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  1. 1. Depression in Teenagers W H AT ? W H Y? HOW
  2. 2. What is Depression?According to MediLexicons Medical Dictionary, depression is "a mental state or chronic mental disorder characterized by feelings of sadness, loneliness, despair, low self-esteem, and self-reproach. Identifying Causes Causes could be biological or emotional. Any of life’s challenges, major events and activities can triggerDepression, i.e., abuse, medications, conflicts, death, seriousillness/terminal diseases, substance abuse, divorce, personal problems and challenges, and genetics.
  3. 3. Depression has become a prevalent mental disease in our world today. No one is immune from its attack. It does notdiscriminate on the basis of race, religion, nationality, age or sex. Millions are affected. Yet, there is hope.Although many may already be suffering from depression, a majortrigger is our current economic situation . This is what promptedMWwM to launch this bible study series to provide help and hope to the many individuals and families that are deeply affected by depression. Ironically, depression is not a new illness; it’s ancient. In fact, itaffected persons in the bible long before Christ. We can learn howto overcome it by the power of God’s word, if you would believe and receive God’s word like a “medicine” into your mind, body and soul (spirit).
  4. 4. Biblical Examples Job, Jonah, Jeremiah, Elijah, David, Judas Iscariot.Job’s depression was caused by a calamity of events, sickness, death of his children, loss all of his possessions, and friends that questioned his character (Job 17:1-16).Jeremiah’s depression is notable in the Book of Lamentation because of his opposition and the rebellion of God’ s people. Elijah became depressed after his Mt. Carmel victory, which enraged Jezebel and he began feeling all alone and wanted to die (I Kings 19:1-5) David- gets depressed because he is overwhelmed by constant harassment from his enemies (Ps. 143).
  5. 5. Affects of DepressionsDepression zaps a person’s energy and take a greatdeal of time out of one’s life. It’s affects becomemore intensive as the depression deepens. A personbecomes more withdrawn and it becomes moredifficult for others to communicate with theindividual. Consequently, if the person’s mentalstate does not change, the person can lose thedesire to face reality, or continue living. At thispoint, the “spirit” of depression has taken fullcontrol. But, nothing is impossible for theAll-powerful One to overcome.
  6. 6. Symptoms of Depression Sleep: decrease/increase in sleep Eating: significant loss/gain in weight Interest: loss of interest in previously enjoyed activities Fatigue: loss of energy Concentration: indecisiveness and/or difficulty concentrating and irritability Self-worth: feelings of worthlessness or guilt Death: repeated thoughts about death, suicide (with or without a plan) or a suicide attempt Mood: depressed mood noticed by others Motor activity: noticeable agitation in activity, including aches and pains
  7. 7. Symptoms of Depression cont’d. The teen experiences five or more of these symptoms in a two-week period These symptoms are severe enough to impair the teen’s work, school and/or personal life These symptoms are not due to other factors such as substance abuse or health problems (such as thyroid disease)
  8. 8. Symptoms of Depression cont’d. When moving from childhood to adolescence the teenager will present a lot of changes in behavior. These include eating more, sleeping more, withdrawing from parents for time with peers, etc. These changes are normal and healthy! But when such changes are coupled with others from the symptom list and appear to impair aspects of the teen’s life, the guardian/practitioner should seek consultation.
