A Teacher's Guide to Understanding and Working With

A Teacher's Guide to Understanding and Working with

Students with Depression

Introduction

The position of depression as a disability is ambiguous. Though early definitions of emotional and behavioral disabilities included depression, more recent definitions seem to leave depression as a possible side effect of the primary emotional and behavioral disabilities (Gearheart 367). Our primary textbook lists depression and suicide under "Related Considerations" along with adolescence and Substance Abuse (413). Despite this apparent backpedaling, Gearheart, et al. states that "childhood and adolescent depression as a disorder differentiated from adult depression has only recently become a topic of study."

What is clear is the need for recognition and dissemination of information about this very valid disability. As one student wrote, "Teachers are trained to handle students who lack discipline, the slow learners, the extremely bright, and even kids who have ADHD. What I've discovered, though, is that they aren't prepared to teach the students suffering from depression" (Madison). This student went on to describe the kinds of teachers she had: those who ignored her and those who approached her on a too personal level.

I am very afraid that these two reactions remain the most popular ones for a disability that can and quite often does kill the students it affects. Of all the disabilities, it seems depression should be one of the most studied and most watched for. What follows is an early attempt to provide a resource for initiating this reintroduction (or introduction) of depression into the regular teacher's awareness.

A History of Depression in Writing

Little has been written about adolescent and child depression until recent years. Adult depression has had greater press, but discussion of depression at all has been inconsistent because of social taboos against discussion of suicide and depression. Much more prevalent is discussion of emotional and behavioral disabilities, but without emphasis on mood disorders such as the many variants of depression and suicide. These studies show that EBDs are a very serious and potentially debilitating disability in terms of educational and economic potential (Osher, et al).

However, childhood and adolescent depression is less researched and has a relatively short history. Children were not considered capable of experiencing depression in the past, particularly in the wake of Freudian psychology, which does not consider them sophisticated enough (Nunley). In the 1970's, childhood depression was viewed as "masked" by other disabilities, but others in more recent times have moved toward looking at it in terms of adult depression, which is probably unwise (Nunley). Nevertheless, looking at depression as equivalent in some degree to adult (or established) depression gives credibility and weight to depression in youth (children and adolescents).

Depression Today

A 2000 study determined that 2.5% of children and 8.3% of adolescents live with depression. This number has generally increased over the past three decades while adult numbers have not increased as much (Warwick 62; Cooper 47). This number also increases during adolescence, especially among girls. Of course, adolescence is not the most ideal time to become distracted or otherwise dysfunctional. The sapping of motivation involved in depression can seriously affect schooling, thereby putting the youth back in her studies and furthering the depressive cycle by suggesting the student's academic worthlessness. Depression does effect academic performance. Lose (or never gain) a sense of direction or purpose, thereby affecting their adult lives as well.

Most youths with depression also exhibit other behavioral problems. Warwick reports that 75% also have anxiety disorder, 50% have oppositional disorder, 33% have a conduct disorder and 25% have substance abuse problems (63). Episodes of depression have a 70% chance of relapsing in five years (Warwick 68) and most childhood depressives also experience depression in adulthood. Studies over the past five years have only reinforced the position that depression in these age populations is significant and largely misunderstood.

Divisions and Definitions

Depression can be viewed either as a continuum or as discrete illnesses (Warwick 62). As a continuum, depression is a stage in reacting to stresses, occurring after anxiety and anger, generally (51). When depression interferes with function, it becomes a disorder. When it develops into a significantly dysfunctional or abnormal state, it is an illness. These are all merely terms, however, and the discussion emphasizes not only the frequency of depression but the possible clinical seriousness of it as well.

The following are the major divisions or kinds of depression. More specific information about each division can be found at the surgeon general's website, www.surgeongeneral.gov or the National Institute of Mental Health website, www.nimh.nih.gov.

Dysthymia (Depressive Neurosis)

A lifelong, chronic and mild form of depression.

Depressive Syndrome

Useful as a neutral term that encompasses the many signs of a depressive state, thereby differentiating between an isolated "blues" period and a more serious, recurring depression that encompasses many related symptoms.

Major Depressive Order (Unipolar Depression)

Main category used by the American Psychiatric Association. Five of their nine primary characteristic symptoms must be present for at least two weeks, producing a functional impairment. Some consider this category to be too inclusive, resulting in the over-identification of severe, clinical depression.

Bipolar Depression (Psychotic Depression)

Severe depression alternates with mania. Bipolar depression can be hard to separate from ADHD. These children exhibit grandiose behaviors (believing they can do anything) and flight of ideas. They can also become hyper-sexualized.