Therapy for Depression
I see a common theme in terms of depression in children. They have told me, “I feel sad.” In terms of teenagers, they tell me two things, “I’m not depressed, and I don’t want medication, or I am depressed.” Children and teenagers tend to be clear about current feelings. From adults, I usually hear, “I think I may be depressed. My friend/family/husband/wife told me I needed to talk to you. I’m not depressed.”
Many people have ideas, feelings, and beliefs about depression. What is depression? How they judge themselves and others in terms of a depressed state.
For me, depression is a state of being. It is a spectrum. If you think about it in those terms, we fluctuate depressed moods depending on a particular time in our lives. Consider this, on a scale of 1 to 10, maybe 1 is your elated feelings of bliss. A five would be feelings of sadness, a seven may despair, and perhaps a ten dread, perhaps the experience of being out of control, psychosis, not being oneself.
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Let me provide some examples to help clarify. Individuals who are between 1-3 are elated with life. Things are joyful, blissful, and spiritually satisfying. Individuals at a five may feel okay with some moments of tearfulness, sadness, and thoughts of not knowing one’s purpose. Individuals at a seven will experience grief, loss, even feelings of hopelessness. Their life is painful, and there are little moments of relief from this type of despair. At ten, individuals experience life as completely painful; there is no hope, no way to see that change is possible in their lives. I would say individuals at a five and above should seek out professional help. It is best to ask for help early rather than later. Asking for help does not mean someone is depressed based on a clinical diagnosis with the Diagnostic Statistical Manual (DSM) 5. It means that someone can recognize changes in their mood, and they are strong enough to ask for support before getting to a higher level on this spectrum.
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Individuals between 3-5 may need spiritual guidance and adjunctive practices to support their integrative development with the mind, spirit, and body. One goal is to work towards a lower level on the depressed spectrum. If you are around a seven, then the goal is to work towards a 4 or 5. If you are at a ten, then the goal is to work towards a 6 or 7. This type of stuff does not happen overnight. It requires one to be open to change. If anyone knows this, I do, and change is hard. It is hard for me, and it is hard for others, maybe even you. However, I believe you will know when you are ready, and you will want to change; you will have thoughts about changing. You will attempt to change several times. Change will require you to do hard work, challenge your ego, and depending on where you are on this spectrum; your ego will need guidance and support. You will need skills to stay grounded. You can benefit from the wisdom and expertise of a qualified professional to challenge and rebuild the ego. The ego will need to be destroyed. However, destroying the ego doesn’t come until you are near levels 2 or 3.
Let’s explore one form of depression and what this looks like for adults, children, and teenagers.
Major Depression
This form of depressed mood is unrelenting. There is a loss of interest in activities usually interfering with one’s daily life. There are periods of low mood, profound sadness, and an experience of despair. Those who experience this form of depression can find enjoyment in some activities, but their overall mood is sad. This form of depressed state can happen once, and we refer to it as a single episode. The depressed state can happen over a period lasting at least two weeks and longer. There can be different levels of intensity from mild to severe. Individuals will experience changes in their weight, challenges with focus and concentration, changes in sleeping patterns, low energy, agitation, restlessness. An individual will feel worthless, guilt, shame, hopelessness, and engage in self-destructive, self-harming behaviors.
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In children, major depression is experienced as a sense of sadness and worthlessness. Although a sad event may occur for the child when the event ends and time passes, the child still has a decreased capacity to experience pleasure in some activities. Children have special rules to consider in terms of their experiences with grief and stages in their development. The distinguishing factors can be time; depression in children continues for months and years. Children will experience changes in their social interests. Children will have changes in eating and sleeping habits. Parents are usually not aware of a child’s struggle with a depressed state as some children present as “easy,” do not get into trouble, and typically follow others’ plans. Parents and other adults should consider changes in weight, sleep, energy levels, and interest. If a parent has concerns, seek out a professional for an evaluation and assessment. Children will often share their feelings and experience with others. A trained professional can hear, see, and experience things with children that a parent does not notice.
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In teens, major depression falls under three categories: major depression, bipolar disorder (manic manifestation), persistent depressive disorder (dysthymia). I will not focus on bipolar disorder or dysthymia in this section because they need their own attention. Research informs us that adolescents who suffer from major depression usually have a family history of depression, increasing stress levels, history of abuse or neglect, emotional traumas, grief, loss concerns, developmental and learning disorders, gender and sexuality issues, and traumatic brain injuries.
Major depression in teenagers is more than just an unhappy or unpleasant mood. This depressed state impacts their body, mood, and thoughts. Young people with major depression have different symptoms, and although there are some similarities, they are manifested differently depending on the adolescent.
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Some things parents and healthy adults should consider in terms of symptoms to look at for are: feelings of sadness, despair, helplessness, guilt, low self-esteem, not being or feeling good enough, wanting or wishing to die, thinking about or planning one’s death, loss of interest in once enjoyed activities, struggles with peers, changes in sleep, appetite, energy, can’t make decisions, indecisiveness, suicidal thoughts or attempts, threats of or does runaway, sensitivities to failure or rejection, irritability, hostility, aggression, and physical complaints. Some physical complaints are headaches, stomach aches, and fatigue.
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I believe as a parent and a healthy adult in the lives of many children we should be their advocate. You may not know what to do, but if you see, observe, or listen to some of these concerns in a young person. Seek out professional help. Talk to your children, your children’s friends, your students, your neighbors, and those you meet daily. We are at a time in our lives, especially since the pandemic when teen suicide is at a high peak. The successful rates of suicide among African American males are highest than in other groups. Adolescents are engaged in more aggressive and lethal means. The increase in successful suicides is because of access to resources, technology, and less healthy adults wanting to help.
There are treatments and other options available to people suffering from major depression. Some may benefit from one form of therapy and others from another form of treatment.
I will leave you with a collection of beliefs told to me. “I’m sorry for crying. I feel weak if I cry. I’m not strong. I have to keep my feeling inside.” My response, “If you can cry, you are strong, you are doing something most people avoid, you are allowing yourself to be vulnerable, and you are asking for help. This is a sign of super strength, a super power to me.”