Getting teens to confide in adults can be a tough task. Who might they turn to that you wouldn't expect? Their friendly, neighborhood, public, or school librarians! Think back to your childhood ... if were you a bookworm, or maybe a bit of an introvert, you may have had a special librarian in town who could always recommend the best books, even to the most reluctant reader. Many teens spend hours at the library. With special programs, assigned teen areas, and Internet access--not to mention all the CDs, magazines, movies, and books available--it can be the coziest place in town for a teen.
What happens when a teen starts to change, showing signs of depression--where do your responsibilities as a "friendly adult" lie?
TEEN DEPRESSION STATISTICS
About 11 percent of adolescents have a depressive disorder by age eighteen, according to the National Comorbidity Survey-Adolescent Supplement (NCS-A). Girls are more likely than boys to experience depression. The risk for depression increases as a child gets older. According to the World Health Organization, major depressive disorder is the leading cause of disability among Americans age fifteen to forty-four.
TELL-TALE SIGNS OF DEPRESSION
When a teen begins to have noticeable changes in their behavior and/ or appearance, it's difficult not to want to reach out. There's a difference between everyday sadness, compared to a major depressive episode. As listed on http://www.childstats.gov/americaschildren/health4. asp, Major Depressive Episode (MDE) is defined as a period of at least two weeks when a person experiences a depressed mood or loss of interest or pleasure in daily activities, plus at least four additional symptoms of depression (for example: problems with sleep, eating, energy, concentration, and feelings of low self-worth, helplessness, or hopelessness), as described in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).
To see more descriptions of symptoms, you can refer to the following exams that can be performed by doctors:
Hamilton Depression Scale (HAM-D) http://heahhnet.umassmed.edu/mhealth/HAMD.pdf
Child Depression Inventory (CDI) http://www.lifeviewcounseling.com/client_forms/ChildhoodDepressionlnventory.pdf
Beck Depression Inventory (BDI) http://www.thecommunityhouse.org/wp-content/uploads/2012/O l /Beck-Depression- Inventory-and-Scoring-Key1.pdf
Zung Self-Rating Scale for Depression http://heahhnet.umassmed.edu/mhealth/ZungSelfRatedDepressionScale.pdf.
These tests might confirm if a teen is clinically depressed. They are resources you can share with a parent who may come in with concerns looking for help.
DIFFERENT' KINDS OF DEPRESSION
According to the National Institute of Mental Health, the most common depressive disorder is Major Depressive Disorder (MDD), where the symptoms are disabling and interfere with everyday activities such as studying, eating, and sleeping. Those who suffer with MDD may only experience it one time, but often the depression comes back repeatedly.
Dysthymic disorder, or dysthymia, is a milder, chronic depression. Symptoms can last a long time, usually two years or more. It is less severe than major depression, but can still interfere with everyday activities. (People with dysthymia can also have a major depression during their lifetime as well.)
Minor depression is similar to major depression and dysthymia, but the symptoms are less severe and/or last for a shorter length of time. There are other types of depression, such as Seasonal Affective Disorder (SAD), which begins during the winter months and lifts during spring and summer. For more information, go to http://www.nimh.nih.gov.
TRIGGERS FOR DEPRESSION
It is helpful as a librarian to always have the most up-to-date references on hand. Be aware of any local support groups for teens in the area. Find groups for the following afflictions that can trigger a teen's depression:
Alcoholism or substance abuse
Attention Deficit/Hyperactivity Disorder
Body image issues/Eating disorders
Family issues (divorce, economic instability/poverty, death/
Gender identity issues
Sexual identity issues
Terminal illnesses such as cancer
These are just a few examples of some issues teens may be facing that could trigger a depressive episode. You're not in business to become a counselor; however, you are a respected adult that teens look up to and often feel comfortable coming to with personal issues.
As a librarian, you know how to search the Internet to find the most reliable and up-to-date information on a subject. You have the latest books and/or articles at your fingertips. To get started, see the sidebar for a list of online resources you can suggest to your teen patrons or their parents.
BREAKING A CONFIDENCE
If a teen confesses suicidal thoughts to you, tell someone immediately! Encourage the teen to let you call 9-1-1 or call a parent or relative immediately, and also give them resources such as the suicide hotline that's open 24 hours a day, seven days a week: National Suicide Prevention Lifeline, 1.800.273.TALK (1.800.273.8255).
Perhaps the teen who trusted you will get angry initially, but his or her life may be at risk. You are not a trained professional and cannot take this on your shoulders alone. Point that teen in the right direction, and show you truly care by not letting them leave the library in such a dark state of mind. You could possibly be saving his or her life.
When teens are in trouble, emotionally or physically, they don't always have a huge list of people to turn to in their lives. They may not feel they have many people who will understand. Perhaps, some of the people you'd assume they would turn to, such as family, teachers, or clergy, might be the cause of their depression.
