to a change in eating habits, such as extreme dieting, bingeing and purging. Such behaviour can result in an eating disorder such as anorexia or bulimia. Eating disorders are more common among girls, but boys can also be affected.

People with an eating disorder are usually secretive about it, so the condition may be hard to detect. Anorexia usually involves continued strict dieting even when weight has dropped below the normal healthy range. Bulimia can be more difficult to recognise as there may not be a significant change in body weight. If you are concerned that someone you know may have an eating disorder, it is essential to seek professional help as soon as possible. Eating disorders can be overcome with treatment and support; left untreated they may be life-threatening.

What about manic-depressive illness?

Manic-depressive illness (now called Bipolar disorder ) is a medical condition in which extremes of mood interfere with the person’s ability to function day-to-day. These moods may alternate over a period of weeks to months between depression and periods of irrational euphoria and hyperactivity.

If someone you know seems to be experiencing such symptoms, encourage them to see a doctor for an assessment as soon as possible. Treatment, including medication and support, are generally successful at controlling the symptoms of bipolar disorder.

What about suicide?

Depression can often lead to feelings of great despair and distress. These feelings can be so profound that they lead to thoughts of suicide. This does not necessarily mean that the person will act on these thoughts – it is important, however, that any talk of suicide is taken very seriously, and help should be sought immediately.

It is especially important to seek help if the young person:

-talks about feeling worthless or hopeless, and has very low self-esteem.

-is experiencing regular panic attacks.

-has delusions or hallucinations.

-is giving away their personal possessions.

-does dangerous, life-threatening things.

-has made previous suicide attempts.

How do I encourage a visit to the doctor?

This can be difficult. Someone who is depressed may find it difficult to talk about what they are experiencing. They might feel very sensitive, that they are being criticised, or frightened about what is happening. This may result in a rebellious response, or they may deny that there is a problem. They may be unwilling to share their thoughts.

It is important to reassure and support the person. Let them know that you want to help and that you are willing to listen. Reassure them that, with treatment and support, a lot can be done to help how they feel.

-Talk to the person when they seem willing to discuss things with you. Choose a time when they are more likely to be relaxed and open up.

-Make contact with a school counsellor or youth worker who may also be able to help.

-Encourage the person to consider the doctor as someone who can help, who will be confidential, and will not judge them.

-Suggest that you or another trusted friend come along as support when visiting the doctor.

-Discuss the situation with the doctor yourself, to ensure any relevant information is known. It is always helpful to write down your concerns and bring them with you. If the doctor does not seem to understand, or the young person is not comfortable with them, look for another.

 
How do I find out more?
It is important to ask your doctor about any concerns you have. SANE Australia also produces a range of easy-to-read publications and multimedia resources on mental illness. For more information about this topic see:

- The SANE Guide to Depression
Helps people diagnosed with depression and their family and friends by explaining what it means to have depression, the treatments available and what a person can do to help themselves.

- SANE Guide to Staying Alive
Provides practical step-by-step hints and advice for consumers, carers and health professionals on dealing with suicidal thoughts and behaviour.

- Speaking From Experience: Depression (SANE Guide & Video 43 mins)
People who've experienced depression and their carers talk about the things which have helped them cope better.

To order visit the SANE Bookshop at www.sane.org or call 1800 18 SANE (7263)

SANE Australia . . . Meeting the challenge of mental illness-When sadness won’t go away depression and related disorders in young people

©SANE Factsheet 23
This Factsheet may be freely downloaded, copied and distributed on condition no change is made to the contents. SANE Australia is not responsible for any actions taken as a result of information or opinions contained in the Factsheet. SANE Australia is a business name of Schizophrenia Australia Foundation.
[Version English, 2004 ]