Skip to Content
 
 
 
Find:
Advanced Search

Depression and disabilities

 

Parady, J. (1996). Depression and disabilities. S. Hamilton, MA: Center for Youth Studies.

OVERVIEW

The concept of childhood and adolescent depression is relatively new. Until the 1980s, professionals believed that children and teenagers did not suffer from depression. First, it was thought that young people were not exposed to enough stress to develop depression. Secondly, children’s "superegos" are not fully developed, and common Freudian theory maintains that experiencing depression requires a fully developed "superego" (Black, 1995). Anyone working with children and adolescents today is well aware that young people do suffer from depression. Depression, defined by Mary Lou Ramsey of Trenton (New Jersey) State College, is a "disturbance characterized by feelings of sadness, inferiority, inadequacy, hopelessness, dejection, guilt or shame." (Black, 1995, p. 28). Depression can emerge as short-term sadness that we all occasionally experience; dysthymia, a less severe form of long-term depression; or chronic, clinical, and/or severe depression, which can be debilitating and possibly life threatening. "Depression during childhood and adolescence particularly is destructive because it often impedes psychosocial growth during a critical stage of development." (Lamarine, 1995, p. 391)

 

STATISTICS

It is difficult to determine the number of seriously depressed students. Because of its recent recognition, little research exists. Many undiagnosed and untreated students are treated for anti-social behaviors such as skipping school, instead for the underlying cause of depression. Estimates of numbers of depressed children widely vary, from 2% to 17%. Some figures reveal that one in fifty school-aged children exhibits symptoms of major depression (Lamarine, 1995). University of Illinois professor Dr. Lawrence Kerns approximates that six million children and teens in the United States suffer from some form of depression (Black, 1995). Studies agree that depression affects females more than males; some suggest that twice as many females as males suffer from it.

 

SYMPTOMS

 

low energy levels

persistent sadness

eating and/or sleeping problems

somatic complaints

social isolation

lack of motivation

use of substances

difficulty with memory or concentration

restlessness and agitation

decreased school achievement

listlessness

feelings of anger, boredom,

and apathy

anhedonia (inability to experience joy)

thoughts of being socially

feelings of emptiness

prone to crying

              inept or disliked

can’t find anything

 

 

unprovoked anger toward oneself and important people in one's life

 

unusual concern with

self-deprecatory perceptions

             death or dying

guilt leading to self-

diminished self-esteem

              destructive behavior

feelings of helplessness or hopelessness

dramatic behavior changes, aggressive or passive

 

Adolescent depression differs from adult depression in that adolescents have more interpersonal problems and are more likely to overeat and undersleep. Adolescent depression differs from childhood depression in that adolescents are more likely to have suicidal isolation and experience a sense of helplessness and hopelessness (Lamarine, 1995).

 

THEORIES

Several theories attempt to explain depression. Some believe it stems from social deficits; others assert that there is a biological predisposition to it. It seems to run in families. Some studies indicate that depressed individuals produce low levels of the brain chemical serotonin. Emotional stress may leave one vulnerable to depression. Traumatic events such as chronic illness, sexual abuse, or the loss of a loved one may also trigger it. Some theorize that highly stressful family dynamics affect a child’s neuron development, and may lead to later depression.

 

YOUTH WITH DISABILITIES

Recent studies reveal higher incidences of depression among children with learning disabilities, mental retardation, and conduct disorders. Gifted students and those who suffer from traumatic brain injury are also susceptible. Reports estimate that 14% to 54% of special education students are depressed (Wright-Strawderman, Lindsey, Navarett, and Flippo, 1996). Disabled students are at higher risk for depression because they are "more vulnerable to emotional trauma, which can lead to stress, low self-esteem, and suicidal behavior." (Wright-Strawderman, Lindsey, Navarett, and Flippo, 1996, p. 264).

Various studies show that adolescents with learning disabilities have lower academic self-concepts, higher levels of anxiety, more frequent sleeping problems, and minor somatic complaints. "Recent research evidence had suggested that adolescents with learning disabilities demonstrate higher anxiety levels, more frequent and serious bouts of depression, and higher rates of suicide than adolescents without disabilities." (Huntington and Bender, 1993, p. 159). It is not surprising that learning disabled students experience feelings of helplessness when struggling at school.

Suicide is the third leading cause of death for people under the age of twenty-four. Between 1970 and 1980, there was a 66% increase in suicides within this population. (Huntington and Bender, 1993). Figures indicate that depression contributes to 60% of suicides. (Wright-Strawderman, Lindsey, Navarette, and Flippo, 1996). Each year, about 2,000 young people commit suicide. It is estimated that for every one that succeeds, there are 350 attempts. Suicide may be exacerbated by the presence of a disability. One study examined suicides that took place over a three-year period in Los Angeles county. Of the suicides committed by children under the age of fifteen, a startling 50% had a diagnosed learning disability. (Wright-Strawderman, Lindsey, Navarette, and Flippo, 1996). Guidance counselors in 129 high schools in Texas were surveyed about suicide-related incidents, including both suicides and attempts. The study found that 14% of these incidents involved learning disabled students. This is significant, because an average of 5% of a school’s population is learning disabled. (Huntington and Bender, 1993).

Current literature endorses training elementary, secondary, and post-secondary educators to recognize symptoms of depression. In addition, schools should implement prevention programs such as teaching coping strategies and facilitating social support groups. Also, diagnosis of depression is encouraged to be done in conjunction with school personnel. One author suggests using a student study team to diagnose depression, prescribe treatment, and implement and monitor a plan. This team should consist of a counselor, teachers, parents, a social worker, and a mental health worker (Wright-Strawderman, Lindsey, Navarette, and Flippo, 1996). It is also recommended to include a special needs assessment with any intervention plan. Conversely, all special needs assessments in the diagnostic phase should include depression screening.

Various forms of psychotherapy are used with depressed children and adolescents. These include psychodynamic (revealing unconscious conflicts), behavioral (learning healthier behaviors through reinforcement), cognitive (correcting irrational thought patterns), and family. Some literature states that a medley of cognitive-behavioral approaches is effective. These may include pleasant events scheduling, activity scheduling, cognitive restructuring, attribution retraining, self-evaluation, and self-reinforcement. Usually, a therapist prescribes these strategies; they are implemented in the school and at home. Teachers are often involved in observing and reporting students’ behavioral progress.

Others state that treatment should include both medication and psychotherapy. However, some professionals say that, although medications such as monoamine oxidase inhibitors and tricyclics are successful with adults, they yield mixed or poor results with children (Lamarine, 1995). Dr. Ambrosini of the Eastern Pennsylvania Psychiatric Institute’s Division of Child and Adolescent Psychiatry says that antidepressants for severely depressed young people have a "relatively low chance of working." (Black, 1995, p. 30).

A common theme in the literature, as stated previously, is that much more is needed. Few studies have been conducted, and some of those did not include control groups for comparison. For those who work with depressed students, many more answers are needed.

The following sources were used for this topic discussion:

  • Black, S. (1995, November). Wednesday’s child. The Executive Educator, 27-30.
  • Huntington, D. & Bender, W. (1993, March). Adolescents with learning disabilities at risk? Emotional well-being, depression, suicide. Journal of Learning Disabilities, 26, 159-166.
  • Lamarine, R. (1995, November). Child and adolescent depression. Journal of School Health, 65, 390-392.
  • Wright-Strawderman, C., Lindsey, P., Navarette, L., & Flippo, J.R. (1996, May). Depression in students with disabilities: Recognition and intervention strategies. Intervention in School and Clinic, 261-275.
Janet Parady cCYS