Depression (low mood)
Feeling sad or low in mood is a natural state of emotion that everyone has at times. Life is often challenging, and experiences, circumstances and events can cause people to feel low.
Low mood can also happen for no obvious reason. Low mood stays and gets worse often because of unhelpful thoughts and behaviour like avoidance and withdrawal from previously enjoyed activities. If this goes on for too long and it impacts many areas of our lives, we can become depressed.
Do this activity with your child to show them how our minds have developed to be busy all the time:
Let your mind do its’ thing:
Set a timer for 2 minutes
Notice your thoughts. Even if your mind says, ‘I’m not doing this properly’, or ‘Nothing is happening, I’m not having any thoughts’.
Jot down briefly what comes into your mind during the minute
After 2 minutes
Take a look at what you wrote. What do you notice? Was it just a random jumble of thoughts or are you preoccupied with something? Were they profound life changing things or do you now know what you are having for dinner? Just notice.
The function of the mind is to pump out thoughts, like the heart pumps blood around the body.
The mind does not know what is helpful or unhelpful, so it pumps out lots of different thoughts. The ones we engage with tells our mind what thoughts we think are important and it gives us more of those kind of thoughts. So if we engage with self-critical thoughts, our mind thinks that must be important and will give us more of them.
Developing helpful resources
- Helpfully responding to someone who is low in mood we first need to empathise - acknowledge the sadness and offer comfort to the young person. It is important that emotions are seen and validated by others.
- It is important not to give the message that they should not be sad or that their loss is not real.
- Don’t rush in to solve the problem or deny what the young person is thinking about themselves. Instead, reassure them that their mind is not stating facts and that they don’t have to be believed, they need to ask if the thoughts are helpful or unhelpful.
Have a look at this video for more information on how to deal with unhelpful thoughts and feelings.
Summary
- Life is challenging and we will all experience pain.
- Sadness is an inevitable and healthy part of life
- Low mood is normal in situations where people are under stress or have had a difficult life event. We will recover when the stress is over or the difficult life event has been processed if we are able to maintain self-care, connection and activity during these times.
- If a person does not recover from a depressed state over the course of a few weeks more help can be sought through primary care services and CAMHS where psychological therapy and / or medication may be needed.
When should you worry?
CAMHS Depression (low mood) Referral Guidance
Here’s a guide to help you know how best to support your young person if they are experience symptoms of low mood or depression. Young people will experience other types of mood issue and symptoms which may not be included on this guide.
GREEN
Coping / needs support; These are experiences that most young people will have from time to time.
Type and nature of mood issue
It is common for children and young people to experience episodes of feeling sad, low or down as they develop through childhood and adolescence. Examples of situations that may cause/ contribute to a young person to feel down or low in mood might be:
- Adjusting to changes (such as a new school)
- Friendships or relationship issues
- Episodes of being teased or bullied (including being or feeling left out or excluded)
- Being physically poorly or in pain
- Family breakdown or conflict
- Grief or loss (of a pet, family member or friend)
- Struggling with academic work
What you might see or a young person might report
- Being clingy and not wanting to be separated from a parent/ carer
- Not wanting to be left alone
- Seeking verbal reassurance and checking things are ok
- Not wanting to go to school
- Avoidance of seeing friends or doing activities they ordinarily enjoy
- Having mild sleep disturbance
- Feeling tired or appearing lethargic and unmotivated and disinterested
- Appearing withdrawn and less communicative
- May appear more challenging or oppositional/ argumentative
- Crying
Things to try, support and Next Steps
- Normalise that feeling sad or down is a natural emotion particularly in response to a sad, disappointing or difficult event
- Activity helps; encourage a young person to do a range of tasks and activities including one they need to do such as school work to fun things.
- Keep a routine and have nice things planned
- Break things down into small steps and do one at a time so tasks do not seem so overwhelming
- Use distraction techniques, here are some strategies to try;
A-Z of coping strategies: https://youtu.be/5EXpkVw3fh
Useful Resources:
- Stuff That Sucks, by Ben Sedley
- Little Blue book of sunshine - a mental health booklet that has been developed for children and young people living in Hampshire, Southampton and the Isle of Wight. The book aims to help children and young people by sharing tips on how to deal with many problems, such as anxiety, body image, relationships and anger. It also includes information about where to get help when needed, including information about local services. Click here to access the PDF or access the booklet via Apple Books or Google Play Books.
