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Approximately 12 million women in the United States experience clinical depression each year. According to the National Institute of Mental Health, 70% of women are more likely to experience depression during the course of their lives. Depression occurs most frequently in women ages 25-44. Many factors may contribute to depression, such as developmental, reproductive, hormonal, genetic and other biological differences (e.g., premenstrual syndrome, childbirth, infertility and menopause). Social factors may also lead to higher rates of clinical depression among women, including stress , family responsibilities, roles and expectations of women and increased rates of sexual abuse and poverty. Additionally, the risk for depression increases after pregnancy, during menstruation,and during menopause.

Depression often coexists (see comorbidity) with other illnesses such as eating disorders, anxiety disorders, substance abuse, and other serious medical conditions.

Women place a great deal of their self-worth on their personal relationships such as romantic partnerships, friendships, and family connections. When these relationships are strained or lost, this can affect women greatly also leading to symptoms of depression.

Depression is treatable. Women are more likely to seek help from friends, family, and visit a doctor to receive treatment. There are a multitude of resources available for support and treatment. Consult a medical professional and/or mental health specialist to first discuss your concerns. There are also a variety of lifestyle changes and resources available to help with depression by clicking here.

Additional Resources:

• Good Everyday Health Overview
• NIMH Depression Statistics
• CDC Suicide Statistics
• WHO Global Women Health Statistics

Sources:

National Institute of Mental Health, D/ART Campaign: “Depression: What Every Woman Should Know,” (1995).

National Institute of Mental Health, Unpublished Epidemiological Catchment Area Analyses, (1999).

National Institute of Mental Health: “Depression: Treat It. Defeat It.” June, 1999

 

Family members are often the first line of defense in helping someone with depression, therefore it is important to understand the signs and symptoms. You may notice a change in your loved one even before the individual recognizes or is willing to admit they may be having a difficult time.

Here are some ways that you may help a depressed family member.

• Learn about depression and its signs and symptoms.
• Let your loved one know you are concerned. You can ask questions such as, “I’ve noticed you are not quite yourself and wondered how you are doing?”
• Listen without judgment and encourage your family member to talk about their feelings. Depression often leads to withdrawal and isolation, so you may need to continually reach out offering gentle and consistent support. Having someone to talk to can be incredibly helpful for someone experiencing depression.
• Suggest a check up with your family doctor or mental health specialist. Offer to go to the first appointment together.
• Offer to help in making/keeping appointments, keeping the person on task with treatment, and assisting in chores around the house.
• Be patient. Even with optimal treatment, healing can take time.
• Suggest activities like going for a walk. Physical activity and exercise can be incredibly beneficial in helping combat depression. Try not to become discouraged if your loved one is not up to it. Forcing someone to engage in social activities when they are not feeling up to it may lead to increased feelings of worthlessness or failure. Approach your family member with care, compassion, and understanding and offer the activity another time.
• Be sure to take care of yourself. It is important to remember to best support a loved one it is just as important to be sure to take time to meet your own emotional health needs. By making sure to care for yourself, you will have the strength to be there for the person you care about.
• Most importantly, giving unconditional love and support throughout treatment will be one of the best ways to help your family member.

Depression may pose a dangerous risk of suicide so it is important to know the warning signs. If you feel your family member is in immediate danger call 911, go to your local emergency room, or contact The National Suicide Prevention Lifeline at 1-800-273-TALK to speak with a crisis counselor. Here is what to watch for:

• Talking about suicide, dying, or harming oneself.
• Preoccupation with death.
• Expressing feelings of hopelessness, or self-hate.
• Acting in dangerous or self-destructive ways.
• Getting affairs in order or saying goodbye.
• Seeking out pills, weapons, or other lethal objects.
• Sudden sense of calm after a depression.

Although it may be difficult to accept the person you know and love would consider taking their life, a person suffering from depression may see this as their only option as a way to end their unbearable pain. If you have concerns, talk to them immediately and seek professional help. Talking openly about suicidal thoughts or plans can save a life.