By taking time to get to know your patrons personally, you can become a resource to them not only in information seeking, but in caring about their well-being, too. In my book titled Depression: The Ultimate Teen Guide (Scarecrow, forthcoming), there is a chapter titled "Healthy Coping Mechanisms" which highlights ways teens can cope with their depression in non-destructive ways. Some examples are:
Short-term and long-term goals
Creative outlets: journaling, poetry, artwork, and photography
Cognitive-Behavioral Therapy (CBT)
Yoga and/or meditation
Counseling or psychotherapy
This quick list of ideas can be shared with your young adult patrons to show them that, while depression can be debilitating at times, it does not have to last forever. There are treatments that can help alleviate their symptoms, and they can grow up to have happy and healthy lives without feeling helpless or hopeless so much of the time.
Consider establishing a teen peer support group. It can be a safe place for teens to talk to each other and confide in each other the stresses that may be getting them down. Exams, school projects, relationships with friends or romantic interests, part-time jobs, and problems at home are all examples of things that teens have to deal with and we adults may have forgotten about them. With social media so prevalent in teens' lives, they have problems that adults never had to deal with first-hand. Having a peer group available might be just what teens need. Reach out to local counselors or other professionals who may want to facilitate such a group. You are the one with the resources at your fingertips, so go for it and use them!
Other programs you might consider for teens at risk for depression are those with creative outlets. With so many schools cutting their arts programs, creative programs at the library are a community asset. Local authors and artists are often willing to share their time and talents with the community for a fee, or even gratis. Here are some classes or clubs to consider that could be produced on a small budget:
Photography 101: how to take pictures fxom a different point of view
Teen Author Boot Camp: learn to write, and even submit your work to publishers.
Poetry Club or Poetry Slam: write and share poetry from your own journals.
Book Club: come discuss your favorite books and authors, and learn about some great writers you may have never considered.
Calligraphy: learn the art of calligraphy (aka: fancy writing technique)
Improv 101: learn the art of thinking on your feet quickly. Improv is an acting technique where participants get up and make up a scene without a script. Fun!
Anime Club: learn to sketch like your favorite illustrators with this graphic novel class.
Movie Club: watch movies based on books and have discussions on the differences between the two, plus which is better and why.
While there are other places teens can hang out, some alternatives are not always safe or ideal. To increase the number of teens that become regulars at your library, you have to reach out to them and show them that the library is a good place to spend their time. Plus, it's a place where parents won't usually mind their teens being for hours at a time.
The relationship you have with your teens may give you the opportunity to offer a helping hand when needed. The following books may also be helpful to teens when coping with depression or daily stress.
Canfield, Jack, Mark Victor Hansen, Stephanie H. Meyer, and John Meyer, compilers. Chicken Soup for the Teen Soul: Real-Life Stories by Real Teens. Scholastic, 2007. 400p. $14.95 Trade pb. 978-1-62361-080-7.
Cobain, Bev. When Nothing Matters Anymore: A Survival Guide for Depressed Teens. Free Spirit, 2007. 160p. $14.99 Trade pb. 978-1-57542-235-0.
Desetta, A1, and Sybil Wolin, eds. Struggle to Be Strong, True Stories by Teens About Overcoming Tough Times. Free Spirit, 2000. 192p. $14.99 Trade pb. 978-1-57542-079-0.
Irwin, Cait. Monochrome Days: A First-Hand Account of One Teenager's Experience with Depression. Oxford University, 2007. 184p. $9.95 Trade pb. 978-0-19-531005-4.
Schab, Lisa M. Beyond the Blues: A Workbook to Help Teens Overcome Depression. Instant Help, 2008. 184p. $14.95 Trade pb. 978-1-57224-611-9.
Schwartz, Tina P. Depression: The Ultimate Teen Guide. Scarecrow Press, 2014. 240p. $50. 978-0-8108-8387-1.
Depression in Children and Adolescents (Fact Sheet). http://www.nimh.nih.gov/health/publications/depression-in-children-and-adolescents/index.shtml (accessed August 21, 2013).
Depression and High School Students. http://www.nimh.nih.gov/health/publications/depression-and-high-school-students/depression-high-schoolstudents.pdf (accessed August 20, 2013).
Anxiety and Depression Association of America. http://www.adaa.org/
Erika's Lighthouse. http://erikaslighthouse.org/HelpGuide.org.
International Foundation for Research and Education on Depression. http://www.ifred.org/
KidsHealth from Nemours. http://kidshealth.org/
May Clinic answers, http://www.mayoclinic.com/
National Alliance on Mental Illness. http://nami.org/
National Institutes of Health. http://nih.gov/
U.S. National Library of Medicine, National Institutes of Health. http://www.nlm.nih.gov/
Mental Health America. http://www.mentalhealthamerica.net/
WebMD. http://www, webmd.com/
Tina P. Schwartz is a writer from Chicago, who has authored ten books for children and teens. In 2012, she opened her own literary agency, The Purcell Agency, which represents authors of children and teen literature. To find out more, go to http://www.ThePurcellAgency.com.