THE WALL
2
The Invisible Wall
Understanding Teenage Depression
1 IN 5 TEENS WILL
EXPERIENCE DEPRESSION BEFORE ADULTHOOD IN THE UNITED STATES.
3
2
The Invisible Wall
Understanding Teenage Depression
TEENAGE DEPRESSION IS CLOSER TO YOU THAN YOU THINK.
3
Name Yu-Hsuan (Jamie) Chen ID Number
02540307
Jamietmv@hotmail.com
School
Academy of Art University
Course GR 600: Visual Communication Lab Instructor Phil Hamlett Jeremy Stout Semester Fall 2012
Understanding Teenage Depression
THE WALL
3
2
The Invisible Wall
There are wounds that never show on the body that are deeper and more hurtful than anything that bleeds. —Laurell K. Hamilton American writer
CONTENTS 01 What Is Teenage Depression?
2
02 The Hidden Problems
12
03 Consequences
24
04 Breaking the Wall
36
05 My Path
42
Works Cited
56
Photo Credits
59
2
The Invisible Wall
WHAT IS TEENAGE DEPRESSION?
2
The Invisible Wall
Depression is the inability to construct a future. —Rollo May existential psychologist
What Is Teenage Depression
I don’t feel like doing anything lately. I didn’t play basketball with my friends today. I feel really tired and have no appetite. I just want to stay home and sleep. Ms. Lewis said my grades have fallen over the past couple of months. She noticed I couldn’t concentrate in class. I guess I am just having a hard time getting motivated to study. When is this going to end? Should I tell anyone?
5
2
The Invisible Wall
What Is Teenage Depression
Today, parents are facing more difficulties as the rate of teenage depression has become higher and higher. Every parent dreams of having a perfect child. One who is smart, attractive, talented, obedient, polite, and healthy in mind and body. Many spend money on preschool and private education to create academic advantage and increase the odds of acceptance into a prestigious college. (Battle) It comes as a shock when the teenagers have difficulty navigating this traditional path. A school report card may contain Cs and learning disabilities discovered. Or he or she may simply dislike academic courses. A healthy parent learns to love and accept their child as he or she is and relinquishes personal and social expectations. Family resources—emotional and financial—are given to maximize strengths and remove obstacles to the full development of a child’s potential. (Battle) Today, parents are facing more difficulties as the rate of teenage depression has become higher and higher.
7
8
The Invisible Wall
SADNESS VS DEPRESSION Feeling sad, down, or discouraged are natural human emotions. People all feel this way at times. Teens may feel sad over an argument with a friend, a breakup, or a best friend moving out of town. They might be disappointed about doing poorly on a test. The death of someone close can lead to a specific kind of sadness—grief. (“Depression”) Depression isn’t just bad moods and occasional melancholy. It’s not just feeling down or sad, either. Depression is a strong mood involving sadness, discouragement, despair, or hopelessness that lasts for weeks, months, or even longer. Depression affects more than a person’s mood. It drains the energy, motivation, and concentration a teen’s needs for normal activities. It interferes with the ability to notice or enjoy the happiness in life. (Smith) Teenagers with depression may not realize they are depressed. Because self-critical thinking is part of depression, some teens might mistakenly think of themselves as a failure, a bad student, a quitter, a slacker, a loser, or a bad person. (Smith) Teenagers suffering from depression are often in denial about their problem. In fact, denial is a symptom itself. It protects the teen from feeling intense pain and discomfort, impairs their judgment, and prohibits them from perceiving reality. (Fink)
What Is Teenage Depression
Teens Who Suffer from Depression in the US
20% 10 –15% 5% 8.3%
of teens will experience some symptoms of depression before they reach adulthood.
of teens are having some symptoms of teen depression.
of teens are suffering from major depression.
suffer from depression for over the course of one year or more.
9
10
The Invisible Wall
Teens Who Don’t Receive Systematic Treatment
3 in 4
teens don’t have systematic treatment. Their depression episodes are consigned to resolve only with the passage of time.
Understanding Teenage Depression
A flower can’t bloom in a dark room.
3
12
The Invisible Wall
THE HIDDEN PROBLEMS
2
The Invisible Wall
Depression is just anger without enthusiasm. —Anonymous
The Hidden Problems
15
MISCONCEPTION Teenage depression is a worrisome condition. However, one of the real problems is when parents misunderstand it and are blinded to depression symptoms. Occasionally it is the upbringing of mom and dad, or adult peer group pressure, which makes parents simply discount depression as mere moodiness. Even if depressed teens may keep pushing the parents away, they need the support of parents the most. There are four common wrong assumptions that parents often have about depression.
