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Although it is often difficult to communicate with someone who is feeling very low and words may not come easily it is important that you don't ignore your child's feelings. Knowing that friends and family really care and are willing to give support can be the first vital step in getting better.

Important note

• Depression should always be considered with adolescent problems (see symptoms of depression) - it is often not recognised.
• Don't be fooled by angry, aggressive behaviour - always think about the possibility of depression.
• Any suicidal behaviour or thoughts or talk in young people are a cry for help and should be taken seriously.
• A young person who has attempted suicide and whose situation has not changed may go on to complete suicide.
• If suicidal risk is properly treated the chances of survival are high.

TYPES OF DEPRESSION

There are three different types of depression.

• This is when a person is feeling sad or 'blue' and is an emotion common to people of all ages.
• The feeling usually results from minor problems or a loss (eg. a broken date, criticism etc.).
• People usually feel better after talking about the problem with someone close to them or doing something they enjoy.
• A depressed mood doesn't usually interfere with daily activities.

Dysthymia
Dysthymia is a mild type of depression that can last for over a year in young people.

People with dysthymia may:

• gradually lose interest in things they have enjoyed doing and appear to be 'down' most of the time.
• have less energy and find it difficult to concentrate.
• have trouble eating and sleeping.

The most common factor is feeling bad about themselves and having less confidence and enjoyment in their lives. Dysthymia is much more serious than a depressed mood and may need professional assessment and help if you are concerned.

Major depression
Major depression is an illness in which young people no longer enjoy their lives. It usually occurs rapidly and may be triggered by a major stressful event such as a death or a broken relationship. However major depression may begin with no obvious cause.

A teenager with a major depression will display some of the signs listed below:

• loss of interest or enjoyment in his usual activities
• changed eating patterns with weight gain or weight loss
• severe sleeping problems
• low energy levels
• poor concentration
• loss of interest in friends
• reluctance to go out
• feeling hopeless or worthless
• being sad or tearful
• being angry or irritable a lot of the time
• increasing drug and alcohol use
• neglect of personal appearance
• excessive worry about physical health
• complaints about constant headaches, stomach aches and other physical pains
• carelessness about physical safety
• behaviour problems and delinquency
• preoccupation with death and suicide.

While most parents believe they could recognise if their child is depressed, studies of adolescents have shown that at least one third of young people do not have their depression detected, and do not get the support they need. If your teenagers behaviour and mood has changed, it may a good idea to see if he or she will talk to you about feelings, sadness, loneliness and other feelings that happen with depression.

YOUNG PEOPLE AT RISK

Depression can affect anyone, but some young people are more likely to become depressed if:

• they have a close relative who has suffered from depression
• they have had a major life stress or several stresses.

A major life stress can be a family break-up, school failure, child abuse, loss of a parent, accident, broken relationship or moving to another area.

Suicide stressors
Stresses that sound small to adults may be very important to young people and should be taken seriously. Telling a person who is upset that their worry is 'about nothing' only makes things worse. They feel that no-one understands and this increases their sense of being alone in the world.

Suicide attempts in young people are often triggered by recent stress but it is not just the new stress but a combination of feelings and events that usually leads then to take action.

The following things may mean that a young person is seriously thinking about taking his life:

• talk or threats of suicide
• hints such as 'I won't be a problem for you much longer'
• previous attempts - especially if the person was alone at the time
• careless risk taking behaviour
• self destructive behaviour
• sad or angry mood that does not go away
• giving away personal possessions
• suddenly clearing out belongings and getting them in order
• becoming suddenly cheerful without reason after being depressed.

If you notice these things happening you need to take action to keep your child safe. See your doctor if you have any concerns about your young person's mental health or contact any of the agencies listed under resources.

MYTHS ABOUT SUICIDE

• People who talk about suicide won't do it - almost everyone who commits suicide gives some clue or warning.
• Anyone who tries to commit suicide must be crazy - it isn't as simple as this. Suicidal thinking isn't necessarily a sign of mental illness. In young people depression is almost invariably behind suicidal thinking. Often however, no-one has realised that the young person was depressed.
• If people really want to kill themselves nothing will stop them. What they usually want is for the pain to stop. The impulse to end it all doesn't last forever. In fact, sometimes it doesn't last for long at all, particularly if things in the person's life change.
• People who complete suicide don't seek help. More than half of the people who commit suicide have been to their doctor for help in the six months before their death, though they may not tell their doctor they are thinking of suicide.
• Talking/asking about suicide may give someone the idea. The opposite is true. Discussing suicide openly helps people talk about their feelings and look for other ways to stop the pain.

WHAT YOU CAN DO

All situations are different. When young people are suffering with depression they are not always able to ask for help and may even refuse your help at times. This can be difficult as it feels as if you're being rejected.

It is important that you:

• offer unconditional love and concern - this doesn't mean that you have to agree with everything your child does or wants to do, but young people need to know that you still love them no matter what they are or do
• encourage them to do things you know they enjoy
• notice the little things they are doing that you approve of
• take time to listen when they want to talk about their feelings
• show them that you are available without being 'pushy' and in their space
• never treat depression as if it is simply teenage 'blues' - always take it seriously
• support your child to get help without demanding or nagging
• encourage your child to seek help, for example, by providing a list of contacts and letting her choose
• if your child won't go for help and you are really worried, go by yourself first and get some advice about how to best handle the situation
• take seriously any talk about suicide and actions such as giving away special things. Do whatever is needed to protect the young person's safety - even if it is against her wishes.
• Make sure that you do not keep a gun in your home.

Note: This topic can give some practical suggestions and information about health and illness. It is important to see your doctor if you are worried about your child's health as information about a particular illness may not exactly fit your child.

WHERE TO GET HELP

There is a range of different treatments for depression varying from anti-depressant medication to counselling and therapy or a combination of these.

The right treatment will depend on the individual needs and the situation of the young person. It is important to persist until the right treatment is found as often young people are particular about who they will talk to.

The following organisations or people may be of some assistance in either providing treatment or helping you to find the right help for your son or daughter:

• your doctor
• community health centre
• psychiatrist
• psychologist
• counsellor specialising in depression.

Parents can sometimes be wary about bringing their concerns out in the open for fear of what others will think. It is important that you don't allow this fear to stop you from getting the best support you need to help your child.

TAKING CARE OF YOURSELF

Parenting an adolescent who is under severe stress or suffering depression can be very stressful. At times it may seem as if the young person is deliberately not trying or misbehaving.

When you find yourself feeling angry or frustrated (and you will!):

• take a step back and think about what is happening before reacting
• remember that your relationship with your child is important and he needs it to continue
• think about your own views:
  • are you wondering why you should have to put up with the terrible behaviour? (which will make the situation worse)
  • are you thinking 'something must be wrong for my child to be behaving like this'? (which will lead to a search for the cause)
• ask people close to you for support
• ask someone the young person is close to (e.g. another relative) to help provide support - but make sure your child knows that you're not rejecting her
• make sure you do things for yourself - you need to take care of your own needs if you're to help your child
• get professional help if you need to.