AMBER
Needs help; These are challenges that some young people experience and may need some support with
Type and nature of mood issue
Examples of situations that may cause/ contribute to a young person feeling low in mood or depressed:
- Being routinely teased or bullied (including being or feeling left out or excluded)
- Grief or loss (including romantic relationships ending)
- Witness or experience of conflict (at home or school)
- Change and uncertainty (such as family breakdown)
- Family and relationship stressors (parent/ sibling ill-health, financial or social stressors)
- Academic pressures/ demands including exam stress and worry about the future
Please note, there are occasions when there is no apparent trigger/ cause/ contributory factor as to why a young person may be experiencing episodes of low mood/ depression. A young person can still be low in mood without clear reason.
What you might see or a young person might report
As well as the features in Green, the following might also be present:
- Disrupted sleep (difficulties getting to or staying asleep, waking very early in the morning and not being able to get back to sleep)
- Seeking physical or verbal seeking reassurance or wanting to withdrawn from social contact and communication
- Resistance to doing things; appearing unmotivated and disinterested
- Poor personal hygiene (not washing or changing clothes regularly)
- Emotionally labile; frequent changes of emotion, more sensitive (e.g., irritable, upset, confused)
- Thoughts or urges to harm self or some thoughts to end life; some infrequent or superficial (not requiring medical attention) self-harm may occur.
Please note that not all young people who engage in self-harm behaviour are depressed or suicidal. There are many reasons why a young person may engage in self-harm behaviour.
Things to try, support and Next Steps
As well as the steps in Green the following might be helpful:
- Watch our parent/ carer workshop on how to support a young person with self-harm or in crisis here: https://youtu.be/qBAZQVjSmQU
- Share concerns with your child’s school/ college
- See your child’s GP
- Access pastoral support from school
- Consider accessing help from a local counselling service. Kooth is a free online counselling and emotional wellbeing support service offered to young people aged 11 - 25 years (up to their 26th birthday) living in Dorset, Hampshire and the IoW with a safe and secure means of accessing support with their emotional and mental health needs from a professional team of qualified counsellors.
- Seek advice, guidance and support from Young Minds Parent Helpline:
08088025544
Useful Resources:
- Stuff That Sucks, by Ben Shelly
- Am I Depressed? And What Can I Do About It? by Shirley Reynolds and Monika Parkinson
- Beyond The Blues; A Workbook To Help Teens Overcome Depression, by Lisa Schab
- Stopping The Pain; A Workbook For Young People Who Cut and Self-Injure, by Lawrence Shapiro
- Little Blue book of sunshine - a mental health booklet that has been developed for children and young people living in Hampshire, Southampton and the Isle of Wight. The book aims to help children and young people by sharing tips on how to deal with many problems, such as anxiety, body image, relationships and anger. It also includes information about where to get help when needed, including information about local services. Click here to access the PDF or access the booklet via Apple Books or Google Play Books.
RED
Needs Specialist Treatment or a Crisis Response; These are difficulties that cause a significant impact and a young person may need specialist support.
Type and nature of mood issue
Episodes of low mood/ depression are very serious. These cause significant distress to a young person and significantly disrupt daily coping such as school/ college, socialising and even self-care activities (e.g., sleep, bathing, eating). Examples of situations that may cause/ contribute to a young person feeling low in mood or depressed:
- Chronic bullying or abuse (including neglect, emotional, physical, sexual)
- Social or family financial stressors (such as family breakdown, conflict or parental/ sibling ill-health)
- Grief or loss
- Witnessing or experiencing a traumatic event
- Overwhelmed by pressures and stressors including individual factors e.g., health, social factors e.g., relationships, occupational factors e.g., school/ college and environment e.g., living circumstances
Please note, there are occasions when there is no apparent trigger/ cause/ contributory factor as to why a young person may be experiencing episodes of low mood/ depression. A young person can still be acutely depressed without clear reason.
What you might see or a young person might report
As well as the features in Green and Amber, the following might also be present:
- Isolating self from friends and family
- Withdrawn and uncommunicative or not wanting to be left alone at all- this may seem uncharacteristic or age inappropriate for some teenagers
- Refusal to leave the house or attend/ take part in activities such as school, hobbies, interests, seeing friends
- Significant impact on health and wellbeing such as not sleeping or eating for a sustained period of time. May show signs of physical compromise as a result.
