Advice Column, Tween & Teen

Typical Teen or a Teen in Trouble?

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By Janine Shamos

Teenagers have their good days and their bad ones. But every so often, a learner will sit in class and he or she isn’t simply ‘having a rough day’; they didn’t just miss the bus or just break up a relationship or just fail a test. They are struggling in life. And like most teens, they try very hard to hide it, to seem normal and unaffected. But, if you know your learners, if you really see and feel your classroom, you’ll understand that something deeper than a ‘just bad day’ is going on. “We see our kids in the classroom daily, in the playground and on the sportfield which gives us a repeated look at their patterns, personalities, and concerns”, says High School educator, Rose. “We sometimes know kids better than their own parents because we see very different sides to them at school. We are perfectly positioned to recognize the warning signs when things go wrong.”

Depression is not only a grown-up concern. Thousands of teenagers struggle with depression each day. Trying to manage all that teenage life has to present is hard enough for the average, happy kid. So, when any form of depression sets in, their issues multiply, their troubles magnify, and they begin to see life through less hopeful eyes. According to the South African Depression and Anxiety Group (SADAG), an estimated one in five children and adolescents has a mental health disorder, and one in 10 has a serious disorder and may have considered suicide. In South Africa, suicide is the second leading cause of death in the 15 to 24 age group. The facts are scary: 90% of people who develop a mental disorder start showing warning signs during their teen years; youth with a mental health disorder will often have significant impairments at home, school or with peers, and over 60% of youth with a mental health disorder don’t get the treatment they need. According to the National Youth Risk Behaviour Survey (2008), 23.6% of South African youth felt so sad that they stopped doing usual activities, 20.7% were considering suicide, 16.8% have a definite suicide plan, and 21.4% have attempted suicide at least once. The prevalence of suicidal and depressed feelings increases by grade – 19.5% of Grade 8’s, 21.4% of Grade 9’s, 24.2% of Grade 10’s, and 29.7% of Grade 11’s feel helpless, hopeless and depressed. What does that mean in terms of your typical high school classroom?

Teachers have been shown to be effective in detecting mental health issues in their learners. “Teachers are in a great position to identify teens at risk, because they have the greatest access to the adolescent population over the longest period of time”, says psychologist Liane Lurie. “Therefore they have the greatest opprtunity to observe changes in teen behaviour and performance, identify vulnerable kids and take appropriate action.” Mental health problems in teens are real, painful and, left untreated, can have serious consequences.

Knowledge and education are key if we are to save lives. “The more you know about teen depression, the better equipped you are to intervene”, says SADAG’s Cassey Chambers. SADAG offers teachers’ workshops as well as school-based talks to empower teachers and learners to recognise the warning signs and take action. . SADAG is open 7 days a week from 8am to 8pm on 0800 21 22 23 (toll-free) or SMS 31393. “Some warning signs and behaviours may be simple, obvious to pick up, while others are more hidden and complex. But no matter how depression presents itself, we can help”, says Chambers. Seeing the signs, talking about the problem, taking appropriate action and offering support can go a long way toward getting a teenager back on track. “We must remember that most depressed or vulnerable teens are looking for help but have no clue how to ask for it”, says Chambers. The sooner a mental health disorder is recognized, the greater the likelihood that treatment will be effective. What you know and what you do will make a real difference in a teen’s life

So how do you know if a grumpy teen is being ‘typical’ or if they’re ‘troubled’? Teenagers face many pressures, from the changes of puberty to questions about who they are and where they fit in, and trying to assert their independence can lead to fights with parents and teachers. With all this ‘natural’ drama going on in a teen’s life, it isn’t always easy to differentiate between depression and normal teenage moodiness. If you’re not sure whether a teen is ‘typical’ or ‘troubled’, read the warning signs at the end of the article and consider how long the symptoms have been present, how severe they are, and how different the teen is acting from his or her usual self. “While some ‘growing pains’ are to be expected as teenagers grapple with the challenges of growing up, dramatic, long-lasting changes in personality, mood, or behaviour are red flags of a deeper problem”, says Lurie.

There are 6 most common symptoms that teachers see in the classroom that are warning signs that something is wrong. Remember that while a teen might not be depressed, there may be other problems or issues they are grappling with.

Loss of enthusiasm and interest: It’s true that some high school learners don’t show much drive, most have some level of investment, whether academically or on the sports field. When that shuts down for an extended period of time, your warning bells should be going off.

Headaches: Headaches have always been an early indicator of stress and depression, so be aware if a learner continually talks of headache pain.

Fatigue: Teenagers do admittedly sometimes look and behave like zombies. But when a learner continually looks exhausted, take notice.