  9. 9. Causes
  10. 10. Societal Disconnection • In boys depression may be affected by early disconnection• External: Life’s stresses affect serotonin levels • Shame• Examples are trauma, illness, loss and exercise • Boy code • Gender straitjacketing
  11. 11. Relationship related depression• Also external• Poor social support• Tenuous family connections• rejection
  12. 12. Explanation of organic ( Internal) • People vary in MAO• A change in electrical levels, so some need potential between cells higher transmitter levels• Dopamine, norepinephrine • Type R• Serotonin • Alcoholic • Anxious• Transfer between cells • May need need more and broken down by MAO chemical transmission
  13. 13. Another Theory • Some may have small• There may be differences numbers of D2 and D4 in brain receptors and dopamine receptors their levels of stimulation required • Excitement may be needed to increase• This may exist for many dopamine levels in low types of neuroreceptors numbered folks
  14. 14. Depression, an indistinct meaningDysthymia (mild)Major depression( moreproblematic)Bipolar Depression ( Mania)
  15. 15. Common • EmotionalSymptoms • Feeling sad and hopeless • Irritable and anxiousMost Common:TYPES OF • Loss of interest in what you used to enjoyDEPRESSION • Guilt, and shameMajor Depression, alsoknown as clinical depression • Death & suicidal thoughts • PhysicalChronicDepression, alsoknow dysthymia • Headache & Back pain • Appetite / weight changeManic Depression, also knownas bipolar (disorder) • Sleeping problemsdepression • Chest pain & Joint achesSeasonal Depression, also • Digestive problemsknown as SAD (SeasonalAffective Disorder)
  16. 16. Usually Depression diagnosis requires 4 of followingDepressed moodWeight loss or gainSleep disturbances These criteria are mostly used inAgitation women and adultsLoss of energyGuiltTrouble concentratingSuicidal thoughts
  17. 17. Types of DepressionSeasonal Affective DisorderMajor Depressive DisorderBipolar DepressionChronic Depression (Dysthymia)AtypicalPsychoticPostpartum Depression
  18. 18. Bipolar Disorder psychiatric diagnosis that describes a category ofmood disorders, or mood swings, defined by the presence of one or mormania or, if milder,hypomania. Individuals who experience manic episodes also commonly exdepressive episodes or symptoms, ormixed episodes in which features of both mania and depression are premood, but in some individuals, depression and mania may rapidly alternarapid cycling. Extreme manic episodes can sometimes lead topsychotic symptoms such as delusions andhallucinations. The disorder has been subdivided intobipolar I, bipolar II,cyclothymia, and other types, based on the nature and severity of moobipolar spectrum.
  19. 19. Major depression• mental disorder characterized by a pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. The term " American Psychiatric Association for this symptom cluster under mood disorders in the 1980 version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) classif depressed mood, more precise terminology is preferred in clinical and r suicide, and up to 60% of all people who commit suicide have depressio
  20. 20. Dysthymia chronic mood disorder that falls within thedepression spectrum. It is considered a chronic depression, but with less sevmajor depressive disorder. This disorder tends to be a chronic, long-lasting[1] Dysthymia is a type of low-grade depression. Harvard Health Publicationsymptoms than major depression but lasts longer.” Harvard Health Publicati psychiatric disorder such as one of the anxiety disorders, drug addiction, oralcoholism”. The Primary Care Journal says that dysthymia “affects approxi
  21. 21. Treat the symptoms- Not the label!!!
  22. 22. Biblical Methods to Help Overcome DepressionTalk it Out” – being able to talk to yourself, God, or someone else (preferably a counselor). Journal it Out- writing can be a form of expression and therapeutic for depression before it intensifies. I encourage people to journal. Pray it Through – Seek the Lord’s help by talking to God, believing and trusting that He hears you and will intervene byrescuing your soul from the “spirit” of depression. Pour out yoursoul to Him! Read the Gospels how Jesus prayed as it was time to be crucified; depression was upon him (Matt. 26:36-38) Praise & Worship- David was a praiser and a worshiper. Praise is what he did. So when nothing worked; he praised; he song; he played his harp. (READ THE BOOK OF PSALMS)***In no way are these meant to be substitutes for professional counseling and care. ***
  23. 23. Review and Discussion1.  Meditate on Psalms 41:1-13; 42:1-11. What similarities are there that suggest depression? 2. Consider your life; do you recognize symptoms of depression? If so, how are you handling? 3. Biblical examples show us that even Christians can get depressed. From the biblical examples, how did they deal with their depression? 4. Who in the New Testament suffered major depression to the point of suicide? Why?
