Sue Scheff - Teenage Depression

Source: Connect with Kids

“Just this gloom was like hanging over my head and I knew something wasn’t right but I wasn’t exactly sure what it was.”

– Amy, 16 years old

New research from Columbia University finds that nearly 50 percent of teens suffer from some form of depression, anxiety, or a number of other psychiatric disorders.

“A lot of people I know get depressed all the time about lots of stuff,” says 15-year-old Meagan.

“It’s like everything’s all on your shoulders and you have to take everything at once,” says Meredith, 14.

Sixteen-year-old Amy agrees, “Just this gloom was like hanging over my head and I knew something wasn’t right but I wasn’t exactly sure what it was.”

“My parents went through an awful divorce my ninth grade year and I was devastated, worse than my heart could ever imagine,” says 18-year-old Brittany, “and it hurts a lot, and I still hurt to this day and I’m a senior in H.S.”

The symptoms vary: some kids may be lethargic and withdrawn; others may show agitation and frustration, even aggression. Often, there is a drop in grades.

And sometimes these symptoms can cause parents to punish the child, instead of providing treatment.

“Rather than thinking of children’s misbehaviors as discipline problems or misbehaviors as deliberate,” says psychologist Sunaina Jain, Ph.D., “it’s important to see them as communications from the child.”

Experts say lots of kids experience depression or anxiety, often mild and temporary, but not always. And that’s why parents need to constantly check their child’s emotional pulse.

“You know it doesn’t take hours and hours. Even a few minutes of checking in with each other every day is a great way of saying you know I’m here, I’m interested in you,” says Jain.

Tips for Parents

All teens experience ups and downs. Every day poses a new test of their emotional stability – fighting with a friend, feeling peer pressure to “fit in” with a particular crowd or experiencing anxiety over a failed quiz – all of which can lead to normal feelings of sadness or grief. These feelings are usually brief and subside with time, unlike depression, which is more than feeling blue, sad or down in the dumps once in a while.

According to the Nemours Foundation, depression is a strong mood involving sadness, discouragement, despair or hopelessness that lasts for weeks, months or even longer. It also interferes with a person’s ability to participate in normal activities. Often, depression in teens is overlooked because parents and teachers feel that unhappiness or “moodiness” is typical in young people. They blame hormones or other factors for teens’ feelings of sadness or grief, which leaves many teens undiagnosed and untreated for their illness.

The Mayo Clinic reports that sometimes a stressful life event triggers depression. Other times, it seems to occur spontaneously, with no identifiable specific cause. However, certain risk factors may be associated with developing the disorder. Johns Hopkins University cites the following risk factors for becoming depressed:

Children under stress who have experienced loss or who suffer attention, learning or conduct disorders are more susceptible to depression.
Girls are more likely than boys to develop depression.
Youth, particularly younger children, who develop depression are likely to have a family history of the disorder.

Possible Symptoms:

Prolonged sadness or unexplained crying spells
Significant changes in appetite and sleep patterns
Irritability, anger, worry, agitation or anxiety
Pessimism or indifference
Loss of energy or persistent lethargy
Feelings of guilt and worthlessness
Inability to concentrate and indecisiveness
Inability to take pleasure in former interests or social withdrawal
Unexplained aches and pains
Recurring thoughts of death or suicide

It is important to acknowledge that teens may experiment with drugs or alcohol or become sexually promiscuous to avoid feelings of depression. According to the National Mental Health Association, teens may also express their depression through other hostile, aggressive, risk-taking behaviors. These behaviors will only lead to new problems, deeper levels of depression and destroyed relationships with friends and family, as well as difficulties with law enforcement or school officials.

The development of newer antidepressant medications and mood-stabilizing drugs in the last 20 years has revolutionized the treatment of depression. According to the Mayo Clinic, medication can relieve the symptoms of depression, and it has become the first line of treatment for most types of the disorder. Psychotherapy may also help teens cope with ongoing problems that trigger or contribute to their depression. A combination of medications and a brief course of psychotherapy are usually effective if a teen suffers from mild to moderate depression. For severely depressed teens, initial treatment usually includes medications. Once they improve, psychotherapy can be more effective.

Immediate treatment of your teen’s depression is crucial. Adolescents and children suffering from depression may turn to suicide if they do not receive proper treatment. Suicide is the third leading cause of death for Americans aged 10-24. The National Association of School Psychologists suggests looking for the following warning signs that may indicate your depressed teen if contemplating suicide:

Suicide notes: Notes or journal entries are a very real sign of danger and should be taken seriously.

