Depression awareness & Helpful resources

1. Depression awareness &Helpful resources PTSA Meeting TJHSST December 13, 2012 Presented by Greg Myers, School Psychologist (703) 750-8365 gdmyers@fcps.edu

2. Agenda • How common is depression? • Types of depression • Signs and symptoms • What you can do to help • Treatment options • Promoting mental health • Suicide prevention

3. How common is depression? • According to the National Institute of Mental Health, 20.8% of all adults will suffer from some form of a mood disorder in their lifetime • 16.5% major depressive disorder • 3.9% bipolar disorder • 2.5% dysthymic disorder

4. How common is depression? • 14% of adolescents (ages 13-18) will suffer from some form of a mood disorder • 11.2% major depressive disorder or dysthymia • Up to 3% bipolar disorder • 4.7% of adolescents will experience a severe mood disorder

5. How common is depression? • At TJ, that would mean that among our current student body, about 260 of our students would have a diagnosable mood disorder by the time they graduate from high school; about 90 students could have a severe mood disorder.

6. How common is depression? • According to the most recent Fairfax County Youth Survey data (2011-2012 school year) • During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities? • 24.1% (98 students) of TJ sophomores • 20.6% (82 students) of TJ seniors • Note: this is not necessarily a significant difference, nor does it necessarily represent a predictive trend

7. Types of depression • Mood disorders include • Major depressive disorder • Bipolar disorder • Dysthymic disorder (example) • Cyclothymic disorder • Related conditions • Seasonal affective disorder • Postpartum depression • Substance-induced depression

8. Types of depression

9. Signs and symptoms • Depression • Persistent sad and irritable mood • Loss of interest or pleasure in activities once enjoyed • Significant change in appetite and body weight • Difficulty sleeping or oversleeping • Physical signs of agitation or excessive lethargy and loss of energy • Feelings of worthlessness or inappropriate guilt • Difficulty concentrating • Recurrent thoughts of death or suicide

10. If you think your child may be depressed… • Ask yourself: • What changes have you noticed? • How long have you noticed the changes? • How have the changes impacted your child? • Talk with others (friends, family, teachers) • Have they noticed these changes too?

11. If you think your child may be depressed… • Talk with your child • As a parent, let your child know that he or she can tell you anything. • When your child shares personal information, be an active listener

12. If you think your child may be depressed… • Being an active listener: • Start by making a comment about what you’ve noticed: • “I’ve noticed that you have been looking sad lately…” • Encourage them to share more by saying things like, “Tell me more”, “And then…?” • Just listen; don’t think about what you’ll say next • Try to listen without judgment

13. If you think your child may be depressed… • Being an active listener (cont.) • Ask your child one question at a time and then wait for the answer; be comfortable with silence • Ask them if they want your advice; if they say no, then let them think about it (unless it is a highly risky or dangerous situation) • Tell your child you’re proud of him/her; it takes courage to share feelings like this • Tell your child that you love him/her no matter what

14. If you think your child may be depressed… • Regarding communication… • 15.8% of county wide respondents—that’s 4,840 students—said they seriously considered attempting suicide in the past 12 months • 3.8%, or 1,153 students, reported actually attempting suicide in the past 12 months. • TJ data, though slightly lower, were similar • What percentage of parents were even aware?

15. If you think your child may be depressed… • If you think your child may be having thoughts of suicide, don’t be afraid to ask them! • Don’t be concerned about “putting thoughts in their head;” it may save a life • “Have you ever felt so depressed that you want to hurt yourself?” • “Do you have thoughts of suicide?”

16. If you think your child may be depressed… • If your child has an immediate plan • Don’t leave him/her alone • Call for help: 1-800-273-TALK (8255) 1-800-SUICIDE (784-2433) 703-527-4077 • Call 911 if necessary

17. Protective factors for suicide • Protective factors are conditions or attributes that diminish the likelihood of a problem or disorder occurring • Intact family/support system • One caring adult with whom he/she can confide • Feeling accepted/belonging (family, school, community connectedness) • Feeling worthy/productive • Access to services (mental health, substance abuse treatment) • Feelings of permanence/stability

18. Treatment options • Depression is treatable • Where to turn for help: • Try starting with your insurance company! • They can tell you what’s covered, who’s in-network • Psychologist, psychiatrist, clinical social worker, etc. • School staff • Family doctor • Crisis hotlines: 1-800-273-TALK (8255) 703-527-4077 • Pastor, spiritual leader, clergy

19. Treatment options • Treatment starts with a conversation • Get informed first! • May include an evaluation • A mental health professional: psychologist, licensed clinical social worker, psychiatrist • Education • Learn about depression • Try starting with NAMI or NIMH • Talk with your family

