Depression in Teens and Children
Ms. Nejman’s article, Experts call teen depression a challenge highlights the challenges of balancing the need to treat depression in teens and children against the safety risks of treating depression with antidepressants. Talk therapy may be an excellent option, and a required one when medication is involved, but adolescence is not the period when trust in adults is particularly strong. I had severe depression as a teenager and to this day, I continue to feel tremendous gratitude to high school counselors and teachers who must have found me a terror to work with, but never gave up trying to “reach” me.
I’m not sure how wide a network “teen counselors” are, but we have a need for teens who have successfully managed depression to partner with counselors and therapists. This may help ease the stigma that can come with not just having depression, but as a teenager navigating peer pressure AND social stigma. Having depression may not be “cool”, but it doesn’t have to ruin your life.
Work-Related Stress and Depression
Please do not underestimate what stress can do. My depression relapse was, in fact, triggered by work-related stress.
Work-related stress is one of those insidious occurrences where you didn’t know it had hit you until you’re picking up the pieces from the ground. Because work-related stress was both subtle and sneaky, prolonged exposure without proper attention and treatment (by removing/relieving the stress or the inducers(s) of the stress) makes those of us already vulnerable to depression face serious consequences.
Of course, like various myths we are conditioned to subscribe, you may believe that the average person dealt with stress better than you could. I have believed that it was a sign of weakness to not be able to accept copious demands of work and still come through with gusto, ready for the next round of projects or tasks. It was easy for me to ascribe my difficulty sleeping as being jet-lagged too often due to my frequent business travels. I waved away shortening tempers as “results of a tough day.” I excused persistent tension headaches as temporary.
don’t wait until you’re drowning in a sea of rage to get helpThe tough day stretched into a tough week, which stretched into a tough month, which stretched into a tough year. One evening after finishing a business trip aboard a plane in turbulent weather, I became utterly overwhelmed, fearful, anxious, numb, angry, confused, and exhausted. I got fantastic migraines to accompany my irritated moods. I felt like hemorrhaging punching bag - there was nothing left to hold up a brave front. Stress had filled me to the brim. It was swimming between my bones, plucking at my muscles and tangling my nerves.
I want to bring attention to a very serious problem that is important for all employers and employees to address. Stress is especially important to recognize, address, and manage for those of us who are prone to depression or are currently clinical depressed. At the end of the day, even if this is “just a job,” we want to avoid approaching the point when corrective measures become costly to both the employer and the employee.
As one who has first-hand experience with depression, I can attest to the reality that it takes a tremendous amount of remediation once unchecked stress wreaks havoc. I am happiest when I am productive at work, so I want to make the necessary adjustments that will allow me to continue to contribute effectively to an organization for the long term.
Here are signs of stress that holds dangerous potential for triggering depression and destroying quality of life:
1. You feel like you have an itch you cannot scratch, at a place you cannot identify. As a result, you feel restless and impatient.
2. You feel like someone is sitting on your chest (heavy pressure) even when you are standing up.
3. You find yourself holding your breath and not even realizing it (take a deep breath right now and see if you’re doing it!)
4. You bite the head off a loved one who asks you an innocent question, such as “Are you OK?”
5. You wake up much earlier than usual, regardless of how little you had slept, because you feel like you have too much to do and not even time in the day to do them.
I’d like to give you what has worked for me in the face of job stress, but prevention is a better strategy than remediation. In case you are staring at a stress-induced mini-breakdown in the face, consider some initial corrective actions:
1. Drink less caffeine, more decaf or caffeine-free tea.
2. Try sleeping at the same time each evening, catch up on sleep with short naps if needed. If you are oversleeping, stick to a regimented amount of sleep rather than letting yourself go for fourteen hours in bed (too much sleep or too little sleep are both signs of depression).
3. EXERCISE! This has been the most effective stress reliever I have found. If you are able to do aerobic exercises at the gym or run, this is effective in dissipating nervous energy. The hardest part is getting myself to the gym. I could talk myself out of it many times (too tired, too stressed, too weak, headache), but once I get there and finish, I feel much better and sleep much better at night too. In fact, at the time when I was writing this, I was planning to skip today’s exercise class (”too tired, too weak, too hungry, too late, this article needed to be finished”). However, I stopped and drove to the gym to do an aerobics class. Now I’m back and I feel much better.
4. Smell the flowers. I’m not talking figuratively; I’m talking literally. If you have flowers in the house, stop and smell them. If you don’t, visit the supermarket and head for the flowers section. Sometimes watching “The Amazing World of Animals” on television has a similar effect, if you like animals.
5. Call EAP (Employee Assistance Program) - it’s free and it’s there to help. Employers often pay for 3-6 counseling visits.
Please do not underestimate what stress can do. My depression relapse was, in fact, triggered by work-related stress.
Talk therapy
I believe in combination therapy for the treatment of depression: combining medication therapy with psychotherapy. Depression is a vicious cycle of a biochemical imbalance and destructive or unproductive behavior/thought patterns. Many experts agree that psychotherapy is a powerful tool for helping depressed patients explore core thought processes and behaviors that can exacerbate the depression.
Medication is often necessary to overcome the chemical imbalances in depression. Managing psychological reactions to external triggers that occur through the day can only help with the recovery process. Even the most analytical individual may not always step back from the situation and look at what is happening objectively. I went through the phase of “if I were so smart, I can talk myself through it.” Then, I meet a mental “wall” in the face of an emotional or environmental trigger. Even as I consciously knew that I was repeating a pattern, I felt powerless to overcome the reactionary behavior. Psychotherapy helps trip my old behavioral wires so I can establish new, productive coping skills.
Cry. it’s good for you!I see the medication therapy as giving me a window of opportunity so that what I have learned from talk therapy can “sink in and take lasting effect”. Medication had gotten me out of bed to be functional (this is especially critical for severely depressed patients who could not imagine life beyond the next minute). Psychotherapy helped me gain insight into conditioned patterns of thinking. This helped me manage unproductive emotional reactions before I became overwhelmed.
Finally, it is helpful to look at therapy as Dr. Alan Siegel at Cambridge Hospital in Boston puts it: “It is hard to resolve depression without tears.”