Family Therapy

Interpersonal stress is not only a precursor to depression, but marital/family dysfunction during the acute phase of a depressive episode is common and often leads to difficulties in multiple family domains. Family therapy may be defined as any psychotherapeutic endeavor that explicitly focuses on altering interactions between or among family members and seeks to improve the functioning of the family as a unit, or it subsystems, and/or the functioning of the individual members of the family. The goal of family therapy for depression is working with participants and their family to disengage from destructive forms of communication, and through that process, to reduce the symptoms of depression. Therefore, the primary outcome in trials is not always the reduction of depression in the patient.

There are several family-oriented treatment traditions.

Psychoeducational Models: Focus on altering negative attributions about patient illness, teaching coping skills, and providing support to patient and family.

Behavioral Models: Based on learning theory and operant conditioning. They typically focus on the parent or parent-child dyad and seek to improve skills by teaching about behavioral contingencies and reinforcement.

Object Relations Family Therapy: A form of psychoanalytic therapy in which marital and family relationships are considered in terms of the projection of internalizing infant-parent patterns onto contemporary adult relationships. The therapist takes a position of containment and comments on replication of patterns and working through toward a more complete integrated and realistic perspective.

Family functioning can be greatly improved by working as a unit and supporting one another, especially with dedicating to family therapy.

Sources:

• Families for Depression Awareness
• HelpGuide.org

Cottrell D, Boston P. Practitioner review: the effectiveness of systemic family therapy for children and adolescents. Journal of Child Psychology and Psychiatry (2002).

Cottrell D. Outcome studies of family therapy in child and adolescent depression. Journal of Family Therapy (2003).

Diamond, G., Siqueland, L. Current status of family intervention science. Child and Adolescent Psychiatric Clinics of North America (2001).

Go to this page for list of support systems

Since October 2001, about 1.6 million U.S. troops have been deployed to Iraq and Afghanistan. Military members and their families face unique challenges. Soldiers deal with stressors in combat that may not exist in civilian life. Those exposed to high levels of combat are significantly more likely to experience depression, acute stress and post-traumatic stress disorder (PTSD).

There are also additional stigmas that soldiers who suffer from depression must face. The first is a personal or internal perception that most service members feel. When they seek out help and admit there is a problem, they feel that they are seen as weak or inadequate in some way.

Military family members are also affected by unique pressures and stress. When depression is involved, it is prudent that the family handles it together and become educated about multiple and prolonged deployments and trauma-related stress. In addition to individual therapy and medication, it is often recommended that family therapy also be considered.

Resources: The Veterans Crisis Line provides confidential help for veterans and their families online and by phone. Dial 1-800-273-8255 (TALK); press 1 OR text to 838255

The Real Warriors website features articles, tools, and information for service members, veterans, and family members. It also includes a 24/7 confidential live chat feature with a trained health resource consultant. For more details, call toll-free 24/7 at 1-866-966-1020.

 

More veterans resources through this link.

Sources:

Jacobson, I.G., Horton, J.l., LeardMann, C.A., Ryan, M.A., Boyko, E.J., Wells, T.S., … & Smith, T.C. Post-traumatic stress disorder and depression among U.S. military health care professionals deployed in support of operations in Iraq and Afghanistan. Journal of Traumatic Stress, 25 (6), 616-623. (2012).

Verdeli, H., Baily, C., Vousoura, E., Belser, A., Singla, D., & Manos, G. The case for treating depression in military spouses. Journal of Family Psychology, 25 (4), 488. (2011).

Wadsworth, M. Even the Daylight Appeared Dark: A Journey Through Life, the Military, Depression and Post Traumatic Stress Disorder. AuthorHouse. (2011).

 

Depression can affect people of all ages including children and adolescents. Globally, depression is the number one illness among 10-19 year olds and suicide is the third leading cause of death (World Health Organization, 2014). If children and adolescents get the necessary care for their mental health, we can prevent suicides and avoid suffering that could occur throughout their life.

Children who develop depression often continue to have episodes as they enter adulthood. They are also more likely to have other severe illnesses accompanied with depression in their adult life.