Threats: Threats may be direct statements (“I want to die.” “I am going to kill myself”) or indirect comments (“The world would be better without me.” “Nobody will miss me anyway”). Among teens, indirect clues could be offered through joking or through comments in school assignments, particularly creative writing or artwork.

Previous attempts: If your child or teen has attempted suicide in the past, a greater likelihood that he or she will try again exists. Be very observant of any friends who have tried suicide before.

Depression (helplessness/hopelessness): When symptoms of depression include strong thoughts of helplessness and hopelessness, your teen is possibly at greater risk for suicide. Watch out for behaviors or comments that indicate your teen is feeling overwhelmed by sadness or pessimistic views of his or her future.

“Masked” depression: Sometimes risk-taking behaviors can include acts of aggression, gunplay and alcohol or substance abuse. While this behavior may not appear to be depression, in fact it may suggest that your teen is not concerned about his or her own safety.

Final arrangements: This behavior may take many forms. In adolescents, it might be giving away prized possessions, such as jewelry, clothing, journals or pictures.

Efforts to hurt himself or herself: Self-injury behaviors are warning signs for young children as well as teens. Common self-destructive behaviors include running into traffic; jumping from heights; and scratching, cutting or marking his or her body.

Changes in physical habits and appearance: Changes include inability to sleep or sleeping all the time, sudden weight gain or loss and lack of interest in appearance or hygiene.

Sudden changes in personality, friends or behaviors: Changes can include withdrawing from friends and family, skipping school or classes, loss of involvement in activities that were once important and avoiding friends.

Plan/method/access: A suicidal child or adolescent may show an increased interest in guns and other weapons, may seem to have increased access to guns, pills, etc., and/or may talk about or hint at a suicide plan. The greater the planning, the greater the potential for suicide.

Death and suicidal themes: These themes might appear in classroom drawings, work samples, journals or homework.

If you suspect suicide, it is important to contact a medical professional immediately. A counselor or psychologist can also help offer additional support.

References
American Academy of Child and Adolescent Psychiatry
American Foundation for Suicidal Prevention
Columbia University
Johns Hopkins University
Mayo Clinic
National Association of School Psychologists
National Depressive and Manic-Depressive Association
National Institute of Mental Health
National Mental Health Association
Nemours Foundation
Thomson-Reuters

Sue Scheff: Teen Anxiety

The lesser known relative of depression, anxiety, afflicts people of all ages and can be especially detrimental for teenagers. It is completely normal and even common for individuals to experience anxiety, particularly during stressful periods, such as before a test or important date (think Prom). For many, this is beneficial, serving as motivation to study hard and perform well; however, for many, anxiety goes beyond standard high-stress periods. While occasional stress is nothing to worry about and can even be healthy, many people experience anxiety on an ongoing basis. People, especially teenagers, who suffer from anxiety disorders, find that their daily life can be interrupted by the intense, often long-lasting fear or worry.

Anxiety disorders are not fatal; however, they can severely interfere with an individual's ability to function normally on a daily basis. The intense feelings of fear and worry often lead to a lack of sleep as it makes it very difficult for people to fall asleep. Those with anxiety disorders also commonly suffer from physical manifestations of the anxiety. The anxiety can cause headaches, stomach aches, and even vomiting. In addition stress can cause individuals to lose their appetite or have trouble eating. One of the more difficult aspects for students to deal with is difficulty concentrating. When one is consumed with worry, his or her mind continuously considers the worrisome thoughts, making it considerably harder for teenagers to concentrate on school work and other mentally intensive tasks. These affects of anxiety can make it difficult for teenagers to simply get through the day, let alone enjoy life and relax.

While there seems to be no single cause of anxiety disorders, it is clear that they can run in a family. The fact that anxiety disorders can run in families indicates that there may be a genetic or hereditary connection. Because a family member may suffer from an anxiety disorder does not necessarily mean that you will. However, individuals who have family members with this disorder are far more likely to develop it.

Within the brain, neurotransmitters help to regulate mood, so an imbalance in the level of specific neurotransmitters can cause a change in mood. It is this imbalance in a neurotransmitter called serotonin that leads to anxiety. Interestingly, an imbalance of serotonin in the brain is directly related to depression. For this reason, SSRI medications, more commonly referred to as anti-depressants, are often used to help treat an anxiety disorder. Medication can provide significant relief for those suffering from anxiety disorders; however, it is often not the most efficient form of treatment.