Hygiene and appearance: While teen fashion is often odd to say the least, a general disinterest in caring for himself is a clear warning sign that something’s wrong. Closely watch the learner whose physical appearance declines and remains that way.

Loss of concentration: Slowed thinking and distracted thoughts get in the way of a learner keeping any decent level of concentration so watch the teen who is always ‘out of it’, disconnected or looks lost.

Academic trouble: We all know that when performance plummets, there is a reason. No teen just starts failing or dropping academically unexplainably.

There are three basic steps every teacher can take to help a learner get the help they need:

  1. Notice: Notice the warning signs of mental health problems. The signs usually aren’t one-time occurrences; they persist over several weeks.
  2. Talk: If you see any of the warning signs, talk to the teen. The sooner the better. Ask how he or she is doing, and be compassionate as you listen and respond.
  3. Act: Get help and counselling as soon as possible. Teachers are a vital first line of defense but we aren’t all counsellors or psychologists. Call SADAG on 0800 21 22 23 to get advice and referral for a teen in crisis.

If you suspect that a learner is suffering from depression, speak up right away. In a loving and non-judgmental way, share your concerns and let him or her know what specific signs you’ve noticed and why they worry you. Then encourage the learner to share what he or she is going through.Getting a depressed teen to open up can be a challenge and it can be frustrating to know that aone of your learners needs help, but not be able to get them the correct intervention because they won’t talk. Teens may be reluctant to open up for a number of reasons: they may be ashamed, afraid of being misunderstood, or simply may have a hard time expressing what they’re feeling. Remember that denial is a strong emotion so trust your instincts. SADAG has some tips on talking to a depressed teen:

Offer support : Let depressed teenagers know that you’re there for them. Hold back from asking a lot of questions (teenagers don’t like to feel patronized or interogated), but make it clear that you’re ready and willing to provide whatever support they need. Make sure you can back up and deliver what you promise.

Be gentle but persistent: Don’t give up if you are shut out at first. Talking about depression (sometimes talking about anything) can be very tough for teens. Be respectful of their comfort level while still emphasizing your concern and willingness to listen.

Listen don’t lecture: Resist any urge to criticize or pass judgment once the teenager begins to talk. The important thing is that they are communicating. Avoid setting ultimatums.

Validate feelings: Don’t try to talk teens out of their depression, even if their feelings or concerns appear silly or irrational to you. Simply acknowledge the pain and sadness they are feeling. If you don’t, they will feel like you don’t take their emotions seriously.

Youth who are contemplating suicide frequently give warning signs of their distress and teachers are in a key position to pick up on these signs and get help. “Never take these warning signs lightly or promise to keep them secret”, says Chambers. The youth spend a substantial part of their day in school under the supervision of school personnel. Effective suicide and violence prevention engages the entire school community. Youth need to be able to trust their teachers and so it is crucial for all school staff to be familiar with and watchful for warning signs of depression and suicidal behaviour. Untreated depression can result in feelings of hopelessness and suicide – in behaviour with irreversible consequences. Let’s be educated and intervene to save the lives of South Africa’s youth.

Warning Signs

Following are a few of the warning signs that may indicate that a teen has a mental health problem. These signs usually aren’t one-time occurrences; they persist over several weeks.

  • Marked change in school performance.
  • Inability to cope with problems and daily activities.
  • Marked changes in sleeping and/or eating habits.
  • Many physical complaints.
  • Sexual acting out.
  • Depression shown by sustained, prolonged negative mood and attitude, often accompanied by     poor appetite, difficulty sleeping or thoughts of death , intense sadness or hopelessness, tearfulness or frequent crying.
  • Abuse of alcohol and/or drugs.
  • Persistent nightmares.
  • Threats of self-harm or harm to others.
  • Self-injury or self-destructive behaviour.
  • Frequent outbursts of anger, aggression , irritability, or hostility.
  • Threats to run away.
  • Aggressive or non-aggressive consistent violation of rights of others; opposition to authority, truancy, thefts, or vandalism.
  • Strange thoughts and feelings; and unusual behaviours.
  • Withdrawal from friends and family
  • Feelings of worthlessness and guilt
  • Loss of interest in activities, lack of enthusiasm and motivation
  • Thoughts of death or suicide

Suicide warning signs in depressed teens

  • Talking or joking about committing suicide.
  • Saying things like, “I’d be better off dead,” “I wish I could disappear forever,” or “There’s no way out.”
  • Speaking positively about death or romanticizing dying (“If I died, people might love me more”).
  • Writing stories and poems about death, dying, or suicide.
  • Engaging in reckless behaviour or having a lot of accidents resulting in injury.
  • Giving away prized possessions.
  • Saying goodbye to friends and family as if for good.
  • Seeking out weapons, pills, or other ways to kill themselves.
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