Research—Striped Sweater

Approaching Students
Who Show Warning Signs of Depression

Mental health is a crucial aspect of everyone’s life. If mental health is not properly maintained, it can negatively affect one’s relationships, self esteem and quality of life. But society seems to overlook its impact on our lives. We all know someone who struggles with depression or anxiety- the fact is clear these types of illness are common.  Although there are coping methods designed for such illness, they are applied after the patient was already affected. We see this protocol in the physical health department: medication and physical therapy. Many physical injuries such as muscle tears or cut/broken limbs can be prevented with proper maintenance and attention to safety. From a young age we are also educated on how to stay healthy. We take measures such as a healthy diet and exercise to not get sick or hurt. Ultimately, the goal of being healthy is to prevent physical disorders and illness for as long as possible. Similarly to taking measures to prevent physical illness, research below provides warning signs in hopes of preventing mental illness such as depression.

As symptoms of depression may vary among age groups, the age group that will be focused on is teenagers in high school. An article called “Depression Symptoms and Warning Signs,” by HelpGuide.org, provides a list of symptoms for depression. Despite the fact that this list was designed for individuals to self-analyze, some points on this list may be observable. Symptoms on the list such as “loss of energy, loss of interest in daily activities, and appetite or weight changes” are slight changes in behavior that may be noticed by family. Within the article, one can see that “irritability, anger, and agitation are often the most noticeable symptoms in depressed teens- not sadness.” We see a behavior that is different than we may expect. The importance of learning these warning signs is that we can avoid concern for the wrong individuals. Rather than a melancholic mood, a depressed teenager may show a higher level of frustration and stress. 

Research shows that changes in energy level, weight and frequent agitation are not the only warning signs of depression. The National Women’s Health Report analyzed warning signs in the article “Teens & Depression: Recognizing Red Flags” and concluded that observable red flags are changes in sleep schedule and decrease in academic performance. The article continues to report that “Above all, when kids stop doing things they used to do with pleasure, such as parties with friends, sports, et cetera. These are good indicators that an adolescent may be depressed.” This source emphasizes the physical behavior of the teenager, such as decrease in activity or participation, suggesting these behaviors can be as noticeable as anger or agitation. These warning signs are most easily detected by family, as the adolescent will consult parents about not participating in an activity or notice a drop in grades.

Recognizing warning signals is the first step to prevention. Depression is a risk factor for suicide; a more severe case of depression may intensify suicidal ideation. Therefore, recognizing warning signs is only a portion of the necessary action to prevent depression. The current solution to this mental illness is treatment after diagnosis, not preventive measures. There is no doubt that therapy is effective; however, only for those who can build up the courage to seek it. A certain barrier stands in the way between a depressed student and therapy: the stigma surrounding mental illness. The Choices Therapy Team evaluated studies and warning signs of depression while stating “the stereotypical picture of depression and anxiety limits people from identifying those at risk, and makes it difficult for those suffering to identify it themselves.” Not only does detecting warning signs prevent depression, it also prevents those from misunderstanding the concept of mental illness. The stigma of depression is mostly negative and discourages announcing the need for mental help. We are expected to keep that information to ourselves and handle it our own way.  Teenagers aren’t very familiar with dealing with a mental illness; the social stigma surrounding depression may lead them into denial or prevent them from making the initial step to seek professional help. Countering this mentality is crucial for teenagers as they are beginning to enter high school: an environment that can drastically affect one’s mental health. To avoid this, an action following the recognition is necessary: approaching teenagers who show warning signs. 

Learning to detect warning signals of depression is a starting point to helping struggling adolescents. Human error cannot be avoided but can be minimized by training authority figures to detect warning signs and avoid misjudgement of depression. As one can conclude, mental health has a significant impact on our lives; detection and action towards warning signs of depression can save lives.

