|Teachers' Christian Fellowship of NSW : Conference papers|
THE INVISIBLE PROBLEMS
The most common mental health problems amongst children often go unnoticed. This workshop provides teachers with the knowledge to recognise, refer and support children with signs of depression and anxiety, as well as ideas for talking to parents about these issues.
Depression will be the second largest health problem worldwide by 2020, after cardiovascular disease (WHO, 1996). The level of disability caused by depression is equal to that caused by blindness or paraplegia. Depression is a chronic condition.
becoming depressed can expect to have 5-6 episodes of depression in a
lifetime. Most episodes resolve within 7-8 months, however 20% of
people continue to be depressed for up to 2 years.
The younger the person is at their first episode of depression, the greater the likelihood of further and increasingly severe episodes. Depressed young people are six times more likely to kill themselves than those who are not depressed, and three times more likely to: use alcohol or drugs, have poor health and to perform below grade level at school.
With regard to prevalence, up to 24% of young people will have had one or more episodes of depression by the time they are 18. Ten to twenty percent of school-aged children will have anxiety problems and 20-30% of children with depression will also experience anxiety.
There are a
number of factors that put children at risk for developing mental
health problems. These include: unstable relationships with parents,
the death of a parent, inadequate parenting skills, poor quality child
care, family discord such as violence, parental separation, family
breakdown, lack of peer support, bullying, abuse (physical, emotional,
sexual), neglect, accidents or trauma, poverty, physical illness or
disability, parents with mental health problems eg, depression, mental
illness, drug & alcohol problems and lack of social support.
which specifically put a child at risk for depression, are, having had
a previous episode of depression, early onset of first episode, and
anxiety. It believed that anxiety might be involved in the
developmental pathway of depression.
There are a number of factors that can protect children from developing mental health problems. Many of these can be addressed via the school setting. These include: nurturing affectionate and secure relationships with adults, Positive rewarding school environments, a sense of connectedness to school or community, social support, self-esteem or self-efficacy, positive personal achievements eg, sporting, academic, drama, involvement in pro-social peer groups, positive ‘temperament’, responsiveness to change and the child’s own coping skills.
There is a
considerable amount of overlap between the features or symptoms of
depression and anxiety. With depression, the mood could be described as
empty, sad, depressed, angry, irritable and “down in the dumps”. With
anxiety the mood is fearful, shy and nervous. Both depression and
anxiety have worried and sensitive mood features. With regard to
behaviour, depression is characterised by lethargy and suicidal acts,
anxiety by shaking, avoidance, panic attacks, repeatedly asking
questions and seeking reassurance. Crying, restlessness, fidgeting,
pacing, social withdrawal, dependency, and clinginess are
characteristic behaviours of both.
features of depression include appetite disturbance and subsequent
weight loss or gain; those of anxiety are vomiting, diarrhoea, nausea,
rapid heart rate, sweating, dizziness and rapid breath. Common to both
are headaches, stomach aches, fatigue, and sleep disturbance. Both
depression and anxiety feature poor concentration and negative
thoughts; anxiety features a preoccupation with some perceived danger
or threat. With depression there is a loss of interest, low
self-esteem, indecisiveness, guilt, suicidal ideation, thoughts of
some time will experience features of depression and anxiety.
Depression and anxiety are normal responses to some situations or
events. Not all children who seem sad or worried have a mental health
problem or need help. If a child displays a significant number of the
features of anxiety and/or depression, most days for 2 or more weeks,
and you believe it is stopping them from doing something they want to
do, or causing distress in the family or problems with school, or
limiting the child’s potential, you should refer them to the school
counsellor or equivalent service.
There are a number of ways to support these children in the classroom. Provide feedback to children about their strengths. Encourage the child to attempt new challenges. Help children realistically evaluate their own efforts. Remind children to praise themselves for their achievements. Break down tasks to simplify them. Approach the child and check how they are coping.