In addition to medication, treatments for anxiety disorders include cognitive-behavioral therapy, other types of talk therapy, and relaxation and biofeedback to control muscle tension. Talk therapy can be the most effective treatment for teenagers, as they discuss their feelings and issues with a mental health professional. Many teens find it incredibly helpful to simply talk about the stress and anxiety that they feel. Additionally, in a specific kind of talk therapy called cognitive-behavioral therapy teens actively "unlearn" some of their fear. This treatment teaches individuals a new way to approach fear and anxiety and how to deal with the feelings that they experience.

Many people attempt to medicate themselves when they suffer from stress or anxiety. While individuals find different ways to deal with the intense worry that they may experience, self medication can be very detrimental to their body. It is not uncommon for people who suffer from anxiety disorders to turn to alcohol or drugs to relieve the anxiety. While this may provide a temporary fix for the afflicted, in the long run it is harmful. By relying on these methods, individuals do not learn how to deal with the anxiety naturally. Reliance on other substances can also lead to alcohol or drug abuse, which can be an especially significant problem if it is developed during the teen years.

Statistics on teen anxiety show that anxiety disorders are the most common form of mental disorders among adolescents:

8-10 percent of adolescents suffer from an anxiety disorder

Symptoms of an anxiety disorder include: anger, depression, fatigue, extreme mood swings, substance abuse, secretive behavior, changes in sleeping and eating habits, bad hygiene or meticulous attention to, compulsive or obsessive behavior

One in eight adult Americans suffer from an anxiety disorder totaling 19 million people
Research conducted by the National Institute of Mental Health has shown that anxiety disorders are the number one mental health problem among American women and are second only to alcohol and drug abuse among men

Anxiety disorders cost the U.S. $46.6 billion annually

Anxiety sufferers see an average of five doctors before being successfully diagnosed

Learn more click here.

Sue Scheff: Teens and Sleeping Pills

Source: Connect with Kids

“Part of it I think now is there is so much more pressure in the academic settings. There are kids who are working tremendous numbers of hours each evening to get their schoolwork done. I get a sense that many of them worry about how they are doing academically, and that tends to spill over into difficulties with sleep.”

– Richard Winer, M.D., Psychiatrist

Whether it’s an over-the-counter medication like Nyquil, or a prescription drug like Ambien or Sonata, more and more teens say they often take something to get to sleep.

“It’s mainly just stress… you want to study and then you realize you need to sleep because you have a test the next day and then you just take something,” says Chelsea, 19.

“An Ambien to knock me out,” adds 19-year-old Jessica.

“I’ll take Nyquil or something like that, just to help me get to sleep easier,” explains Allison, 19.

Why do kids today need help getting to sleep? Experts say there are several answers: greater academic pressure, more stimulation late at night, with cell phones, TV, computer games, instant messaging, more kids with ADHD taking stimulants like Ritalin, and an explosion in the use of caffeine drinks.

The result: at bedtime, many kids are looking for help in a pill.

“Our culture is certainly turned more toward a living better through chemistry approach,” say Psychiatrist Richard Winer, M.D.

He says the problem is the obvious: Sleeping aids can be habit forming. “My bias is toward keeping kids away from medication for sleep if at all possible. Because you don’t want to create some habits that’ll be even harder to break as time goes on in adulthood.”

He says for many kids, the solution is routine: Relax for a while, and then go to bed at the same time every night.

But, for some, the problem is more serious.

“There are a number of kids out there that have honest to goodness insomnia difficulties,” says Dr. Winer, “They have sleep disorders that do require treatment.”

Tips for Parents

A study performed by researchers at Stanford University found that teenagers require approximately one to two hours more sleep than 9- and 10-year-olds, who only require about eight hours of sleep. This goes against the school of thought that allows older kids to stay up later. Parents may want to be on the lookout for the following things, which could be caused from sleep deprivation:

Difficulty waking in the morning
Irritability in the afternoon
Falling asleep during the day
Oversleeping on the weekend
Having difficulty remembering or concentrating
Waking up often and having trouble going back to sleep
Sleep deprivation also can lead to extreme moodiness, poor performance in school and depression. Teens who aren’t getting enough sleep also have a higher risk of having car accidents because of falling asleep behind the wheel.


As the lives of children seem to be getting busier, their sleeping habits may be one of the first things impacted. Sleep, though being something that often gets sacrificed, is actually one of the most important things in a child’s life. Experts say taking sleep medications unauthorized by the FDA for teenage consumption is not the answer, however. Here are some suggestions about sleep:

Sleep is as important as food and air. Quantity and quality are very important. Most people need between seven-and-a-half to eight-and-a-half hours of uninterrupted sleep. If you want to press the snooze alarm in the morning you are not getting the sleep you need. This could be due to not enough time in bed, external disturbances or a sleep disorder.