In addition, scientific evidence may support the need for detecting and responding to warning signals. There is a link between depression and genetics, suggesting that we cannot fully get rid of this mental illness. In the article “Genetics and Genomics of Depression” by Pavel Hamet and Johanne Tremblay, depression is “subject to a genetically overlapping and distinct genetic influence.” One can come to the disappointing conclusion that depression will always be present, yet that does not mean we can’t lower the rate as much as possible. This knowledge can be taken advantage of by teaching students and teachers to respond appropriately when encountering a friend, family member or peer with this mental illness. 

Despite the soundness of this argument, not all critics agree. When approaching teenagers who show warning signs of depression, there may be several causes for those particular warning signs: a student may be in an argument with someone or just may not be having a good day. With or without the context of the goal(preventing depression), approaching the student may be assumed as invasion of privacy. In a previously mentioned article called “Why Don’t We Treat Mental Illness Like We Do Physical Illness?” by the Choices PsychoTherapy Team, we see that “from the outside, a person can look completely normal.” Depression is associated with a negative stigma, causing people who suffer from it to hide the illness. A warning signal may be detected, and when acted upon, the student can be overwhelmed. As a result, approaching a student showing warning signs of depression may be seen as an insult. Teaching how to detect warning signs may be the difference in looking “normal” and seeing a “hidden” warning sign.  While the intent of the approach might be clear, we must also consider the most careful but effective method to help the student.

High school, along with any other educational institution is a learning environment. It is mandated and designed to educate students and lead them to a hopeful career. This is perhaps the perfect time and place to detect warning signals for depression, as students can be educated to help others and possibly save lives. In high school, many students begin to think about their future; it is essential to keep the school environment as positive as it can be in hopes of a healthy future. As one can see in “A Whole-School Approach Promoting Mental Health and Wellbeing” by Johanna Wyn, Helen Cahill, Roger Holdsworth, Louise Rowling, and Shirley Carson, “Promoting the mental health and wellbeing of all young people is a vital part of the core business of teachers by creating a supportive school environment that is conducive to learning.” A student’s academic performance is greatly affected by mental health. A welcoming school environment will discourage judgement and negative stigma that is associated with depression. As a result, approaching students who show warning signals would be more accepted as an offer for help rather than a personal invasion or insult.

In the perspective of an authority figure, the students’ safety is top priority. This responsibility is generally more applied to physical wellness, but deserves to also be applied to mental wellness. The negative stigma of depression causes those who struggle to refuse to acknowledge the possibility of the mental illness, leading the condition to worsen. This puts the student at risk of suicide. However, when an authority figure begins to question whether or not warning signs are detected, the fear of insulting the student and causing a lawsuit overrides the motivation to help the student. But is it really worth risking a student’s life under your responsibility for not wanting to offend the student? Choosing not to approach the student to avoid the risk of invading his/her personal life may be much worse than making an effort to help one who may desperately need it. More often than not, many would rather stay quiet in fear of misjudging what one may think is a warning signal. Specifically for this reason there would need to be a learning process to detect these warning signs. We must take action to those who show warning signs rather than wait for the mental illness to develop and then treat it. An appropriate setting for learning these warning signs is in high school, with a mental health course and psychologists and professionals nearby if they are needed.

In a school setting, it is important to remember that before approaching the student who may be depressed, there must be a respected relationship between the student body and the staff. A positive and welcoming aura in school would drastically increase the effectiveness of this solution. According to “Teachers as Builders of Respectful School Climates,” by Maria D. LaRusso, “schools with positive climates increase students’ attachment to healthy norms of behavior that are promoted and modeled by teachers and other adults.” Research shows a significant relationship between the school climate and a student’s mental health. The importance of the school environment is that a positive and respectful relationship between staff and students allows the student to feel comfortable. After all, students and teachers spend a majority of their day at school. Creating a healthy school community is essential for everyones’ mental health. One can also conclude that the very presence of positive energy may contribute to preventing depression. 