  24. 24. TreatmentsMedicationPsychotherapy (Individual, Group and/orFamily)Cognitive Behavioral TherapyResidential ProgramsHospitalization
  25. 25. Medications• Some antidepressants (and antipsychotics- often used for mood stabilization) are approved for use by patients under the age of 18.• Medication alone is significantly less effective for treating depression than combination treatments.• While many medications have been proven to be effective in decreasing symptoms of depression, there are risks and side-effects that teens appear to be particularly susceptible to.
  26. 26. Black Label Warning
  27. 27. Powerful Living Bible Study Series God’s Power is Limitless To Help and Heal Anxiety • Summary and Introduction • Anger • Fear • Depression • Frustration • PowerlessnessDisclaimer: The lessons, information, and links at this site are intended forbiblical teaching and educational purposes and should not be construed asmedical advice or instruction. In no way are any of these teachings meantto be a substitute for professional medical care or counseling. Text: Gods Power to Help Hurting People, Publisher: Urban Ministries (c)2003; Editor: Dr. Colleen Birchett; (c)2009 Queen Phillips, Majestic Worldwide Ministries, Inc.
  28. 28. Scriptural Basis & Introduction   In John 16:33 Jesus said, “I have told you these things, so that in Me you may have [perfect] peace and confidence. In the world you have tribulation and trials and distress and frustration; but be of good cheer [take courage; be confident, certain, undaunted]! For I have overcome the world. [I have deprived it of power to harm you and have conquered it for you.]” (AMP) There’s absolutely nothing that can overtake us if we put our TOTAL trust and confidence in Him and obey the Word.Consequently, these lessons are designed to teach you how to embrace the power of God that’savailable in the Person of the Holy Spirit. He will empower you to handle and overcome anxiety,anger, depression, frustration, and feeling powerless during this economic downturn.The truth is what Jesus told His disciples over 2000 years ago are applicable today. Do you believeit? Do you want help? Would like to experience the compassion of the One who created you in Hisimage and likeness?If so, you’re at a good place to begin the healing process. We’ll focus on six (6) emotions that aremost common during stressful and challenging times. It is my prayer that you receive theencouragement for which this series is purposed.
  29. 29. ACTION PRAYER:Father, thank you for being concerned about every area ofmy life because it’s your desire for me to in peace andabundance here on Earth. I need you to help me. I confess  that I am subject to becoming depressed; therefore, I’masking that you give me the strength to overcome it in my life  and the life of my family. I refuse to allow the spirit ofdepression to overtake me or my family in Jesus’ name. I willarise with fresh excitement and a fresh zeal for life. Isurrender my all to you, and trust your sovereignty to handlelife’s challenges for my good, even when it appears the worstis happening. I will meditate on your word; believe andreceive your power and unconditional love, grace and mercyto carry me and my families through any situation. Thankyou, Father. In Jesus’ name. Amen
  30. 30. CBT for Depression• Cognitive behavioral therapy (CBT) is an effective treatment for depression.• Generally speaking, persons with mild or moderate depression can benefit from CBT, even without taking medication.• Studies have demonstrated that CBT can be as effective as antidepressants in treating mild and moderate depression.• Studies have also demonstrated that a combination therapy of antidepressants and CBT can be effective in treating Major Depressive Disorder (MDD).
  31. 31. • CBT theory supports that a persons mood is directly related to their thought patterns. Negative thoughts affect a persons mood, sense of self, behavior, and even physical state.• The goal of cognitive behavioral therapy is to help a person learn to recognize their negative thought patterns, assess how true they really are, and replace them with healthier ways of thinking.• In addition, therapists also help their patients change behavior patterns that are directly linked to their negative thinking. Negative thoughts and behaviors make a vulnerable person more susceptible to depression.• CBT seeks to change patterns of thought and behavior and thus impact mood.
