Question:

I am a middle school teacher and have a couple of students who may be depressed. Are there symptoms I should be looking for? How do I know what is serious and what are just normal teenage behaviors? What should I do?

Answer:

Dear middle school teacher,

Thank you for your important question. Quite a number of teachers have recently expressed concerns to me about students who may be depressed. When a student in your class is struggling with depression, you are likely to observe some of following signs:

• Helplessness and hopelessness – your student may give up easily and express the feeling that nothing he/she does makes any difference and that nothing will ever get better.
• Withdrawal – your student may avoid friends and show little enthusiasm for activities that he/she once enjoyed.
• Increased irritability or agitation – your student may be sulky, irritable, grouchy, or blow up easily.
• Missed school, tardiness, or a drop in school performance.
• Unusually poor concentration, forgetfulness.
• Difficulty making even minor decisions.
• Excessive guilt or self-blame; student may express feelings of worthlessness.
• Frequent physical complaints (often vague symptoms, headaches, or stomach pains).
• Sleepiness, low energy, apathy.
• Change in pace – physical movements may become much more slow and laborious or increasingly abrupt and restless.
• Episodes of crying or sadness for no identifiable reason.
• Signs of alcohol or drug abuse.
• Thoughts about death or suicide – these may be expressed in drawings, writing assignments, or conversation.

Although increased moodiness is quite normal as students enter their teens, if you see several of the behavioral changes listed above, there is cause for concern. If your student has recently experienced a major loss or a traumatic event, these symptoms may represent grief or adjustment problems which will gradually diminish over time. Nevertheless, it is important to monitor the symptoms. Hopelessness and preoccupation with death are particularly serious signs of trouble that should be followed up by a mental health professional.

Depression can become a serious, chronic, and sometimes fatal, illness. It is helpful to keep in mind that:

• As many as 1 in 33 children and 1 in 8 adolescents experience clinical depression. Many more experience symptoms of depression that can disrupt their school functioning and place them at risk of developing clinical depression.
• Many experts believe that students with language and learning disorders are at increased risk of depression.
• Students with depression and anxiety are at increased risk of being bullied or socially excluded by their peers.
• Suicide is the 3 rd leading cause of death for 10-19 year olds.

Here are some ways that you, as a teacher, can help a student who may be struggling with depression:

• Refer your student for psychological and/or medical evaluation and treatment.
• Work closely with the student’s mental health provider and family members. This will enable you to prompt your student to use coping skills he/she is working on and to recognize and reinforce the student’s use of these coping techniques.
• Combat feelings of helplessness and hopelessness by setting up numerous opportunities for your student to experience success and recognition. This may involve having the student share special expertise with the class.
• Decrease social isolation by working to develop a school and classroom community that fosters inclusion.
• Promote a sense of belonging by giving your student a vital role in group projects or arranging for the student to do an important classroom or campus job.
• Seek and create ways to energize and motivate the student. Find ways to individualize assignments to capitalize on the student’s particular strengths and interests.

I’m impressed that you, and so many other teachers, express concern about your students’ mental health and hope that you find these guidelines and suggestions helpful.