20. Treatment options • Psychotherapy/Counseling • Often cognitive-behavioral therapy (CBT) or psychodynamic approaches • Individual or group therapy • Family therapy • Medication • Not usually a first line treatment for adolescents, but may be paired with psychotherapy • http://www.parentsmedguide.org/

21. Promoting mental health • Help your teen be active and exercise…or better yet, do it with him or her! • Get out of the house, get some sunshine, go for a walk, play tennis, throw a football, kick a soccer ball, ride a bike, take a yoga class, lift weights, etc. • Exercise can boost endorphins, relieve stress, increase energy levels, improve mood and self-confidence, help you sleep better

22. Promoting mental health • Exercise is one of the few areas where TJ does worse than the county averages • Overall, 33.7% met recommended amount: • Physically active (heart rate up, heavy breathing some of the time) for > 60 min during at least 5 days out of last 7 • County = 41.9% • Seniors reported being less active than sophomores • Females (28%) reported being less active than males (39%)

23. Promoting mental health • Help your teen get sleep • NIH recommends that teens get 9 hours! • TJ is also worse in this area than county averages • Only 2% get recommended amount! (>9) • County = 9.4% • 31.2% get 5 hours or less • County = 16.6% • Seniors reported getting less sleep than sophomores

24. Promoting mental health • The National Sleep Foundation says not getting enough sleep can: • Limit your ability to learn, listen, concentrate and solve problems • Increase (worsen) response time • Cause you to eat too much or eat unhealthy foods • Contribute to illness or driving drowsy. • Make you more prone to pimples/acne • Lead to aggressive or inappropriate behavior such as yelling at your friends or being impatient with your teachers or family members

25. Promoting mental health • Even more importantly, getting inadequate sleep can affect your mood: • UPenn study found subjects limited to 4.5 hours/ night for one week reported feeling more stressed, angry, and sad • When they resumed normal sleep they reported a dramatic improvement in mood • Recovery required 2 full nights of sleep Dinges, David F.; Pack, Frances; Williams, Katherine; Gillen, Kelly A.; Powell, John W.; Ott, Geoffrey E.; Aptowicz, Caitlin; Pack, Allan I. Cumulative sleepiness, mood disturbance and psychomotor vigilance performance decrements during aweek of sleep restricted to 4-5 hours per night.. Sleep: Journal of Sleep Research & Sleep Medicine, Vol 20(4), Apr 1997, 267-277.

26. Promoting mental health • Napping • If napping, try to keep within the range of 20 to 40 minutes per weekday • This allows for improved performance and alertness, while minimizing groginess or “sleep inertia” • NASA study found 34% improved performance and 100% improved alertness among sleepy military pilots and astronauts for 40-minute naps • Napping on weekends may disrupt restorative overnight sleeping • “Emergency napping”

27. Promoting mental health • The Sleep Model for TJ? • 7 to 9 hours of sleep per night during week • If napping, 20 to 40 minutes per weekday • Avoid naps on the weekends if following this schedule • 9+ hours of sleep on both Friday and Saturday nights • Teach your kids about “emergency napping” to combat drowsy driving

28. Promoting mental health • Eat healthy foods • Reduce caffeine intake, especially within 6 hours of sleeping • Avoid refined sugars which can cause highs and lows, affecting your mood • Encourage friendships/social supports • Help your teen get “quality time” with at least one friend at least once a week

29. Promoting mental health • Help your child set realistic goals • Help your son/daughter learn when to say “I’ve done what I can” • What message are you sending about the priorities of sleep, grades (accomplishments), friends, mental health/self-care? • What message are you modeling? • Help your child help others • Volunteer work, tutoring, etc. can help boost self-confidence and a sense of community/social support

30. Promoting mental health • Make sure your child gets some downtime • Don’t overbook with activities • Give your teen some private time • Try yoga, meditation, or mindful breathing • Meditation podcasts (UCLA) • Mindful breathing exercise (Jon Kabat-Zinn) • Free meditation exercises from TJ’s Mind-Body Medicine Society

31. Promoting mental health • Don’t look for immediate fixes; most mental health problems improve gradually • Approaching vs. avoiding • Toward or away from threats • Research suggests that those with an avoidant coping style may be more likely to experience mental health problems

32. Resources • National Institutes of Mental Health (http://www.nimh.nih.gov) • National Association of School Psychologists (www.nasponline.org) • Youth Suicide Prevention Program (www.yspp.org) • American Foundation for Suicide Prevention (www.afsp.org)

33. Actual Questions from the Youth Survey • Q67 During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities? • Q68 During the past 12 months, did you ever seriously consider attempting suicide? • Q69 During the past 12 months, did you ever actually attempt suicide? • Q128 During the past 7 days, on how many days were you physically active for a total of at least 60 minutes per day?

34. ESPN documentary E:60 Unbreakable