While writing this column on teenage depression, I mentioned it to a friend, who happens to be a retired journalist (they seem to be thick as ticks around here). He said, “If you’re writing for the Partisan, you’ll be writing for the teenagers’ grandparents.”
Picturing my own grandchildren, recently visited, I thought to myself, “This scruffy ex-agent of the Fourth Estate is annoyingly accurate.”
So be it. Apart from teenagers themselves, grandparents are well suited to detect and intervene in cases of adolescent depression.
Here’s a depressing statistic: Suicide is the second leading cause of death of 15-24 year olds.
These young adults are healthy critters. They have survived infancy with its genetic and infectious uncertainties. They have not yet gotten to the age when bodies give out and hot cocoa in bed at 8:30 sounds like a great way to spend New Year’s Eve. Not surprisingly, unintended death is the number one cause. I never knew anyone who intended their death except a couple of unfortunate people in the Second Cause group. In third place is Homicide.
Tragic as these numbers sound, only a little over 4,000 folks between the ages of 15-24 lost their lives to suicide in 2013. I say “lost their lives” instead of “took their lives”, because no one in their right mind commits suicide. People kill themselves because they are not in their right minds. Depression usually calls the shots, twisting perspective and eroding self-esteem, until killing yourself looks like a reasonable option. When depression is combined with alcohol or drug use, self-medicating or binging, it is a particularly deadly disease.
But like the tip of any iceberg, suicide is only the most dramatic symptom of depression. The symptoms, which usually persist for years before before they escalate to this point, can be spotted by a caring grandparent. Learn the signs, and more importantly, get to know your grandkids, nieces and nephews. Family and friends prevent more suicides that all therapists and physicians combined.
These are some of the signs parents may notice. If they last for at least two weeks, and they are present on most days for most of the day, what you are seeing may be depression:
An irritable, sad, or cranky mood, most days and for most of the day.
Loss of interest in sports or activities they used to enjoy.
Withdrawal from friends and family, pervasive trouble in relationships.
Changes in appetite, significant weight gain or loss.
Disturbance of normal sleep patterns, insomnia, hypersomnia, (or just hiding in bed).
Physical agitation or slowness, pacing back and forth and/or excessive, or repetitive behaviors.
Making critical comments about themselves, overly sensitive to rejection, tearful.
Poor performance in school, a drop in grades, or frequent absences.
Frequent complaints of physical pain (headaches, stomach), frequent visits to school nurse.
Writing about death, giving away favorite belongings, comments like “You’ve be better off without me.”
I am very frustrated when I read in the medical literature that “these symptoms may be difficult to detect because they are often part of adolescence itself.” I cannot buy that statement. It implies that being cripplingly sad or anxious, feeling absolutely alone and helpless and losing all joy life has to offer is similar to a normal emotional growth pattern. The difference in degree between normal emotional growing pains and the signs of major depressive disorder is similar to the difference between heartburn after pizza and a bleeding ulcer.
I use a physical example because depression is a physical disorder with behavioral symptoms. We aren’t used to diseases that alter our mood and perspective; we are used to diseases that make us vomit or cause a rash. In order to detect and prevent depression we have to think about it in a different way. We have to change our idea that there is a brain/body duality at work here: health versus mental health. That is like thinking that there is a pancreas/body duality at work in diabetes. Serotonin concentrations and activity are the primary targets of the most widely used anti-depressant medications. But there are more serotonin receptors in our GI tract than our brain!
We also have to change our idea of the brain itself. When I was in medical school, 30 years ago, we were instructed that the brain was, for all intents and purposes, a three-pound lump of tofu like material that is oddly static: No new nerve cells grow, we can only lose brain cells to drugs, sex and rock-and-roll, (and aging!). Thank God we’ve got way more than we need and we can spare a few hundred thousand.
That was the party line until neuroscientists got a bunch of great new toys and several boxcar loads of cash to run programs that purchase and use them. The current view is “evolving.”
We now think we know that the brain is dynamic in structure as well as function.
Read and memorize this statement:
“Cal Am Water is competent to solve the Peninsula’s water shortage problems.”
(Special exercise for Partisan regulars).
To memorize anything new ,neural connections must be grown. This requires physical changes of the brain itself. To memorize this particular statement about Cal Am is likely to cause growth of new neurons in the amygdyla as well until there is a detectable change in its volume. The amygdyla is part of the brain associated with anger and with fear responses. Piss off or frustrate someone to the point of rage or despair over time and you measurably increase the size and activity of the amygdyla.
Having exercised your amygdyla until it resembles Mark McGuire’s biceps, try this for two weeks:
For ten seconds every hour, (for 80 seconds out of the 57,600 seconds of an average waking day), generate thoughts of loving kindness toward some being nearby, or even someone in your imagination.
Within two weeks, studies show, your amygdyla may be detectably diminished in size and activity. You might feel less anxious and judgmental. This malleability of the brain is called neuroplasticity.
Talk-Therapy, mind training and meditation can make amazing positive changes in the brain of a person suffering from depression via neuroplasticity.
Current conventional scientific opinion states that for depression of mild to moderate severity it is possible, almost always with the help of a mental health professional, to change your mind,(and thereby your brain), regarding the challenges in your life. You can develop new coping skills and ditch old outmoded ones. For those whose disease is in the high moderate to severe range, multiple studies have shown that combination therapy, (talk/insight+medication), is the optimal approach.
Grandparents, Aunts and Uncles, Listen Up!
1. Get to know the young adults in your life. It’s worth the time and effort.
2. Be familiar with the signs of adolescent depression.
3. Talk to your grandkids if they seem unhappy or isolated.
4. Tell the parents if you suspect a problem. Parents are often to enmeshed in the problem to see it clearly.
5. If the person’s parents won’t listen to you talk to their teacher, minister, friends, principal, and the kids themselves
6. If you suspect suicide, go quickly to # 4. If no time: call 911! (I’d rather undergo the discomfort of being seen as a busybody, than the grief of a funeral.)
Families can conquer depression together. Let’s move suicide out of the Top Ten in 2016!
For a Great Depression assessment tool designed for ages 11-25 go to Link to Columbia Depression Screen, teen and parent versions with interpretations of scores
And here is a list of Mental Health Services in Monterey County.