Pine Rest Mission Statement
Pine Rest Christian Mental Health Services is called to express the healing ministry of Jesus Christ by providing behavioral health services with professional excellence, Christian integrity and compassion.

Understanding the Realities of Childhood and Adolescent Depression

By Alan Harper, M.A.

Many adults are surprised when told that children and adolescents can and do become clinically depressed. We often think only adults have the type and severity of life stressors that can result in depression. After all, we adults have to deal with careers, financial concerns, marital issues, parenting challenges, tax season, home repairs, health problems, and more. Children and adolescents have little to worry about in their relatively stress-free lives. Children simply have to do their best in their fun classes at school, play with their friends, enjoy all the toys they’ve accumulated, and put up with Mom and Dad when told it’s time to go to bed so they can rest up for another fun-filled, stress-free day.

As much as we may want the above scenarios to be true, the fact is the time of our lives from childhood through adolescence can be an emotionally tumultuous time. It can be filled with uncertainty, insecurity and confusion caused by difficult peer-relational issues, heart-breaking dating experiences, academic stressors, health problems and conflict in home environments. This is a time of transition from the relative protection of young childhood to the significant challenges of adulthood. The demands placed on children and adolescents by society, parents, peers, and the girls and boys themselves can be staggering.

SIGNS AND SYMPTOMS
There are a number of signs and symptoms of childhood and adolescent depression, some of which are readily observable by others. Some others require questioning of the child or adolescent and/or deliberate monitoring of his or her moods and behaviors. Parents cannot count on their child or adolescent to openly state they are feeling depressed or are struggling in various areas of their lives. It is important that parents pay close attention to changes in their child or adolescent’s general level of functioning in areas such as academics, peer relations, physical appearance and grooming, and involvement in usual areas of recreation. Significant and lasting declines in one or more of these areas may be an indication of depression, and should prompt further investigation. Parents must also listen for words indicating feelings of low self-worth and watch for observable moods that suggest chronic sadness, irritability or discouragement. Common signs and symptoms of depression among children and adolescents include:

• Frequent sadness, tearfulness, or crying
• Relationship problems
• Feelings of hopelessness or helplessness
• Threats or attempts to run away from home
• Frequent complaints of various physical ailments
• Frequent school absences and/or poor school performance
• Low energy or restlessness
• Alcohol and/or drug use
• Persistent boredom
• Decline in activity level or interest in previously enjoyed activities
• Communication difficulties
• Social isolation
• Excessive guilt or low self-esteem
• Significant changes in eating and/ or sleeping patterns
• Increased levels of anger, irritability, or hostility
• Increased sensitivity to rejection or failure
• Concentration problems
• Thoughts or threats of suicide or other self-destructive behaviors

Not all children or adolescents will share the same signs and symptoms of depression. Some may appear sad, while others may act angry or irritable. One child may sleep excessively while another may have difficulty falling or staying asleep. It is important to look for changes in the typical moods, behaviors or physical functioning to determine whether depression may be present.

Also, it is important to remember that each individual sign or symptom above is not necessarily an indication of depression (although suicidal thoughts, threats or attempts do require immediate intervention). It is the combination of the various signs and symptoms that determines whether a depression diagnosis is made.

It is also important to remember the above changes in moods, behaviors, physical symptoms and general functioning must be present on a fairly consistent basis for at least two weeks before a depression diagnosis should be considered. Children and adolescents will occasionally experience emotional turmoil that may mimic depression, but be resolved within a few days. This is not considered depression, but rather a temporary emotional upheaval that does not require the same type of intervention. This is not to say parents should wait two weeks to seek help if serious concerns exist. Rather, the depression diagnosis itself requires two consecutive weeks of impairment.

PRACTICAL TIPS
What Can Parents Do To Help?
There are many things parents can do to help their child or adolescent recover from depression. Conversely, there are also many things parents sometimes do that can actually create more difficulties for the child and perhaps even worsen the depression. Below is a list of some of the ways parents may support and assist their child or adolescent, as well as a number of reactions to avoid.