  32. 32. • CBT for depression focuses on: • Cognitive restructuring (therapist and patient work together to change thinking patterns) and behavioral activation( patients learn to overcome obstacles to participating in enjoyable activities). • The immediate present- what and how a person thinks more than why a person thinks that way. • Specific problems- problem behaviors and problem thinking are identified, prioritized, and specifically addressed. • Goal setting behavior-patients are asked to define goals for each session and long- term goals too. • Education- the use of structured learning experiences teach patients to monitor and write down their negative thoughts and images. The goal is to recognize how those thoughts and images affect their mood, behavior, and physical condition. Therapists also teach important coping skills, such as problem solving and scheduling pleasurable experiences. • Homework assignments- patients must take an active role in learning, both in the session and between sessions. Homework is assigned at every session, can be graded in the beginning, and the HW is reviewed reviewed at the start of the next session. • Using many different techniques, including Socratic questioning, role playing, imagery, guided discovery, and behavioral experiments. 
  33. 33. Cognitive Restructuring• Cognitive restructuring refers to the process of identifying and changing inaccurate negative thoughts that contribute to the development of depression.• This is done collaboratively between the patient and therapist, often in the form of a dialogue. EXAMPLE: a college student fails a math quiz and responds "That just proves Im stupid.” The therapist might ask if thats really what the test means. In order to help the student recognize the inaccuracy of the response, the therapist could ask what the students overall grade is in math. If the student answers, "Its a B," the therapist can then point out that his answer shows hes not stupid because he couldnt be stupid and get a B. Then together they can explore ways to reframe what the performance on the quiz actually says.• "Im stupid” is an example of an automatic thought. Patients with depression may have automatic thoughts in response to certain situations. Theyre automatic in that theyre spontaneous, negatively evaluative, and dont come out of deliberate thinking or logic. These are often underpinned by a negative or dysfunctional assumption that is guiding the way patients view themselves, the situation, or the world around them.
  34. 34. Practitioners should educate parents on data collection. Data should becollected before, during and after any medication changes!
  35. 35. PsychotherapyThere are many different approaches totherapy. Parents are encouraged to gatherresearch on what type of therapy has beenmost effective for what their teen is facing.Psychotherapy may be beneficial if familyconflict is lending to the depression. Schoolpsychologists may help if the environment atschool is influencing the teen’s health.
  36. 36. Cognitive Behavioral Therapy (CBT)Based on the theory that thoughts andobservable behaviors are directly related tomood. If changes are made to patterns ofthought and behavior, changes will follow inthe mood pattern of the patient.Focuses on what a person is thinking, asopposed to why they think the way they do.Goal-oriented and focuses on specificproblems.
  37. 37. CBT cont’d.Employs multiple strategies such as role-playing and guided imagery.Coping skills and problem solving strategiesare taught to the patient. CBT isconsidered educational as well astherapeutic and patients are to take anactive role.Uses behavioral approaches to reinforceactivities that were previously enjoyed byand beneficial for the teen.
  38. 38. Continue to take data on any changes in target behaviors to determine the effectiveness of any treatment.
  39. 39. Residential & HospitalizationTeens suffering from severe depression mayrequire more supervision and structure.Suicide is the third leading cause of deathfor American teens.
  40. 40. Referencinghttp://www.befrienders.org/http://www.wingofmadness.com/Multiple books by Dr. Kay Redfield Jamisonhttp://www.twloha.comNational Hopeline Network 1-800-SUICIDE(Pollock,W) Variation by age , sex and cultureAccrding to Pollock, 3.5 million children < 19 are depressedAlli s o n R e i dS p ald i n g U n i ve rs i ty
  41. 41. (Disclaimer: These are only resource links for your convenience. I am not affiliated with these organizations or business entities, and cannot be held liable for their content. The information/content on the websites or books does not necessarily represent the views or beliefs of Majestic Worldwide Ministries, Inc.http://health.yahoo.com/depression-videos/what-is-depressi http://www.medicalnewstoday.com/articles/8933.php http://www.hartinstitute.com http://www.aacc.net

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