Depression Awareness Powerpoint/Video

 Start with a depression vignette. “How many think this is stress, anxiety, depression”
o Meena is a 15-year-old girl who has been feeling unusually sad and miserable for the past few weeks. She gets tired
all the time and finds it
hard to sleep at night. Meena does not feel like eating and has lost weight. She finds studying difficult and her marks
have dropped. She is not
interested in any decision making and daily activities seems to be difficult for her
 Include stuff from WHO brochure (highlighted)
 Symptom profile (include adolescents)
o DSM-5 Criteria 5 or more symptoms present during a 2 week period; (1) depressed
or irritable, cranky mood (outside being frustrated) or (2) loss of interest or pleasure
and any three of the following:
o 1. Significant weight loss or decrease in appetite
(more than 5 percent of body weight in a
month or failure to meet expected
weight gains.)
o 2. Insomnia or hypersomnia
o 3. Psychomotor agitation or retardation
o 4. Fatigue or lack of energy
o 5. Feelings of worthlessness or guilt
o 6. Decreased concentration or indecisiveness
o 7. Recurrent thoughts of death or suicide In addition to the above DSM-5 criteria,
children and adolescents
 may also have some of the following symptoms:
 Persistent sad or irritable mood
 Frequent vague, non-specific physicalcomplaints
 Frequent absences from school or poor performance in school
 Being bored
 Alcohol or substance abuse
 Increased irritability, anger or hostility
 Reckless behavior Symptoms cause significant distress or
impairment in functioning.

Reference:
https://www.mdwise.org/MediaLibraries/MDwise/Files/For%20Providers/Behavioral%2
0Health/gl-depressioninchildren.pdf

Sadness Depression

An ordinary emotional reaction to adversities such as Thoughts and perception are distorted in some ways.
loss or disappointment. It is nonetheless normal and The effects of such distortion can be a serious
acceptable provided that the response and burden.
perception remain realistic, logical, and undistorted.
 An explicit sadness which one understands that there A feeling of a never-ending unhappiness.
is a way out, either knowingly or unconsciously, and
that the sadness will go away.

Alleviate the blues by diverting attention to other At least two weeks of incessant barrage of depressive
things. thoughts.

Grief goes away eventually; the low mood does little Depressive symptoms tend to persist or recur,
to one's self-esteem. causing harm to one's self-esteem

Does not affect much on interpersonal relationships, Affects interpersonal relationships, performance at
or performance at school or at work. school or at work significantly.

o Reference: http://www.depression.edu.hk/en/content/p2_2.php

 Risk factors and Causes

 Because of the clinically heterogeneous and diverse causes of the illness, to understand the
pathogenesis of depression in adolescents is challenging. Like many other common health
disorders, several risk factors interact to increase the risk of depression in a probabilistic
way. To assess the contribution of any single risk factor in isolation and to identify crucial
developmental periods when exposure is especially risky is difficult because many individual,
family, and social risks are strongly correlated and relate to continuing and later adversities.
 Depression in adolescents is a major risk factor for suicide, the second-to-third leading cause
of death in this age group,4 with more than half of adolescent suicide victims reported to
have a depressive disorder at time of death

Psychosocial risk factors

Much research has been done into the association between depression and
environmental factors such as exposures to acute stressful events (eg, personal injury,
bereavement)68,69 and chronic adversity (eg, maltreatment, family discord, bullying by
peers, poverty, physical illness). Nevertheless, such exposures do not always lead to the
development of depression in adolescents, although those at high genetic risk seem to
be especially susceptible to the effects of such stressor


Female gender
Education related
Academic satisfaction of parent[29]#
Not performing well[29]#
Physical punishment at school[19]#
Self or parental dissatisfaction with academic achievement[21]#
Stress at school[59]@
Students staying away from home[21]#
Teasing at school[19]#
Academic stressors[10]@
Change of schooling[10]@
Inability to cope with academics[31]#
Government school[34]#
Studying in class Xth and XIIth[34]#
Spending less time in studies[34]#
Lack of supportive environment in school[34]
Lower level of participation in cultural activities[34]#
Lower academic performance[61]#
Failure in examination[61]#
Relationship issues with parents or at home
Argument with our parents[29]#
Familial discord[31]#
Poor relationship with family[21]#
Relationship difficulties[31]#
Parental fights[19]#
Stress in the family[59]@
Interpersonal conflicts or scoldings[10]@
Physical abuse by family members[10]#
Family‑related issues
Birth of a sibling[10]@
Family history of psychiatric illness[10]@
Change of house/residence[10,61]@,#
Rejection[28]#
Punishments[28]#
Deprivation of privileges[28]#
Working mothers[21]#
Death of a family member[61]#
Alcohol use and smoking by father[34]#
Prolonged absence or death of a parent[60]@
Economic difficulties
Economic difficulties[19,31]#
Others
Extracurricular activities and type of activities[22]#
Extracurricular activity[29]#
Going out for outing[22]#
Not having a hobby[21]#
Peer pressure[21,29]#
Social isolation[28]#
Illness, injury/death[10]@
Serious illness[61]#
Rural locality[34]#
Having a boy/girlfriend[34]#
o End of a relationship[61]#
 How to seek mental health info
 Self-treatments, professional help available
 Cause of major depression is not known
 It does run in families
 No one is immune to depression
 It is treatable, but not curable
 You don’t always have to feel sad with depression
  Alcohol and drug abuse can be a sign of depression
 Having a lot of stress or a stressful life event doesn’t mean you will develop depression
 Depression cannot just be controlled through willpower

Note: The optimal PHQ-9 cutoff score for adolescents is 11 or higher; it has been shown to
have a sensitivity of 89.5% and specificity of 77.5% compared with a diagnosis of major
depression on a structured mental health interview.1
Mild: 29.7% (PHQ 5‑9)
Moderate: 15.5% (PHQ 10‑14)
Moderately severe: 3.7% (PHQ 15‑19)
Severe: 1.1% (PHQ 20‑27)