1. Depression symptoms and teen drama are identical. Slamming the door is a dramatic expression of a bad mood. The hole that your teen punched into the drywall is also a lot of show. On the flip side are the emotions that go hand in hand with true teenage depression. The University of Houston identifies feelings of “sadness, dejection, lack of energy, hopelessness� as well as isolation. A teen, who is sullen over the prospect of having to clean out his room, acts different than a teen who despairs over feelings of abject loneliness. (Cochran)
16
The Invisible Wall
Teen depression can go unrecognized.
2. It’s just the hormones. Puberty and the hormonal changes lead to some significant mood swings. No teenager can escape these occasionally dark moods followed by explosive temper tantrums. On the flip side are the symptoms of teenage depression. Rather than the roller coaster up and down of hormonal change, teenage depression is consistent for at least two weeks. Regular teen moodiness usually resolves itself in about a day or two.
3. Teenage depression happens to others. Not necessarily. Do you have someone in your family who might have had depression, or someone who is currently battling with the illness? Genetics, as well as personal trauma and stress, are contributing factors to clinical depression.
4. He’ll just have to snap out of it. The old “pulling up at the bootstraps” type of thinking is a common response to teenage depression. It is easy to get caught up in the small things of daily life and hone in on the bad grades, disrespectful attitudes and mouthy back-talk that the adolescent dishes out. Parents usually get frustrated, but they don’t realize these are the signs of teen depression. (Cochran)
Understanding Teenage Depression
3
18
The Invisible Wall
Public Attitudes on Mental Illness
33% 1 in 3 people believe children should be placed in an alternative setting as soon as they exhibits a mental illness in school.
50% More than half of people believe major depression might be caused by the way someone was raised.
The Hidden Problems
40% More than 40% believe depression is the result of a lack of will power.
60% More than 60% said an effective treatment for major depression is to “pull yourself together.�
19
2
The Invisible Wall
The Hidden Problems
21
STIGMA Stigma can be defined as an identifying “mark” or uncharacteristic “blemish.” For people with depression, stigma ultimately results from society developing biases or negative views. (Campbell) Mental health researchers explain that the pain of stigma is as devastating to people with mental disorders as the symptoms of illness. For many centuries mental illness was terribly misunderstood. Individuals afflicted were viewed by the society as dangerously demon-possessed, were locked up in prisons and even executed as witches. Today, it is still very common for mental illness to be treated a joke. Consider how frequently we hear words that mock these serious brain disorders—“wacko,” “nut case,” “schizo.” These constant jokes reject teenagers struggling with mental illness and make it very tough to engage them in treatment. Who wants to acknowledge having a mental health problem if it leads to being the target of name-calling? They are called “crazy” and “psycho” and are socially isolated and victimized. (“The Media and Mental Illness Stigma: Have we turned a corner?”)
2
The Invisible Wall
Understanding Teenage Depression
3
Many depression sufferers believe their illness is a nasty little secret and they pray no one ever finds out about it.
24
The Invisible Wall
CONSEQUENCES
26
The Invisible Wall
BARRIERS TO TREATMENT A new research shows that concerning about the family’s reaction to their depression is a major reason why many teens don’t seek treatment. In the study, which included 368 teens and one parent or guardian of each teen, half of the teens had been diagnosed with depression. The teens and the adults were asked to rate possible barriers to depression treatment, including cost of care, concerns over perceptions of others, difficulties making appointments with a doctor or therapist, constraints due to time and other responsibilities, not wanting family members to know about the depression (asked of teens only), the unavailability of good care and simply not desiring treatment. The researchers found that while the adult guardians were less likely to report barriers to depression treatment, among teens, worries about stigma and the reactions of their family members were listed as major issues. “With teenagers, treatment decisions greatly involve other parties, especially parents. For instance, teenagers often rely on adults for transportation. Doctors need a sense not just of what the teen thinks or what the parents thinks, but what both think,” study leader Lisa Meredith said. (Health Day)
The Hidden Problems
With teenagers, treatment decisions greatly involve other parties, especially parents. —Lisa Meredith social psychologist
35
28
The Invisible Wall
Understanding Teenage Depression
Stigma keeps teens from depression treatment.
