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Throwback Thursday: Responding to Depression in Our Schools

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A 1990 Education Week article entitled Higher Rates of Mental Disorders Found Among Teenagers, reported on data from "nearly 5600 students attending public and private high schools in an unidentified county in New Jersey." The report revealed, "4 percent had major depression; 4.9 percent had dysthymic depression, a less severe but more chronic disorder; and 3.7 percent had generalized anxiety disorder." We were recognizing the existence of this challenging and painful reality 24 years ago.  Where are we now?

A much larger study from the National Institute of Mental Health (NIMH) based upon 2012 data revealed in the United States, "2.2 million adolescents aged 12-17 had at least one major depressive episode in the past year. This represented 9.1 percent of the U.S. population aged 12 to 17."

On This #tbt, The Good News Is We Continue To Learn About Depression and Share The Data
The challenging news is, as the numbers reported are becoming larger, our knowledge about how to address these struggling children may not be growing. Actually, sources to help recognize, intervene, and support these children and their families have emerged over the years. Resources like the ones on the National Association of School Psychologists (NASP) offer many helpful suggestions for school personnel (as well as for parents).  Let's look at the first four suggestions for school personnel:

  1. Learn the signs and symptoms of depression at various ages and developmental levels.
  2. Consult with the school psychologist or other mental health professional in the school if a child is suspected of being depressed.
  3.  Report suspected abuse or neglect to the appropriate authorities.
  4. Inform the parents of any concerns about their child, and help link them with resources for effective follow up.

They all direct us, and rightly so, to learn, consult, report, and inform. Essentially, they require us to be attentive and responsive and, when necessary, an advocate. A child with depression isn't identified as the result of a single behavior or event, but rather a through a series of behaviors or events.  What we do in and between those moments can make a difference in the child's life. While the behaviors are presenting themselves, these children are sitting in our classrooms, being asked to attend, learn, perform, follow rules, make deadlines, pass tests, and interact with their peers and adults. And these children, while being tugged at by depression, do not know that how they feel is the result of an illness. Many try to get through each day and meet our requirements anyway; others fade into silence.

Companions to Depression
Compound that with the fact that depression sometimes is a companion to another challenge. From NASP:

Many children suffering from undiagnosed depression have been accused of being shy, lazy, stubborn, or disobedient. More recently, as awareness of emotional problems has increased, depressed children have often been diagnosed with a temporary response to stress (adjustment disorder), Attention Deficit Hyperactivity Disorder (ADHD), oppositional-defiant disorder, or some other problem. Although a number of children do have these other disorders, they often coexist with or are misdiagnosed instead of depression.

How often have children been described as "shy, lazy, stubborn, or disobedient"? And how often are we told a child has been diagnosed with Attention Deficit Hyperactivity Disorder or Oppositional-Defiant Disorder?  How often do we hear ourselves or others saying, "Just try harder.  I know you can do it." We may have no idea what is taking place within the mind and body of these children. Nor are we the experts on how medications interact for children who carry multiple or erroneous diagnoses.  Yet, there we often are, asking them to do something that may even add to their depression, another thing they are not able to do. 

Concerns about Depression Must Remain on Our Radar
While we are busy implementing changes, trying to get our schools to better respond the needs of our 21st century students, we must not let our concerns for the well-being of children slide, especially those who may be suffering with depression and other mental health issues.  We have become aware that children who are bullied may be prone to this disease.  We have become aware that children who may be questioning or gay may be prone to this disease. But have we become aware of how to recognize and interact with these students?  Or are we still at the stage where we recognize and refer to others to intervene?  While all of this takes place in our schools, these children are not removed from our demands for learning and performing and the pressure mounts.  So it seems logical that it is extremely important for schools to spend time learning about identifying those children, and developing plans for what to do and how to best serve these children.

Depression Affects Adults Too
The CDC also reports that 1 in 10 adults suffer from depression.  That means our attention also needs to be placed on the adults working in our buildings.  An undiagnosed depressed adult can have a deleterious effect on all children and may be suffering deeply while we write it off as being difficult or not cooperative. We can only know by first accepting the fact that depression exists, that it is a serious illness, that it is so dangerous it can be life threatening, and that we can make a difference. These are statistics, and we know there remain those who are not reported, those simmering in our schools, undiagnosed, misdiagnosed, and certainly misunderstood.

We wake up to depression when we experience the extreme act of a depressed person.  Robin Williams' tragic suicide has brought our attention back to wonder about the depth of the invisible pain depression brings.  Haunting the mind and beliefs of the host, it can even cause one to choose death over life.  Imagine that haunting in a child.  We are the observers of these children and have the ability to work together to recognize and intervene. The only time children are observed for a series of hours, days, weeks, and months, by a consistent group of professionals, is in our schools.  

Suicide is a companion to depression. According to the Center for Disease Control and Prevention (CDC) suicide is the third leading cause of death in youth ages 10- 24. They report:

A nationwide survey of youth in grades 9-12 in public and private schools in the United States (U.S.) found that 16% of students reported seriously considering suicide, 13% reported creating a plan, and 8% reporting trying to take their own life in the 12 months preceding the survey.

Parker Palmer
, himself a survivor of depression, recently wrote:

At its depths, depression is not so much being "lost in the dark" as it is "becoming the dark." And when you reach that place--your sense of self annihilated--you have NO capacity to stand back from the experience, and say to yourself, "This, too, will pass." There is much I/we don't understand about depression. But this much I do know: the mystery is not why some people take their own lives, but why some people are able to find new life on the other side. Public respect for that fact would help sufferers and survivors feel more understood--and that in itself would be life-giving.

Depression is a serious disease and can be treated.  In our children, that involves our ability to recognize, and refer, but it also involves our learning how to deal with these children while parents and other professionals are called to act.  Without the understanding and compassion of school personnel, we may be contributing to the problem when, in fact, we want to be part of the life giving work of creating healthy learning spaces and supporting healthy children.

From the NASP website on Suicide.

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