Depression in Young People

The World Health Organisation predicts depression will be the second greatest cause of ill health globally, at enormous cost to national and world economies. Depression is on the increase and will become "second only to heart disease as the world's leading disability by 2020." Depression is responsible for 70 per cent of recorded suicides in Britain. One in five people suffer from depression at some point during their lives. Severe depression is at worst a killer and in its less severe forms, debilitating and damaging to the health of individuals and their families. Massive changes to working conditions, reduced exposure to the natural environment and to the amount of exercise that we undertake have occurred over the past 100 years and these changes continue to affect society.

Childhood is written in invisible ink. There is an alarming increase in depressive conditions at various levels in young people. The experiences and tribulations of childhood resonate throughout adolescence, creating patterns of behaviour that usually remained unexamined until adulthood. By then we have a lifetime of successes and failures behind us on which to reflect. However, young people are suffering from insecurities and anxieties in the present moment and cannot wait for adulthood to sort their problems out. If we regard the mental health of young people as a litmus test for the general health of society, then a serious problem is developing.

Medication isn't the answer There has been a well-documented increase in the sales of SSRI (Selective Serotonin Reuptake Inhibitor) drugs such as Prozac to adults and young people. They are a manufacturing success story, prescribed to 54 million people worldwide. Manufacturers claim that these drugs correct chemical imbalances in the brain. Serotonin is a chemical that is linked, according to drug manufacturers, with happiness. Low levels of the chemical affect mood and lead to depression and it is claimed that SSRI drugs address the imbalances to relieve depression.

The drug companies continue to make huge profits despite evidence of damaging side effects, and despite providing no long-term solution to the problems that led to patient's problems in the first place. These drugs appear to level out the damaging symptoms of depression and beak the cycle that reduce sufferers to inactivity, but only for as long as they take the pills. They do nothing to change the underlying causes of depression and nothing to create sustainable healing for sufferers.

31 million people were prescribed ant-depressants last year, at a staggering financial cost (ﾣ291.5 million) often in the face of deep reservations on the part of doctors who feel that have little option but to prescribe drugs for a condition that might be better treated some other way. They continue prescribing when faced with patient's belief that anti-depressants are the only answer to their problem, in what is becoming a dependency culture. We have been gradually robbed of our independence and capacity to maintain our own health in direct proportion to the growth of a culture in which pill-popping is easier and requires less effort that actually doing something positive for ourselves.

Deep depression shuts people down and isolates them. Depression drains and debilitates all who suffer from its insidious effects. In its extreme form, the experience is of treading water, of being unable to move because of a lack of hope, lack of energy and a sense of despair, which can vary from low level to overwhelming paralysis. This is an extreme version of the more common conditions of low motivation, low morale and low expectations. People regularly suffer from some or all of these states of mind and usually either try to soldier on, or retreat into helpless. Medication temporarily alleviates severe symptoms but is no answer to the underlying causes, which can be varied in origin. Sufferers become locked in a closed world in which their condition overpowers all sense of perspective, dominating their reactions to events. In such states it is difficult to plot a healthy course that will not only alleviate the symptoms, but also shift the underlying condition and establish a framework for sustained, long term activity and positive renewal. But it is possible.

Many of the methods for dealing with low motivation, low mood and depressive conditions involve activity conducted at an external level, often in an outdoor environment, and these methods are fine when it is possible to take ourselves to gardens, mountains, gyms and such places. They offer practical opportunities for changing mood and outlook and, importantly, re-connect people with their environment and their own bodies. For adults, with relative independence, this approach can be both practical and accessible. MIND, the leading mental health charity, has an "Ecotherapy agenda, which provides solid evidence of the benefits of "green exercise". The combination of nature and exercise has obvious benefits for all who are able to take part.

However, effective activity takes many forms, especially where young people are concerned. Physical activity needs to be supported by other pro-active measures. There is only so much one can do in a day or a week, and at the end of the activity we go home to ourselves and all the nagging anxieties and desperation that ferments inside us. No amount of walking, digging or exercising will completely remove the crippling effects of recurring patterns of self-damage, self-doubt and low self-esteem. Ultimately, we need to shine a light on the things that disempower, to stimulate change from within. The key factors, when instigating review and change to alleviate any degree of depression are:

" Slow down and pay attention to the core activities of self-care, hygiene, exercise and nutrition. " Find expressions of gentle care from family and friends. " Take things in stages, one simple step at a time. " Look ay things realistically and don't exaggerate the importance of good or bad events. " Recognise and accept change, which is inevitable. " Avoid stimulants; tea, coffee, alcohol and other substances don't solve the problem. " Don't let the past overwhelm the present; be aware of the present and live one day at a time. " Use discomfort as a force for change. Don't dwell on past mistakes, but change the way we look at them, learn from them and use them. " Look out for the effects of stress and fatigue and know when to stop and rest. " Channel emotions into positive actions. " Be wary of the wildly excessive range of choice that is presented to us through every form of media, every day. Too much choice is detrimental to health. " Challenge our thinking, stop blaming others and ourselves, learn to see our own character and accept it. " Look at and learn to love the simple pleasures - walking, reading, seeing the natural world. " Learn to focus on positive things that are outside ourselves - family, others, etc&&

One programme uses these principles and is breaking new ground in centres, schools, colleges and businesses. The Creating Game addresses these key factors, together with issues of self-awareness, self-defeating patterns of behaviour, false and frustrated expectations and personal, social and health education, through a series of practical activities. The programme, consisting of twenty-two linked sessions, brings about a realistic appraisal of personal desires, goals and expectations, leading to realistic and sustainable actions plans for personal projects. The programme forms a solid basis for major shifts in awareness. Pilot schemes in businesses and schools have been very successful. Recent examples include two year six boys on the cusp of transition. One was troubled and disruptive. He suffered with problems of anger management, self-esteem and had troubled relationships within his peer group. He clearly loved his family, but lived in a continual state of tension in an environment that was filled with aggression. Through The Creating Game he quickly developed strategies for coping with the immediate effects of anger and was soon able to see his reactions to events in a new light. His teachers saw major changes in his relationships within the class, and he learned to express feelings and emotions safely and constructively through the journaling activity that is central to The Creating Game. The other boy was small in stature and very shy. He had been in the country only two years and his command of English was poor in comparison to others in his class. Once he began to work through the Game, this did not impede his urge to express himself, and through visualisations, role-play and journaling he was able to describe facets of his life and his world-view in ways that surprised his teachers. In a mixed group consisting of children from different schools he became animated and resourceful, describing thoughts, emotions and deeds, vividly and with passion.

One programme alone cannot solve all the complex and widespread problems of personal identity, self-esteem and low expectations that affect many thousands of adults and young people. The Creating Game does offer a proper foundation for enquiry into the connections between outlook and behaviour, and an effective and purposeful way to build structure, clarity and purpose within personal and social relationships social and educational and career pathways.

About The Author We are the authors of The Creating Game for Young People and work with schools and colleges encouraging self development with young people. Linda is a psychotherapist and jim is an educationalist all our work is mapped against educational guidelines and can be used individually or in groups.