Keep regular hours. Try to go to bed at the same time and get up at the same time every day. Getting up at the same time is most important. Getting bright light, like the sun, when you get up will also help. Try to go to bed only when you are sleepy. Bright light in the morning at a regular time should help you feel sleepy at the same time every night.

Stay away from stimulants like caffeine. This will help you get deep sleep, which is most refreshing. If you take any caffeine, take it in the morning. Avoid all stimulants in the evening, including chocolate, caffeinated sodas and caffeinated teas. They will delay sleep and increase awakenings during the night.

Use the bed just for sleeping. Avoid watching television, using laptop computers or reading in bed. Bright light from these activities and subject matter may inhibit sleep. If it helps to read before sleeping, make sure you use a very small wattage bulb to read. A 15-watt bulb should be enough.

Avoid bright light around the house before bed. Using dimmer switches in living rooms and bathrooms before bed can be helpful. Dimmer switches can be set to maximum brightness for morning routines.

Don't stress if you feel you are not getting enough sleep. It will just make matters worse. Know you will sleep eventually.

Avoid exercise near bedtime. No exercise at least three hours before bed.

Don't go to bed hungry. Have a light snack, but avoid a heavy meal before bed.

Bedtime routines are helpful for good sleep.

Avoid looking at the clock if you wake up in the middle of the night. It can cause anxiety.
If you can't get to sleep for over 30 minutes, get out of bed and do something boring in dim light till you are sleepy.

Keep your bedroom at a comfortable temperature.
If you have problems with noise in your environment, you can use a white noise generator. A fan will work.

References
American Sleep Apnea Association
National Sleep Foundation
Shuteye
Thomson Reuters

Sue Scheff: Low Self Esteem - Teen Depression

Teen low self esteem can lead to teen depression. Author Gary Nelson has written a most compelling story of his journey with his son and family dealing with teen depression in his new book.

Read his recent post - that can help many parents take a moment to pause and consider their own teens and how they are feeling.

Source: Dr. Gary Nelson - Author of “A Relentless Hope, Surviving Teen Depression’
Depression hides under a lot of rocks, including “low self-esteem.” It is truly amazing how many different ways depression can hide and fail to be recognized for what it is - a potentially very dangerous illness that can wreck and even take the lives of teens and adults. Many times I’ve listened as a pastoral counselor and pastor as teens have told me that they believed for a long time that they had suffered from “low self-esteem.” In most cases that meant they had been suffering from depression but never knew it. They and others around them simply thought they had “low self-esteem.” That also means the teen went all that time suffering instead of getting the necessary help. Learn to look under the rocks. When you hear a teen say they just suffer from “low self-esteem,” take a closer look. You might just lead them toward the help they need.
For more information on teen depression check my website: www.survivingteendepression.com

My new book, “A Relentless Hope: Surviving the Storm of Teen Depression” is available at Amazon and other outlets.

Sue Scheff: Parenting Blogs and Parenting Teens

"It's not enough in today's challenging world to just love our kids. We must give them the tools to be prepared to cope with life’s challenges in a caring and humane way. It's our job to give them the direction they need to avoid negative influences, and become successful, caring human beings. We all need to work together... educators, moms, dads, caretakers, communities... we all have a stake in helping our kids create a better world... as a mom of three, I've been there." – Dr. Michele Borba

Depressed Teens and New Years Resolution by Gary Nelson

Teens suffering from depression and related illnesses like anxiety and bipolar disorder find it very difficult to even make New Year's resolutions, let alone keep them. Depression and its relatives very quickly tend to overwhelm teens. When faced with the idea of change depressed teens often see a mountain so huge that it seemingly can never be climbed or chiseled slowly into a molehill. They quickly feel overwhelmed and often respond with some thought or statement like, "It's too big. I'll never be able to do it... so why bother to even try." The teen then falls deeper into their pit of despair. One of the first things that the depression "steals" from the depressed teen is their ability to take large, seemingly impossible tasks and break them into smaller, manageable pieces. Most of us take this ability for granted and practice this making of mountains into manageable molehills everyday. Depressed teens want to change. They want healing. They just don't see a way over the mountain. The depression has them hog-tied, leaving the teens looking like they're just lazy and don't "want" to try. These depressed teens need help, not judgement. They need hope. For more information on this and other aspects of teen depression check out my new book, A Relentless Hope: Surviving the Storm of Teen Depression. If you have a teen who is struggling you might also want to check out Sue Scheff's new book, Wit's End.