3
30
The Invisible Wall
Consequences
31
SOCIAL EFFECTS A study of stigma among teens taking psychiatric medication discovered through interviews that 90% of participants demonstrated at least one of three measured stigma themes: secrecy, shame, and limiting social interaction. Many of these teenagers endorsed feeling some stigma from their friends or peers. Others expressed fear of being bullied by peers in school environments, consequently leading to secrecy, shame, and social withdrawal. Not only does stigmatization from family and peers negatively affect a teen’s psyche, but it can lead teens to actually define themselves by their illnesses, a phenomenon known as self-labeling. The majority of teens do not seem to be self-labelers, but it is important to note that self-labeling positively correlates with self-stigma, depression, and a lower sense of mastery. That being said, self-labelers seem to have an overall poorer self-image, with a greater susceptibility to depression. Teens who self-label refer to their illness as an organic part of themselves. Furthermore, they often face difficulties in establishing friendships among their peers. (Lippman)
32
The Invisible Wall
BEHAVIOR CHANGES Teenagers who feel more stigmatized are less likely to seek treatment. Therefore, the illness causes great damage to teens’ lives and health. Depression in teens may result in reckless and high-risk behaviors. For example, teens become so overwhelmed by their negative thoughts and emotions that they feel unable to cope with even minor problems in everyday life. Many depressed teenagers try to escape their realities by running away or using drug and alcohol. It also causes violent and reckless behavior. (Day) Constant exposure to negative emotions can cause violent outbursts in some teens who find it difficult to express their emotions verbally. There is also an increasing trend of teens who “bottle-up” negative emotions over a long period of time to lash out with violence when these emotions become intolerable. Since the depressed teens often lack self-respect, reckless behavior such as sexual permissiveness can be used as a cry for help. Moreover, when hopelessness and helplessness feelings become so severe, depressed teens may have suicidal thoughts, which inevitably leads to suicide attempts if the depression goes untreated. They may experience their situation to be so hopeless that they see death as the only option. (“Teen Depression”)
Understanding Teenage Depression
3
2
The Invisible Wall
Consequences
Behavioral Consequences
Substance Abuse Teenagers may use drugs and alcohol in an attempt to escape their feelings of hopelessness. It can lead to drug addiction or alcoholism.
Self-injury Self-injury causes permanent scarring on physical or mental part of the body. It could lead teens to attempt suicide.
Eating Disorder Teens focus on food in order to control an aspect of their lives when they feel out of control. It causes diabetes, obesity, or other diseases.
Violence Teens who are usually the victims of bullying become violent. The self-hatred emotion can erupt into violence and homicidal rage.
35
36
The Invisible Wall
Depression and Teenage Pregnancy
24%
of girls who experience depression have a biological child at age 18.
9%
of girls who experience less or no depression have a biological child at age 18.
Understanding Teenage Depression
3
Feeling lonely is more dangerous for health than smoking. —The World Health Organization
Consequences
39
PHYSICAL EFFECTS Teenagers with depression seem to catch physical illnesses more often than other teens. And, studies are increasingly linking more illnesses to depression, such as osteoporosis, diabetes, heart disease, some forms of cancer, eye disease, and chronic pain. (“Teen Depression”) Furthermore, 20% to 40% of teens with depression eventually develop bipolar disorder (manic-depression) which is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Most teenagers with depression experience a recurrence at some point in their lives. 20% to 40% of depressed teenagers relapse within two years, and 70% will do so by adulthood. The reasons for relapse are not known, but there is some evidence that experiencing a depression leaves behind psychological “scars” that may increase vulnerability throughout early life. (Schoenstadt)
40
The Invisible Wall
ACADEMIC EFFECTS The primary task of teens is to complete education and pursue a career. University of Montreal Doctoral candidate Cintia Quiroga researched the effect of depression on high school students and found that a depressed student is 1.66 times more likely to drop out than a non-depressive student. The higher the feelings of depression, the higher the risk of dropping out. Males typically drop out at a higher rate than girls, but there are more girls with depression than boys. (Carranza) At the age of 23, youths who have a history of major depression during teenage years are less likely to have graduated from college. They make less money and are more likely to have a period of unemployment. (“Youth with Depression/Anxiety�)
Consequences
The Average Annual Earnings of 23-Year-Old Youths
Youths Who Experienced Depression
15.5K
$$$$$$$$$$ $$$$$$
Youths Who Experienced Less or No Depression
23K
$$$$$$$$$$ $$$$$$$$$$ $$$
41
42
The Invisible Wall
BREAKING THE WALL
44
The Invisible Wall
LIVE GATHERINGS The live gatherings will be held in schools or community spaces. Both parents and teenagers are going to participate in the events. There will be professionals giving a speech that tells everyone the right knowledge about teenage depression and the effects of stigma. Moreover, participants will be split in small sharing groups to talk and play interactive games.