Symptoms of depression in children may present differently than in adults. Here are some additional things to watch for:

• pretending to be sick
• refusing to go to school
• clinging to a parent or caregiver
• worrying about the death of a parent/caregiver
• outbursts of shouting, complaining, or crying
• lack of interest in playing with friends

Older children may:

• sulk
• get into trouble at school, act out
• be negative
• be irritable
• feel misunderstood
• have poor school/academic performance
• have frequent absences from school
• exhibit chronic boredom

*Because these signs may be viewed as normal mood swings typical of children as they move through developmental stages, it may be difficult to accurately diagnose a young person with depression.

Before puberty, boys and girls are equally likely to develop depression. By age 15, however, girls are more likely to have had a major depressive episode.

Depression during teen years comes at a time of great personal change-when boys and girls are forming an identity apart from their parents, grappling with gender issues and emerging sexuality, and making independent decisions for the first time in their lives. Depression in adolescence frequently co-occurs with other disorders such as anxiety, eating disorders, or substance abuse. It can also lead to increased risk for suicide.

According to a recent study published in the Journal of Adolescent Health, 1 in 9 students attempt to take their life before graduating high school, with 40% in grade school. An increase in suicide attempts happens when students reach sixth grade, or an average age of 12.

With hopelessness as the number one symptom of depression and leading predictor to suicide (Association of Physicians, 2004), iFred developed a curriculum called Hopeful Minds based on research that suggests hope is a teachable skill. Our goal is to provide fifth grade students with the social and emotional learning tools to have and maintain hope throughout life’s challenges. By providing students with pathways to hope, no matter what they may experience, we ultimately can save lives. iFred aims to teach hope to children around the world. For information on how your school and community can be involved, please visit our website or contact us at info@ifred.org. You can make a difference in the life of a child. #teachhope

Immediate Telephone Support

If someone has talked to you about suicide, and you believe they are currently a threat to themselves or someone else but won’t take your help, call 911.

Suicide Hotlines:

• (800)273-8255 …..1-800-273-TALK National Suicide Prevention Lifeline
• (800)784-2432 …..1-800-SUICIDA Spanish Speaking Suicide Hotline
• (877)968-8454 …..1-877-YOUTHLINE Teen to Teen Peer Counseling Hotline
• (800)472-3457 …..1-800-GRADHLP Grad Student Hotline

Schools for Hope Information/Resources on Depression in Children

Guidelines for Educators

Guidelines for Families

Signs and Symptoms of Depression in Children

Who To Call

Additional Resources:

American Academy of Child & Adolescent Psychiatry

Children’s Mental Health Network

Choices Magazine by Scholastic “We Have Depression”

Contemporary Pediatrics Information and Screening Tools for Children and Adolescents

National Alliance on Mental Illness (NAMI) Depression in Children and Teens

National Institute of Mental Health (NIMH) Fact Sheet on Depression in Children and Adolescents

UMIND Inspiring Youth After a Suicide Attempt Webinar Presented by Dr. Jenn Brasch, McMaster University & St. Joseph’s Healthcare Hamilton

Sources:

Cyranowski J.M., Frank E., Young, E., Shear, M.K. Adolescent onset of the gender difference in lifetime rates of major depression. Archives of General Psychiatry, 57:21-27. (2000).

Merry, S.N., Hetrick, S. E., Cox, G. R., Brudevold-Iversen, T., Bir, J. J., & McDowell, H. Cochrane Review: Psychological and education interventions for preventing depression in children and adolescents. Evidence Based Child Health: A Cochrane Review Journal, 7(5), 1409-1685. (2012).

Nolen-Hoeksema, S., & Hilt, L. M. (EDS.) Handbook of depression in adolescents. Routledge. (2013).

Weissman, M. M., Wolk, S., Goldstein, R.B., Moreau, D., Adams, P., Greenwalk, S., Klier, C.M., Ryan, N.D., Dahl, R.E., & Wichramaratne, P. Depressed adolescents grown up. Journal of the American Medical Association, 281 (18): 1701-1713. (1999).

Depression is the number one illness globally among 10-19 year old children and adolescents and suicide is the third leading cause of death (World Health Organization, 2014). There are many steps educators may take when concerned about a child, teenager, or student.