Sue Scheff: ADHD ODD - Parenting the Defiant Teen

As a mom of an ADHD son, I remember the adolescent years - they were not always the easiest. ADDitude Magazine has some great parenting tips, ideas and answers to help parents today. Years ago I don’t recall as much information was available to us.

Source: ADDitude Magazine

ADHD behavior issues often partner with oppositional defiant disorder (ODD) — making discipline a challenge. Try these strategies for parents of ADD kids.
Every parent of a child with attention deficit disorder knows what it’s like to deal with ADHD behavior problems — sometimes a child lashes out or refuses to comply with even the most benign request. But about half of all parents who have children with live with severe behavior problems and discipline challenges on an almost daily basis.

That’s because 40 percent of children with ADHD also develop oppositional defiant disorder, a condition marked by chronic aggression, frequent outbursts, and a tendency to argue, ignore requests, and engage in intentionally annoying behavior.

How bad can it get? Consider these real-life children diagnosed with both ADHD and ODD:
A 4-year-old who gleefully annoys her parents by blasting the TV at top volume as soon she wakes up.

A 7-year-old who shouts “No” to every request and who showers his parents with verbal abuse.
An 11-year-old who punches a hole in the wall and then physically assaults his mother.

“I call them tiny terrors,” says Douglas Riley, Ph.D., author of The Defiant Child and a child psychologist in Newport News, Virginia. “These children are most comfortable when they’re in the middle of a conflict. As soon as you begin arguing with them, you’re on their turf. They keep throwing out the bait, and their parents keep taking it — until finally the parents end up with the kid in family therapy, wondering where they’ve gone wrong.”

The strain of dealing with an oppositional child affects the entire family. The toll on the marital relationship can be especially severe. In part, this is because friends and relatives tend to blame the behavior on ‘bad parenting.’ Inconsistent discipline may play a role in the development of ODD, but is rarely the sole cause. The unfortunate reality is that discipline strategies that work with normal children simply don’t work with ODD kids.

Fortunately, psychologists have developed effective behavior therapy for reining in even the most defiant child. It’s not always easy, but it can be done — typically with the help of specialized psychotherapy.

Looking for links

No one knows why so many kids with ADHD exhibit oppositional behavior. In many cases, however, oppositional behavior seems to be a manifestation of ADHD-related impulsivity.
“Many ADHD kids who are diagnosed with ODD are really showing oppositional characteristics by default,” says Houston-based child psychologist Carol Brady, Ph.D. “They misbehave not because they’re intentionally oppositional, but because they can’t control their impulses.”
Another view is that oppositional behavior is simply a way for kids to cope with the frustration and emotional pain associated with having ADHD.

“When under stress — whether it’s because they have ADHD or their parents are getting divorced — a certain percentage of kids externalize the anxiety and depression they’re feeling,” says Larry Silver, M.D., a psychiatrist at Georgetown University Medical School in Washington, D.C. “Everything becomes everyone else’s fault, and the child doesn’t take responsibility for anything that goes wrong.”

Riley agrees. “Children with ADHD know from a young age that they’re different from other kids,” he says. “They see themselves as getting in more trouble, and in some cases may have more difficulty mastering academic work — often despite an above-average intellect. So instead of feeling stupid, their defense is to feel cool. They hone their oppositional attitude.”
About half of all preschoolers diagnosed with ODD outgrow the problem by age 8. Older kids with ODD are less likely to outgrow it. And left untreated, oppositional behavior can evolve into conduct disorder, an even more serious behavioral problem marked by physical violence, stealing, running away from home, fire-setting, and other highly destructive and often illegal behaviors.

Getting treatment

Any child with ADHD who exhibits signs of oppositional behavior needs appropriate treatment. The first step is to make sure that the child’s ADHD is under control. “Since oppositional behavior is often related to stress,” says Silver, “you have to address the source of the stress — the ADHD symptoms — before turning to behavioral issues.”

Says Riley, “If a kid is so impulsive or distracted that he can’t focus on the therapies we use to treat oppositional behavior,” he says, “he isn’t going to get very far. And for many ADHD kids with oppositional behavior, the stimulant medications are a kind of miracle. A lot of the bad behavior simply drops off.”

But ADHD medication is seldom all that’s needed to control oppositional behavior. If a child exhibits only mild or infrequent oppositional behavior, do-it-yourself behavior-modification techniques (see Getting Your Child to Behave) may well do the trick. But if the oppositional behavior is severe enough to disrupt life at home or school, it’s best to consult a family therapist trained in childhood behavioral problems.