• Seek help from a qualified mental health professional as soon as it appears the child or adolescent may be depressed. Do not hesitate to take emergency measures (crisis line, 911, etc.) if it appears the child is at immediate risk of self-harm.
• Stay involved throughout the course of the child’s treatment whether it involves medication, therapy, or both. Ask questions of the mental health professionals regarding treatment plans, medication issues, and ways you can assist with treatment through necessary changes in the home environment and/or ways you respond to the child.
• Proactively address any concerns or reasonable suspicions of drug or alcohol use. Drug and alcohol use can intensify the downward spiral of depression and can be a significant obstacle to effective treatment.
• Monitor the depressed child or adolescent’s moods and behaviors without "suffocating" him/her with outward concern or questions.
• Maintain home rules and expectations concerning the child as consistently as possible, except in cases when specific changes have been discussed and identified as part of the treatment plan. Parents sometimes become over accommodating to a depressed child or adolescent, which can actually encourage the continuation of the depression due to the perceived "benefits" of being depressed.
• Monitor and encourage healthy nutrition and sleep habits with the depressed child. Clinical depression has a biological dimension that can be affected by the consistency and quality of physical self-care.
• Encourage the depressed child to maintain reasonable physical, recreational, and social activity levels. These activities will provide opportunities for emotional respite from the depression and help maintain much-needed social contacts.
• Make it clear that you are available to the child to assist in any reasonable way possible, but don’t be surprised if he or she rarely takes you up on your offer. Simply sensing you as an available quiet strength can sometimes be enough to help the child feel your support.
• Allow the depressed child some "space," but discourage prolonged isolation.
• Do not be overly critical of your depressed child, or suggest they "snap out of it." They probably would if they could and what they really need from you is nonjudgmental support, encouragement, and understanding. But remember, reasonable expectations should continue in most areas of the child’s life, including academics, behavior, and household responsibilities.

(Excerpted from "Today" magazine's "What is Depression?" issue. The complete magazine is available online at:http://www.pinerest.org/education/today/depression/default.asp)

Alan Harper earned a M.A. in Counseling Psychology at Western Michigan University. He has been employed at the Pine Rest Campus Clinic for six years and works with children, adolescents, and adults. To reach Alan Harper, contact 616/455-5270.

How Do I Reduce My Risk Of Dementia?

While there is no cure for dementia, there are things you can do to reduce your risk or slow symptoms if you have already been diagnosed.

• Keep learning new things
• Keep your mind active
• Spend time in relationships that are important to you, with family and friends, where you experience being cared for and giving care to others
• Make healthy food choices, particularly focusing on increasing fresh fruits and vegetables and avoiding “bad” fats
• Exercise regularly, getting both stretching and strengthening as well as cardiovascular activity. Your family doctor can help you develop a healthy exercise schedule that can be as simple as taking regular walks.

While many areas related to prevention need further research, these findings are consistent with the long-held belief that healthy living can decrease the risk of cognitive decline later in life. Because the effects of poor diet and little or no exercise can take years to add up, the sooner one begins a healthy lifestyle the more likely it is to make a difference down the road. The Alzheimer’s Association has a helpful web site with healthy lifestyle recommendations, www.alz.org/maintainyourbrain.

(*Source: National Institute of Health’s Cognitive and Emotional Health Project, in Alzheimer’s and Dementia: the Journal of the Alzheimer’s Association, January, 2006)

(Excerpted from "Today" magazine's "Living With Dementia" issue. The complete magazine is available online at: http://www.pinerest.org/education/today/dementia/default.asp)

January 4, 11, 18, 25
Anger Management Classes for Adults
Led by Jim Bottenhorn, MA, LLP, Director of Pine Rest’s Contact Center. 7 p.m. to 8:30 p.m. on Pine Rest's main campus, 300 68th Street, SE, Grand Rapids. Open to adults and older teens. Registration is required. Cost: $65/individual or $95/two family members. Class fee due at first class. Call 616/493-6033 for more information and to register.
For more information click here.

January 9, 16, 23, 30
Anger Management Classes for Teens
Pine Rest will host anger management classes for teens during the months of January, February, and March 2007. The classes will be led by Ryan LaRue MSW, LMSW, ACSW, outpatient therapist at Pine Rest’s Campus Clinic. For more information and to register, call 616/222-4584 or email ryan.larue@pinerest.org.
For more information click here.

February 3
2007 Grand Rapids Christian Parenting Conference
The 2007 conference, themed Celebrating the Family, is planned for Saturday, February 3. from 8:30 a.m. to 12:15 p.m. in the Richard and Helen DeVos Center for Arts and Worship, on the campus of Grand Rapids Christian High School. The conference is free of charge and open to the public. No registration is required. Anyone interested in additional information may call the Pine Rest marketing department at 616/455-6500.
For more information click here.

October 9, November 13, December 11, January 8, February 12
Pine Rest’s Southwest Clinic To Host 'Family Connection' Support Group
"Family Connection" helps spouses, parents, siblings and other caregivers more effectively deal with the stresses created by the symptoms or behaviors associated with mental illness. The support group offers guidance through shared experiences, sharing effective coping strategies, and gaining knowledge about various disorders in a safe and confidential setting.
For more information click here.

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Disclaimer

Copyright © 2006, Pine Rest Christian Mental Health Services. All rights reserved. The contents of Mental Health News & Information are for informational purposes only. The content is not intended to be a substitute for professional medical or mental health advice, diagnosis, or treatment. It cannot and should not be used as a basis for diagnosis or choice of treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical or mental health condition.