Learn about the signs and symptoms of depression. Depression may exhibit itself differently in children than in adults. Students may appear unmotivated or uncaring about their school work, when in fact, they may be unable to function at their full potential due to depression. It is important to learn to recognize warning signs. Untreated depression can lead to serious problems including risk-taking behavior, academic decline and failure, social alienation, substance use/abuse, and increased risk for suicide. For a printable resource sheet on Signs and Symptoms of Depression in Children click here.

Here is what to watch for:

• Frequent sadness, tearfulness, crying more often or more easily
• Hopelessness
• Decreased interest in activities; or inability to enjoy in usual activities
• Persistent boredom; low energy
• Social isolation/withdrawal: spending time alone, away from family and friends, poor communication
• Becoming “clingy” and more dependent on relationships with parents and caregivers
• low self-esteem
• Overly pessimistic and negative thinking
• Excessive guilt or feelings of worthlessness
• Extreme sensitivity
• Increased irritability, anger, or hostility
• Difficulty with relationships
• Frequent complaints of physical illness such as headaches and stomachaches
• Frequent absences from school or poor performance in school
• Poor concentration
• Changes in eating or sleeping habits/patterns
• Talking about or planning to run away from home
• Thoughts of death, worrying loved ones will die
• Talking about suicide or dying
• Reckless or self destructive behavior; taking risks and showing less concern for own safety
• Regression

There are many things educators may do to help a student with depression. For a printable resource sheet on Guidelines for Educators, click here.

What You Can Do:

1. Talk and ask the student how they are feeling. Offer care, concern, and support.

2. Connect with their family.

3. Express your concerns with the school counselor/psychologist/nurse/ and support staff. An individual plan may be set in place on how to best support the child.

4. Focus on providing positive feedback to your student.

5. Provide opportunities for success and recognition. These may help boost self-confidence and connect the student to their class.

6. Model positive actions. Children need to see what healthy behavior looks like and may only receive this example in the school environment.

7. Teach problem solving skills.

8. Provide extra learning support. If a child is depressed, they may need extra help with academic tasks. Breaking assignments into smaller pieces, offering extra help with their schedule or study habits, and/or pairing a student with a peer may all provide ways to assist.

9. Teach Hope. See information below and visit Hopeful Minds to learn more about our curriculum. Hopelessness is the number one symptom of depression and leading predictor to suicide (Association of Physicians, 2004), therefore iFred developed a curriculum based on research that hope is a teachable skill, with the goal to support youth mental health and prevent suicide.

If you are concerned a child is in danger of harming oneself or anyone else and refuses help, call 911. To speak with a crisis counselor, call 1-800-273-TALK (8255) or visit the National Suicide Prevention Lifeline website for additional resources.

Additional Resources:

Choices Magazine by Scholastic: “We Have Depression” An article written by teens sharing the stories of four classmates and their depression. For more resource information please visit: http://choices.scholastic.com/

Get Help For Someone Online/List of Social Media Safety Teams: http://www.suicidepreventionlifeline.org/gethelp/online.aspx

Sources:

Huberty, Thomas J. Depression: Helping students in the classroom. National Association of School Psychology. http://www.nasponline.org/communications/spawareness/depressclass_ho.pdf

Schimelpfening, Nancy (2014). Depression in Children. Signs and Symptoms of Depression in Children. http://depression.about.com/od/childhood/a/signssymptoms.htm

Web MD (updated May 2013). Medical Reference from Healthwise, Incorporated. http://www.webmd.com/depression/tc/depression-in-childhood-and-adolescence-topic-overview

Nearly half of all college students report feeling so depressed at some point in time that they have trouble functioning.  If left untreated, depression can lead to suicide.  Suicide is the third leading cause of death for those aged 15-24 and the second leading cause of death of college students.  Many young people are coming to college with an existing diagnosis and treatment history.  Many young adults struggle with the changes and uncertainty during this stage in their lives in which people are faced with important choices about careers, moving to new places away from home, gaining financial independence and pursuing romantic relationships.

Depressed young adults may find themselves frequently waking up at four or five in the morning, unable to fall back asleep.  People with depression may have abnormalities in levels of cortisol, a stress hormone in our bodies.  Young adults with depression often have higher levels of cortisol levels in the early morning hours, which disrupts sleep.