By having a mental health professional, teacher or school psychologist approach students who show warning signs of depression, the social stigma of this mental illness could change and the teenage suicide would decrease. This would be upon the responsibility of authority figures. As previously mentioned, a respected bond between an authority figure and a student has benefits; it allows trust and security to grow from both parties. According to the “Teen Depression and Suicide” article by Keith King and Rebecca Vidourek, “a key component to preventing teen depression and suicide is for professionals, parents/guardians, teachers, other supportive adults (e.g., coaches, religious youth group advisors, after school program leaders,) and youth to remain aware of such warning signs and risk factors and to appropriately intervene when necessary.” This statement is not without reason. The condition of the school community has a major impact on a student’s willingness to accept help. As a warning signal for a physical illness would be cared for immediately, adults must also be prepared to detect warning signs for depression and step in to guide the student. Through this solution, we are taking action beyond addressing the issue. 

A study conducted by Donna Moilanen and Susan Bradbury analyzes the effect of implementing a program called “A High School Depression and Suicide Prevention Program.” In this study, health educators designed this program to educate students about depression, which was also provided to the teachers and staff. Then, the students went through a depression screening process. With respect to the students, their identities were kept anonymous unless they were comfortable with discussing the results of the screening. Resources such as school counselors, psychologists and mental health professionals were available to contact if needed. Donna and Susan mention that “attempts were made to meet with students identified as being most at risk by virtue of their total score on the depression screening survey.” Those students at most risk were generally in grades 9-11(ages 15-17). After a period of time, another survey was sent to the students who chose to accept help. As a result, a majority of the students were more aware of warning signs of depression as well as a slight decrease in attempted suicide; although it is a slight change, it is progress. Over time we would slowly but surely see a decrease in depressive symptoms. With a similar program being implemented into the high school curriculum and current therapy methods in action, the mental state of our community would greatly improve.

Moilanen and Bradbury’s research method supports the idea that approaching students with information and resources is beneficial for students’ mental health. Not only did the students become more aware of warning signs of depression, an unexpected result has emerged from the study(Donna, Susan) previously mentioned: “they were more aware of how to help themselves or someone else who is feeling depressed or suicidal.” Their finding suggests that perhaps the students, not just teachers and psychologists, may also detect and help those who show warning signs or are already struggling with depression. This outcome may “cover more ground” in terms of detecting warning signals and reaching out to the student. 

It is important to remember that those who are struggling with depression may not have the courage to seek help. Maintaining a positive and respectful school environment can encourage a student to not be afraid to speak out. Implementing a mandatory mental health course in the first 2 years of high school would introduce these warning signs and teach students the severity of depression, as well as effective ways to help, either by guiding them to a psychologist and/or providing moral support. The purpose of the course being mandatory in the first 2 years of one’s high school career is that the student learns about this information and resources at a young age, leading to long lasting effects. 

This goal to prevent depression is not a one-step process. To maximize the efficiency of this approach, there must be a respected relationship within the school. With the help of mental health professionals, teachers, and even students, the change in rate of depression may be an influence to communities outside of the education department.

References

Depression Symptoms and Warning Signs.” HelpGuide.org, 15 Apr. 2020.

Team, Choices Psychotherapy. “Why Don’t We Treat Mental Illness like We Do Physical Illness?” Choices Psychotherapy, 19 Nov. 2019.

Teens & Depression: Recognizing Red Flags. (1999). National Women’s Health Report21(2), 5.

Hamet, P., & Tremblay, J. (2005). Genetics and genomics of depression. Metabolism54(5), 10–15.

Wyn, J., Cahill, H., Holdsworth, R., Rowling, L., & Carson, S. (2000). MindMatters, a Whole-School Approach Promoting Mental Health and WellbeingAustralian & New Zealand Journal of Psychiatry34(4), 594–601. doi: 10.1080/j.1440-1614.2000.00748.x

Moilanen, D., & Bradbury, S. (2002). A High School Depression and Suicide Prevention ProgramAmerican Journal of Health Education, 33(3), 148–153.

LaRusso, M., Romer, D., & Selman, R. (2008). Teachers as Builders of Respectful School Climates: Implications for Adolescent Drug Use Norms and Depressive Symptoms in High SchoolJournal of Youth and Adolescence37(4), 386–398.

King, K., & Vidourek, R. (2012). Teen Depression and Suicide: Effective Prevention and Intervention StrategiesPrevention Researcher19(4), 15–17.

 

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