Breaking the Wall
39
Breaking the Wall
47
INTERACTIVE WEBSITE The website will not only give the knowledge and the right information about teen depression but provide many personal stories. Parents can also share their own situations, stay connected with others, and communicate with professionals. They will be giving the direction of how to support their kids without stigmatizing them.
48
The Invisible Wall
INTERACTIVE APP Because of the pressure of stigma, teens are embarrassed to acknowledge their depression and do something about it. The interactive application will be a media for parents to interact with their teens. They can share photos, writings, and emotions. Through the communication, parents will understand their teens better, and teens can talk about their problems feeling more comfortable.
Breaking the Wall
51
PROMOTIONAL MATERIALS The promotional materials, such as posters and brochures, are to make parents know about the live gatherings, website, and application. Also, they will simply be the media to increase awareness of teen depression. Once parents identify the problems, they can get more resources by accessing other media.
52
The Invisible Wall
MY PATH
54
The Invisible Wall
Happiness is the key to a healthy life! Teenage depression was never a topic that people talked about when I was a teenager. As an Asian student, I spent most of my time studying and taking tests everyday in my middle school and high school. Like my classmates, I tried to do my best to get good grade so that my teachers and parents would not point their fingers at me and ask why my grade had become lower. When I was in middle school, the pressure of studying was bigger than I could bear, so I started to feel nervous for no reason. The feeling came and went, but it hit me at any time even if I was just sitting there doing nothing. I didn’t tell anyone about my problem at the time because I was afraid of what my friends would think, and I thought my parents would probably think it was not a big deal. I became better after about one year, but when I looked back, I think I was really having anxiety. During my high school years, I was getting stronger when it came to handling stress. However, there was one girl in the school who committed suicide. She was a hard-working and quiet student, so nobody saw it coming. Later, my father told me that one of his friends’ daughters was suffering from depression, and she was almost 19 at the time. Her family was considering sending her to
Breaking the Wall
55
a psychiatric institution, but after some advices from family friends, they decided not to do it. It was better to spend time with her instead of pushing her away. And, in the same year, my cousin was also having depression symptoms. At the time we heard about it, the situation was already serious. Suddenly, it hit me that so many young people were suffering from mental problems. I was sure that there were still a lot of people who didn’t want to acknowledge their illness because of social stigma. I think people should be able to talk about their problems without being judged or treated differently, especially teenagers who are going to be the future of our society. The stigma of mental illness has existed for a long time. I hope not only parents but everyone should break the stigma together and give teens a comfortable environment to live happy a life. After all, happiness is the key to a healthy life!
56
The Invisible Wall
WORKS CITED Battle, Judy Shepps. About Teen Depression. <http://www.about-teen-depression. com/mood-disorder-diagnosis.html>. Brondou, Colleen. “Study Shows Increase in Anxiety, Depression in Young People.” 11 1 2010. Finding Dulcinea. <http://www.findingdulcinea.com/ news/health/2010/jan/Study-Shows-Increase-in-Anxiety--Depression-in- Young-People.html>. Campbell, Sandra L. “Why Is There a Stigma With Depression?” eHow. <http:// www.ehow.com/facts_5804535_there-stigma-depression_.html>. Carranza, Walli. “Effects of teen depression.” 28 5 2010. Livestrong.com. <http:// www.livestrong.com/article/133955-effects-teen-depression/>. Cochran, Sylvia. “4 Wrong Assumptions that Parents Make About Teens and Depression.” 24 1 2012. Yahoo Voices. <http://voices.yahoo.com/4-wrong assumptions-parents-teens-10873051.html?cat=25>. Day, Chelsea. “The Effects of Depression on Teens’ Lives.” eHow. <http://www. ehow.com/about_5121126_effects-depression-teens-lives.html>. “Depression.” TeensHealth. <http://kidshealth.org/teen/your_mind/mental_ health/depression.html>. “Depression in Children and Adolescents.” NIMH. <http://www.nimh.nih.gov/ health/topics/depression/depression-in-children-and-adolescents.shtml>. Fink, Jeremy. “Surviving Teenage Depression.” 23 10 2010. The Dynamic Counselor. <http://dynamiccounselor.blogspot.com/2010/10/teenage depression.html>. Hall, Ramona. “Adolescent Depression and Parent Communication.” Ezine Articles. <http://ezinearticles.com/?Adolescent-Depression-and-Parent Communication&id=3645596>. Health Day. “Stigma Keeps Teens From Depression Treatment.” 27 5 2009. US News. <http://health.usnews.com/health-news/family-health/brain and-behavior/articles/2009/05/27/stigma-keeps-teens-from- depression-treatment>.
