Tackling teenage depression – what can schools do?

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How can schools and teachers support young people who are suffering from depression? Dr Stephanie Thornton looks at what research into the issue can tell us.

Adolescence can be a tricky time. As anyone who works with teenagers knows, challenges from the social to the hormonal, from academic issues to relationships can very easily create pressures that can seem overwhelming to the young.

Just how big a problem is depression in the secondary school years? The truth is that we don’t know. Recent studies estimate that an astonishing 20 per cent of our young suffer at least one serious depressive episode. But just how many others suffer depressions severe enough to affect their lives, but not severe enough to come to our attention? Probably the majority, at one time or another. 

Depression is a serious business. Horrible in itself, depression can cut a wide swathe of destruction through a young life. Even a mild depression can disrupt education and relationships. A moderate depression can leave a young person feeling hopeless and helpless enough to be suicidal. And left unaddressed, teenage depression can set the scene for a lifelong tendency in that woeful direction.

Traditional medicine

Traditional solutions to adolescent depression have relied on individual counselling, or the use of drugs. Neither has been of as much use as we hoped. 

In skilled hands, counselling can be very effective. But there simply are not the resources to give all those who need help such skilled interventions. Waiting lists are long, treatment schedules short. Can despair wait months for a first appointment? Will a short series of weekly sessions “sort” serious angst? Worse still, research shows that not all popular talking therapies are constructive: going over depressing events may sometimes have the effect of deepening rather than alleviating the problem.

Drugs for depression have had a mixed press: now hailed as miracle cures, now castigated as the cause of teenage suicides. Medical research paints a gloomy picture: a recent major study found that anti-depressive drugs are no more effective than a sugar-pill placebo.

A new view 

Why do people get depressed? Traditionally, we assume that tough life events and the way we experience them provide key triggers for depression, and that there is some physiological change in depression, some change in the brain which may be caused by (or cause) depression, which we can address (with drugs, if we had the right ones). New research suggests that these assumptions are sort of right – but also an oversimplification.

This new research has shown that an astonishingly simple intervention that does not involve drugs, and which wholly ignores the life-events associated with depression, can both measure a depressive tendency and have a marked effect in relieving depression. 

Specifically: you show people an array of faces – a dozen, say – only one of which is smiling and all the others are frowning. Depressives take longer than more positive individuals to find the smiling face. 

But repeat the task again and again over a few weeks, and the depressives begin to find the smiling face faster. More importantly, they also show a tendency to be more positive about life at large.

What this extraordinary discovery implies is that the tendency towards anxiety and depression can be thought of as a cognitive bias: influenced by a conceptual system that is “set” to hone in on the negative and gloss over the positive.

More interestingly, the research implies that this bias can be changed by simple “brain training” exercises, such as the “find the smiling face” task. And this has interesting implications for how we might manage teenage depressive tendencies.

Classroom approaches

Depression is something that we should always take seriously. Sometimes, a young person is so troubled that it is a matter of urgency to find professional help for them (though it can be harder to identify such situations than we suppose: many young people deliberately hide even severe depression). Obviously, no classroom “brain training” exercise is going to deal with this. The rule must always be – if you’re worried about a pupil, get help.

However, there are a number of things we can do in the classroom to try to shift the young away from a negative cognitive bias and toward something more positive which will help to protect against depression developing, or may offer support that allows a teenager to pull him or herself out of a mildly depressive state.

List the positive

List the positive things that happened today. Our grannies knew it – counting your blessings can make life seem better, and lessen depression. What new research adds to that ancient wisdom is the suggestion that some ways of counting our blessings are more effective than others. 

Typically, we count blessings in headlines (I’m so lucky that I have a great family/boyfriend and so on). What works better is an approach which looks for small blessings in each activity, every day, as often as possible. Research shows that setting aside a few minutes to list the little, immediate blessings has a marked beneficial effect on wellbeing. 

This little habit works like the brain-training task described earlier: it “re-sets” the brain to seek out the positive. Learning to see the good things even in a day where the “headlines” were generally black or bleak breaks up a negative mindset and is a real protective against depression. 

Teaching this habit in the classroom may be the most valuable thing we can do to help protect the young from depression – but don’t assume that this will be easy! It can be hard to spot the little blessings, especially if one is starting with a negative view of life (in fact, that difficulty is a key part of depression). Activities to help everyone regularly find little blessings may be useful.

Empower

Even adults tend to assume that our moods are caused by events (you’ve made me so angry/this is such a depressing day), but that is never true. Whatever has happened cannot directly cause our emotional response: it is how we interpret and react to events that causes an emotion. And we can, more often than we suppose, choose to react more positively – laugh rather than cry. This simple idea comes as a surprise to many people. It can be an empowering revelation, making it another useful topic to discuss in arming the young against depression.

Put it in perspective

One of the hardest things for the young to do is to put their personal woes and disasters in perspective. They simply don’t have the life experience to take a calmer view, as an adult might. 

Two stories last year in the press illustrate the point well: in both, an individual was threatened with the publication of photos he had texted of his penis. One, a 17-year-old boy, saw this threat as such a disaster that he killed himself. The other, a prominent American politician, did not see the actual publication of those pictures as an impediment – and he may well be right! 

How do we help the young to put “disasters” in better perspective? Simply advising them in general terms to do that won’t help: they would if they could. What works better is to directly teach a strategy for getting perspective; suggesting, for example, things that should be the real threshold for disaster – as, for example, in the old question did anyone die? 

But what suggestions will work for the young? Try discussing that with them. How do others actually see everyday (or more dramatic) embarrassments? How should we react? Sensitively handled, such a discussion can offer the opportunity for putting many things into a more comforting perspective – and offering advice on getting help when you really get things wrong.

  • Dr Stephanie Thornton is a chartered psychologist and former lecturer in psychology and child development.


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