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  1. 1. Depression 101
  2. 2. Behaviors & Symptoms Associated with Depression <ul><li>Crying, feeling sad, helpless or hopeless </li></ul><ul><li>Feeling discouraged or worthless </li></ul><ul><li>Loss of interest or pleasure in others or most activities </li></ul><ul><li>Fatigue and loss of energy nearly every day </li></ul><ul><li>Bad temper, irritable, easily annoyed </li></ul><ul><li>Fearful, tense, anxious </li></ul><ul><li>Repeated rejection by other children </li></ul><ul><li>Drop in school performance </li></ul><ul><li>Inability to sit still, fidgeting or pacing </li></ul><ul><li>Repeated emotional outbursts, shouting or complaining </li></ul><ul><li>Doesn't talk to other children </li></ul><ul><li>Repeated physical complaints without medical cause (headaches, stomach aches, aching arm or legs) </li></ul><ul><li>Significant increase or decrease in appetite (not due to appropriate dieting) </li></ul><ul><li>Change in sleep habits </li></ul>
  3. 3. Serious & Critical Symptoms <ul><li>Suicidal thoughts, feelings or self-harming behavior </li></ul><ul><li>Abuse or prolonged use of alcohol or other drugs </li></ul><ul><li>Symptoms of depression combined with strange or unusual behavior </li></ul>
  4. 4. Contributing Factors to Depression <ul><li>Loss or reduction of reinforcement </li></ul><ul><li>Social skills deficit </li></ul><ul><li>Lack of family cohesion, expressiveness, organization </li></ul><ul><li>Family conflict </li></ul><ul><li>Deficient ability to provide for self-monitoring, self-evaluation and self-reinforcement. </li></ul><ul><li>Negative views of self, the world and one's future. </li></ul><ul><li>Learned helplessness </li></ul><ul><li>Deficient problem solving skills. </li></ul>
  5. 5. Events that contribute to Depression <ul><li>Separation, divorce of parents or even close relatives. </li></ul><ul><li>Death of a loved one; a person or a pet. </li></ul><ul><li>A move from one town, or even one neighborhood, to another. </li></ul><ul><li>Academic, sports or athletic failure. </li></ul><ul><li>An injury or physical illness resulting in hospitalization or restricted activity. </li></ul><ul><li>Loss of customary surroundings, family, or close friends. </li></ul><ul><li>Embarrassment, shame, guilt or loss of &quot;face&quot;. </li></ul><ul><li>Failure to live up to personal expectations. </li></ul><ul><li>Repeated physical, emotional or verbal abuse. </li></ul>                                       
  6. 6. Approaches to Treating Depression <ul><li>Cognitive </li></ul><ul><li>Behavioral </li></ul><ul><li>Social Skills </li></ul><ul><li>Self Control </li></ul><ul><li>Interpersonal </li></ul>
  7. 7. Cognitive Approach <ul><li>Cognitive approaches utilize specific strategies that are designed to alter negatively based cognitions. Depressed patients are trained to recognize the connections between their thoughts, feelings, and behavior; to monitor their negative thoughts; to challenge their negative thoughts with evidence; to substitute more reality-based interpretations for their usual interpretations; and to focus on new behaviors outside treatment. </li></ul>
  8. 8. Behavioral Approach <ul><li>Behavioral approaches designed to increase pleasant activities include several components such as self-monitoring of activities and mood, identifying positively reinforcing activities that are associated with positive feelings, increasing positive activities, and decreasing negative activities. </li></ul>
  9. 9. Social Skills Approach <ul><li>Social skills training consists of teaching children how to engage in several concrete behaviors with others. Initiating conversations, responding to others, refusing requests, making requests, etc. Children are provided with instructions, modeling by an individual or peer group, opportunities for role playing and feedback. The object of this approach is to provide the child with an ability to obtain reinforcement from others. </li></ul>
  10. 10. Self Control Approach <ul><li>Self-control approaches are designed to provide the self-control strategies including self-monitoring, self-evaluation, and self- reinforcement. Depressive symptoms are considered to be the result of deficits from one or more areas and are reflected in attending to negative events, setting unreasonable self- evaluation criteria for performance, setting unrealistic expectations, providing insufficient reinforcement, and too much self-punishment. </li></ul>
  11. 11. Interpersonal Approach <ul><li>Interpersonal approaches focus on relationships, social adjustment and mastery of social roles. Treatment usually includes non-judgmental exploration of feelings, elicitation and active questioning on the part of the therapist, reflective listening, development of insight, exploration and discussion of emotionally laden issues, and direct advice. </li></ul>