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Reassurance from her parents about her appearance did no good and after some time they gave up trying to reassure her, becoming angry and frustrated at her selfabsorption. This may lead to falling grades in school, or, in conscientious perfectionistic young people, it may lead to excessive hours spent on homework which never reaches what they consider to be a good enough standard. A dilemma for some parents is the fact that their teenagers can concentrate, often for hours on end, on computer games, which, with their rapidly changing imagery, provide constant stimulation. Depressed young people sometimes explain that the computer is a form of self-therapy for them, a time when they can escape from the turmoil in their minds.

Changes in mood and behaviour 21 Aches and pains Minor aches and pains are part of everyday life, and in most cases we do not dwell on them and they pass. Depressed young people often become preoccupied by aches and pains, worrying that they may have an underlying serious illness. I mean, it was akin to feeling sick. I mean, very akin to it. Or, you know, stomach cramps or headache or something. Such thoughts usually occur in response to a row, a broken relationship, a failure or some upset.

These thoughts are usually dismissed and do not lead to suicidal behaviour. They may talk about death or suicide, and conversations like this should always be taken seriously.

It is a myth that people who talk about suicide never carry it out. Suicide, while rare, is a common cause of death in young men in late adolescence and in their early twenties in Ireland, and is also a leading cause of death in this age group in the UK.

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Young people who cut themselves in this way are often not truly suicidal. Many explain that the pain of the cut brings temporary relief from intolerable feelings of anger, sadness or frustration. This can be seen as a warning sign that such a young person needs help, whether or not they are depressed. Please see Chapter 8 for more details of dealing with young people who self-harm or who are suicidal. If in doubt, trust your instincts. You know your child better than anyone else and you have his or her best interests at heart.

There is an overlap between many mental health problems in young people, such that depressive disorders often go hand in hand with other conditions. Any emotional or behavioural problem may be associated with an increased risk of depression, but some disorders have a more clear-cut association. These disabilities pose considerable problems for young people, as they struggle on a daily basis to keep up with peers. It is also useful to help them seek out other extra-curricular activities and interests that they enjoy doing and can boost their self-esteem. The core features are hyperactivity, short attention span and impulsive behaviour.

It is more common in boys than in girls, and there is often a family history of similar problems. Early diagnosis and treatment can make a difference, and there are clear guidelines of treatments that work well in ADHD.


These include:. Some young people with ADHD develop depression in adolescence. If your child with ADHD develops such changes, he might be depressed. He had been in trouble at school Attention deficit hyperactivity disorder ADHD for disrupting the class with his constant chatter and his inability to stay sitting at his table for longer than a few minutes. The other children regarded him as a source of awe and amusement in the classroom as he was always in trouble, always did the same thing again, and never seemed to mind what punishment he got.

At home, things were much the same. His mother dreaded his return from school — he was usually in a bad mood and she knew that the battle surrounding homework lay ahead. They attended a course for parents of children with ADHD, at which they learned about the importance of predictable routine, preparing in advance, breaking tasks down into small steps and avoiding lengthy arguments.

Don started on Ritalin, a medication that has been shown to help children with ADHD, and his parents and teachers noticed a marked improvement in his behaviour and his ability to learn in school.

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Don started to play truant from school, but this was quickly spotted by the school who worked out a system of letting his parents know if he was not at school. Don became increasingly withdrawn at home, spending most of the time in his room. When he did go out he started to use cannabis, initially just at weekends but later regularly throughout the week.

It helped him to feel relaxed and better in himself.

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However, even though he knew he was using too much, he could not stop. When he returned home in the early hours of the morning, there were inevitable rows with his parents who knew from his appearance and behaviour that he was using something. Things came to a head one night when Don hit his father during a row after he had returned home at 2. The next day, when everyone had calmed down, all three agreed that they could not continue the way they were going.

He felt helpless and powerless and had seriously considered suicide, but held back because he could not hurt his parents in that way. He took a month off school, but met with his year head a number of times during that month to talk over how he would manage his schoolwork and his school day when he returned. He also had regular meetings with his psychiatrist, who discussed his cannabis use and how he might cut that down. Antidepressant medication was discussed, but the psychiatrist would only prescribe it when Don was able to give him a guarantee that he was no longer using cannabis.

Don and his parents attended for family therapy, where they worked toward improving communication between them. Don is now He continues to have ups and downs in his life, but overall is making good progress. He is no longer depressed and has not gone back to using cannabis. He plans to do an apprenticeship in painting and decorating. However, ADHD does not have its onset in adolescence, so that the appearance of these symptoms at that stage should lead to a search for other contributing factors, such as drug use or the development of depressive or anxiety disorders. Because of this, every effort should be made to provide help to these young people and to address the problems. Things that can help are extra-consistent parenting that helps these young people learn responsibility, educational programmes that address their particular needs and social skills training that build on their strengths.

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However, it is important to address their emotional needs in this way if possible, and it can be a welcome relief for them, making a change from being constantly in trouble because of their behaviour. The long-term aim is to help them express their feelings and to help them take responsibility for their behaviour. Their understanding of language is very concrete and they do not readily appreciate subtlety or irony. Their use of language is often quite distinctive, engaging in long, one-sided conversations without noticing the effects of their conversation on the listener.

Adolescence can be a very lonely time for these young people. Many long to be accepted by their peers but do not have the social skills for this to happen. If the child is asking why he or she is different and is troubled by this, it is probably helpful for him or her to be given information about the diagnosis in a sensitive way. His main interests in life were wildlife and dinosaurs, and he talked about these incessantly. Other children avoided him, which he could not understand. John was referred again when he was 14 and in his second year at secondary school.

He was adamant that he hated school and that he wanted to leave. At home he had become increasingly angry, sometimes with explosions of anger that invariably ended in tears. He spent most of his time in his room and was not taking care of his personal hygiene.

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His relationship with his parents, which had previously been warm and close, was very strained, and they were worried that he might harm himself, as they had witnessed the depths of his distress and felt powerless to help him. John was referred to an adolescent day treatment programme but was very reluctant to attend. Following negotiation, he agreed to attend initially for 1 hour each day.

This was gradually increased over a 6-week period until he was attending for full days. The day programme had a teacher who was very experienced with adolescents with a range of mental health problems. She worked with John, initially on an individual basis but later within the classroom at the day unit. John was treated with antidepressant medication and his mood gradually improved and he become less agitated and anxious.

Following much deliberation, they decided it was best to tell him. They felt it would be best if his parents did this.

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John is now 16 and is attending an alternative school, where he takes seven subjects, goes in for his classes and leaves when they are over. He remains socially isolated but is no longer depressed, angry and troubled. Many of the ideas in this book are useful for parents of such children, but as change can be slow, even more patience might be needed. Parents who are coping with a child who is depressed often wonder whether this could be the start of some other mental illness.

A number of conditions can be associated with depression, and others have symptoms that may be hard to distinguish from depression.