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Stress, Anxiety, Depression & Coping Skills

November 7, 2012

What is stress?

Eustress

Motivates, focuses energy

Is short-term

Is perceived as within our coping abilities

Feels exciting

Improves performance

Distress

Causes anxiety or concern

Can be short- or long- term

Is perceived as outside of our coping abilities

Feels unpleasant

Decreases performance

Can lead to mental and physical problems

http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=15644

Physiology & Stress

STRESS = CORTISOL

CORTISOL = DOPAMINE

DOPAMINE = ANHEDONIA

Anhedonia: pleasure “deafness”No longer able to derive normal pleasure from those things that have been pleasurable in the

past.

Your Brain vs. Their Brain

Your teen’s prefrontal cortex is still growing until it is 25 years old

This part of the brain is responsible for decision making, judgment, impulse control, emotion regulation, frustration tolerance, empathy, and abstract thinking

When you are stressed, you can rely on your prefrontal cortex to help you cope but teens don’t always have this available to them!

Why So Much Stress?

Higher level of importance is given to things you might see as “trivial” because of lack of life experience.

Your reaction is important.

What you think is trivial is life shattering to them.

What Kids Do To Self-Medicate

Alcohol

Drugs

Self-Injury

Sexual acting out

Gambling

Video Games

Pornography

Excessive sleep

Eating disorders

Criminal activity

Other adventurous/risky behaviors

What are you doing to manage YOUR stress?

Holmes-Rahe

Concrete ways your child can manage stress

Sleep

Eat right

Avoid caffeine

Exercise

Music

Relaxation techniques (video)

Prayer/spirituality

Study smarter, not harder

Planning/organization

Compartmentalizing

23 ½ Hours (video)

Planning and Organization

Identifying Mental Health Issues: Depression

Feeling sad or empty

Irritable mood

Anhedonia: lack of interest in things you used to enjoy

Significant weight loss or gain

Insomnia or hypersomnia

Fatigue or loss of energy

Feelings of worthlessness

Excessive or inappropriate guilt

Indecisiveness

Recurrent thoughts of death

Identifying Mental Health Issues: Mania

Lasts at least 1 week

Grandiosity

Decreased need for sleep

Pressured speech

Racing thoughts or ideas

Distractibility

Goal-directed activity

Excessive involvement in pleasurable activities

Identifying Mental Health Issues: Bipolar

One or more manic episodes or mixed episodes

Type I

Type II

Identifying Mental Health Issues: Anxiety

Panic attacks

Avoidance of places or situations

Obsessions or compulsions

Re-experiencing of traumatic events and avoidance of stimuli

Persistent and excessive anxiety and worry

Other Types of Depression

Cyclothymia

Dysthymia

Bipolar I

Bipolar II

Signs and Symptoms

Disinterest in favorite extracurricular activities 

Problems at school and losing interest in school 

Substance abuse, including alcohol and drug (illegal and legal drugs) use

Behavioral problems 

Withdrawing from family and friends 

Sleep changes 

Changes in eating habits 

Begins to neglect hygiene and other matters of personal appearance 

Emotional distress brings on physical complaints (aches, fatigues, migraines)

Hard time concentrating and paying attention 

Declining grades in school

Loss of interest in schoolwork 

Risk taking behaviors 

Complains more frequently of boredom 

Does not respond as before to praise

Changing friend groups

Isolating from friends and family

How to Deal

Validation I hear you saying you feel really sad. That sounds very painful.

Ask open-ended questions Have you ever felt really depressed? How long have you felt that way? Has this happened before? How long did it last?

Be in contact with your child’s therapist and psychiatrist

Get therapy for yourself Sending only the kid gives them the message: “I am broken, and they

want this therapist to fix me.” It is hard to watch your kids struggle!

The “S” Word

Untreated depression is the number one cause for suicide

In the U.S. alone, suicide kills more than 32,000 people a year. That is the equivalent of a death by suicide every 16 minutes.

In 2005 (data released in 2008), suicide was the third-leading cause of death among 15-24 year olds nationwide.

Every day, 12 youths in America die by suicide – that is one person under age 25 every two hours.

In a typical high school classroom, it is likely that three students (1 boy, 2 girls) have made a suicide attempt within the past year.

SAMHSA, Well Aware

How to talk about it

ASK THIS

Are you feeling suicidal?

Are you thinking about suicide?

Do you want to kill yourself?

NOT THIS

You aren’t going to kill yourself are you?

Are you thinking about hurting yourself?

Relationship between stress, suicide, and substance abuse

Men and women who

smoked marijuana

before age 17 are 3.5 times as likely to

attempt suicide as those who started later.

(NIDA)

Alcohol and drug abuse are second only to depression and

other mood disorders when it comes to risk

factors for suicide.

(SAMHSA)

How to Help

Show empathy

Stay cool, calm, and collected

Don’t judge

Don’t ignore

LISTEN!

Websites

http://www.suicidepreventionlifeline.org/

http://www.teensuicide.us/articles2.html

http://www.wellawaresp.org/

http://www.save.org/

http://www.suicidology.org/home

http://www.afsp.org/

Maggie’s True Story

Outside Help

Cognitive Behavior Therapy

Dialectical Behavior Therapy

Talk Therapy

Psychiatrists

Substance Abuse Treatment

Support Groups

To medicate or not to medicate…

That is the question!

Selective Serotonin Reuptake Inhibitors (SSRIs)

May take 4-6 weeks to become fully effective

There is not a “silver bullet” for everyone

Interaction with alcohol and other substances

Research on long-term outcomes reports the best outcomes for depression and anxiety with the combination of psychiatric medication and therapy

Resources in Houston

NAMI www.namimetropolitanhouston.org/

Interface- Samaritan Counseling www.interface-samaritan.org/

Nick Finnegan Counseling Center www.finnegancounseling.org/

Depression and Bipolar Support Alliance www.dbsalliance.org

Depression and Bipolar Support Alliance Houston www.dbsahouston.org

HPD Crisis Intervention Team http://www.houstoncit.org/ 713-970-4664