References
57
Heley, Katie. “Teenage depression stigmatized.” 9 5 2011. The Baltimore Sun. <http://articles.baltimoresun.com/2011-05-09/news/bs-ed-teenage depression-letter-20110509_1_mental-illness-depression-young-people>. Kearney, Christine. “Depression Linked To Adolescent Bullying.” 11 2 2012. Medical News Today. <http://www.medicalnewstoday.com/ articles/241531.php>. Lippman, Brit Lizabeth. “Stigma: A Different Kind of Bully.” NYU Steinhardt. <http://steinhardt.nyu.edu/opus/issues/2011/spring/stigma>. “Mental Illness and Stigma.” Mental Health Connection. <http://www. mentalhealthconnection.org/stigma.php>. Murray, Bob. “Depression Fact Sheets.” 15 1 2005. Uplift Program. <http://www. upliftprogram.com/depression_stats.html>. Roome, Debbie. “Helping Your Teen With Anger Management.” 3 6 2012. Bright Hub Education. <http://www.brighthubeducation.com/parenting teens/122285-advice-for-helping-teens-cope-with-anger-and-hostility/>. Ross, Anne. “Teenage Depression - Peer Pressure.” Ezine Articles. <http:// ezinearticles.com/?Teenage-Depression---Peer-Pressure&id=4282287>. “Runaway/Homeless Teens.” Diogenes. <http://www.diogenesyouthservices. org/services>. Salahi, Lara. “Teen Depression: Know the Warning Signs.” 14 9 2010. ABC News. <http://abcnews.go.com/Health/MindMoodNews/teen-depression warning-signs/story?id=11631687#.ULvZcIZ8Sb1>. Schoenstadt, Arthur. “Effects of Teen Depression.” MedTV. <http://depression. emedtv.com/teen-depression/effects-of-teen-depression-p2.html>. Smith, Melinda. “Teen Depression.” Helpguide. <http://www.helpguide.org/ mental/depression_teen.htm>. “Teen Depression.” Education.com. <http://www.education.com/reference/ article/Ref_Teen_Depression/>.
58
The Invisible Wall
“The Media and Mental Illness Stigma: Have we turned a corner?” 21 2 2012. TeenScreen. <http://www.teenscreen.org/mental-illness/media and-stigma/>. Trina. “Stigma of Depression.” 23 3 2012. Depression: My Story. <http:// stigmabegone.blogspot.com/2012/03/stigma-mark-of-disgrace associated-with.html>. “Understanding Depression.” KidsHealth. <http://kidshealth.org/parent/ emotions/feelings/understanding_depression.html>. “Understanding teen depression.” MDC. <http://mentaldepressed.com/ Understanding%20teen%20depression%20%202.html>. Williams, Amy. “Statistics and Fact about Teen Depression.” 7 10 2010. At-Risk Teenagers. <http://www.at-risk.org/blog/916/statistics-and-fact-about teen-depression-2/>. Wolfe, Jen. “Teen Depression Could Cause Long-Term Health Effects.” 23 10 2012. Discovery Fit & Health Insider. <http://blogs.discovery.com/ dfh-insider/2012/10/teen-depression-could-cause-long-term-health effects.html>. “Youth with Depression/Anxiety.” 7 2009. U.S. Department of Health and Human Services. <http://aspe.hhs.gov/hsp/09/vulnerableyouth/5/index.shtml>.
Photo Credits
PHOTO CREDITS Inside Cover K. simpson, 2007. Opening Lisa Donato, 2011. 6
KayEllen, 2010.
11 Kora, 2011. 17 Yu-Hsuan Jamie Chen, 2012. 20 Cat Johnson, 2009. 22 Retta Ritchie-Holbrook, 2008. 29
Guy Keating, 2012.
30 Jimmy Changa, 2007. 33 DriveByShutter.com, 2011. 34
The Javorac, 2011.
37 Gellert Vinnai, 2008. 45
Ambitious about Autism, 2009.
46 ybstmotor-trade.com, 2011. 49
siliconangle.com, 2011. (Profile Photo) hopetocope.com.
50
PCES art enrichment, 2012.
59