There’s a marked increase in alcohol consumption and use of other drugs.  To ease the pain and loneliness of depression, it is not uncommon, especially for this demographic to abuse alcohol or other prescription or illegal drugs as an escape or to numb their pain.

Sources:

Mahmoud, J.S.R., Staten, R.T., Hall, L.A., & Lennie, T.A.T.  The relationship among young adult college students’ depression, anxiety, stress, demographics, life satisfaction, and coping styles.  Issues in mental health nursing, 33(3), 149-156.  (2012).

Martin, R.J., Usdan, S., Cremeens, J., & Vail-Smith, K.  Disordered gambling and co-morbidity of psychiatric disorders among college students:  An examination of problem drinking, anxiety and depression.  Journal of Gambling Studies, 1-13.  (2013).

Shim, J.E., An, H.Y., & Kim, J. H.  The relationship between job-seeking stress and depression in college students:  The mediating roles of cognitive emotion regulation strategies.  Underst People, 32(1), 103-118.  (2011).

Depression and suicide have a serious impact on businesses. Previous estimates total depression’s toll on business to be around $70 billion from health expenditures, absenteeism, lost productivity and performance mistakes from employees who do not seek treatment.

It’s important to be prepared by having a smart business plan for employee depression. Employee Assistance Programs offer a broad range of services, including psychological assessment, counseling options, support and referrals. It is in your company’s best interest for your business and your employees to have this as an effective and necessary attribute to ensure appropriate mental health care.

A recent study examining the financial impact of 25 chronic physical and mental issues identified depression as the single most expensive ailment for employers.

Smart Business for Depression

A systematic program to identify depression and promote effective treatment has been shown to not only improve clinical outcomes, but overall workplace outcomes.* When employees are given access to care for depression, studies have shown that businesses may save as much as $10,000 a year per employee in prescription drug and wage replacement costs.** Additionally, integration of depression intervention for patients with depression, heart disease, and diabetes significantly improved control of all disease states, not just depression.***

Did you know?

• 35 million Americans (more than 16% of the population), and 121 across the globe, experience depression. (National Institute of Health, 2003)
• Less than 25% of those with depression are getting help for their disease, simply because of negative perception, poor branding, and stigma. (World Health Organization, 2010)
• 10% of the workforce is currently depressed, and 75% of those suffering from depression do not actively seek treatment. Of those with depression, only about 6% receive adequate treatment. (Unheralded Business Crisis in Canada, 2000)
• Stress overload in the workplace from economic, environmental, social and psychological factors increases our risk for depression, fatigue, diabetes, and cardiovascular disease. (James L. Wilson DC, ND, PhD, 2012)
• Depression accounts for over $70 billion annually in medical expenditures, lost productivity and other costs among U.S. businesses. (The Wall Street Journal, 2001)

Best Business Practices

• Integrate depression prevention and treatment in Employee Assistance Plans (EAP) programs, and improve utilization of programs.
• Release caps on number of visits to mental health service providers, and eliminate copays for their visits.
• Show leadership of de-stigmatizing efforts of depression by having your corporation support mental health nonprofits, participate in cause marketing campaigns for your products for mental health or depression (if applicable), and participate in company-wide fundraisers for mental health.
• Ensure that you positively and proactively
• Train executives and managers at all levels on early identification of depression.
• Write policies to support managers on dealing with depression related issues.
• Implement programs that encourage healthy work practices, and create health index to monitor success of both individuals, and overall company.
• Support depression nonprofits, showing employees your proactive stance on treatment, and encourage participation in programs like the Field for Hope to advocate rebranding.
• Please contact us at info@ifred.org to discuss ways to get involved.

Depression is treatable. iFred’s mission is to eliminate the stigma of depression and encourage those suffering from any form of depression to seek treatment. By partnering with iFred, corporations and organizations can help support this cause and encourage healthy living for employees. iFred will work individually with partners corporations to offer tailored programs to engage, motivate and inspire employees to shine a light of HOPE on depression.

*Telephone Screening, Outreach, and Care Management for Depressed Workers and Impact on Clinical and Work Productivity Outcomes, 2007.
**The Unhearalded Business Crisis In Canada; Depression at Work, 2000.*