- Appearing uncaring or unbothered about people or activities they previously would have cared about- may not honour commitments or responsibilities which is uncharacteristic
- Lack of insight or awareness that others may be concerned- this may lead to arguments or conflict at home
- May on occasion becoming agitated, distressed, oppositional or aggressive towards others
- Reactive and impulsive behaviour such as running away which may place them or others in danger
- Feeling hopeless about the future- not being able to see a future and appearing to give up on dreams, goals and hopes
- Thoughts, feelings, urges, plans or intent to harm self or end their life or harm others. Please note that not all young people who engage in self-harm behaviour are depressed or suicidal. There are many reasons why a young person may engage in self-harm behaviour.
Things to try, support and Next Steps
As well as the steps in Green and Amber the following might be helpful:
- Speak with your child’s GP
- Speak with the School Nursing Team
- Depending on the context and/ or the origins of the low mood/ depression being experienced, other services may be helpful. There may be a role for other services such as Children’s Services or other statutory or voluntary organisations that can support if there are clear triggers for anxiety e.g., abuse, domestic violence, bullying, being a young carer etc.
- Kooth is a free online counselling and emotional wellbeing support service offered to young people aged 11 - 25 years (up to their 26th birthday) living in Dorset, Hampshire and the IoW with a safe and secure means of accessing support with their emotional and mental health needs from a professional team of qualified counsellors.
- Seek advice, guidance and support from Young Minds Parent Helpline: 08088025544
- Consider making a self-referral to a CAMHS Service. If your young person is at risk of harm, please make this clear when making the referral.
- If you are still not able to find the information or support you are seeking, then it might be helpful to speak to a CAMHS clinician. Please contact our Single Point of Access on 02382 317912 option 1; telephone lines are currently open 9am – 12pm Monday to Friday.
Useful Resources:
- Stuff That Sucks, by Ben Edley
- Am I Depressed? And What Can I Do About It? by Shirley Reynolds and Monika Parkinson
- Beyond The Blues; A Workbook To Help Teens Overcome Depression, by Lisa Schab
- Stopping The Pain; A Workbook For Young People Who Cut and Self-Injure, by Lawrence Shapiro
Advice and Guidance
Supporting to maintain pleasurable and meaningful activity
- Developing an activity schedule and sticking to it is one of best ways to improve low mood.
- The 6 ways of wellbeing - it is important to maintain the 6 areas of well-being as part of this activity scheduling. Even if the person does not FEEL like doing it, just doing it helps to improve mood.
- Connection: be with friends, family, pets
- Self-care – sleeping well, eating well, personal care etc.
- Being active – going out for a walk, bike ride, doing PE
- Giving – doing something for someone, a pet, your community etc.
- Being present –use all of the senses to focus on the here and now
- Learning – challenge yourself to learn something new
Problem solving about the difficult situation/stress
Many situations can be improved by problem solving
- Once a person feels validated, listened to and calmer, they can focus on how to overcome challenges they are facing.
- Be clear on what the problem is: E.g I am stressed about exams and think I will fail and that my life will turn out badly.
- Generate as many different solutions to the problem as you can: create a study plan with breaks included, revise, speak to my subject teachers, be more present when I notice my mind trying create a worry.
- Choose one solution: I could notice when my mind makes unhelpful predictions, focus on what is important in the present moment and revise.
- Make a specific plan for the solution
Here is a summary of top tips:
- t is important to encourage the person to tell someone how they are feeling. They need a trusted adult that they can talk to: parent/ carer, teacher, health professional (school nurse or your GP). This is particularly important if they are having thoughts or urges to harm themselves.
- Make sure that they follow a basic daily routine and making sure that they still do the activities they need to do and do some other activities that they used to enjoy but have perhaps stopped doing because they are feeling depressed. Help them to plan activities for the morning, afternoon and evening and try to stick to these even if they do not feel like it. Avoiding or withdrawing from activity is known to lower mood so make sure that they see friends, go to school/ college, do things they enjoy (or used to).
- Encourage them to look after themselves; eating well, getting enough sleep , getting some fresh air daily, doing exercise and avoiding self-medication (for example using alcohol, drugs or caffeine).
- Young Mind
- This service provides free, 24/7 crisis support across the UK. If your child is experiencing a mental health crisis and need support, they can text YM to 85258.
- They will listen to them and help them think through how they're feeling, and will aim to help them take the next steps towards feeling better.
- Texts are free from EE, O2, Vodafone, 3, Virgin Mobile, BT Mobile, GiffGaff, Tesco Mobile and Telecom Plus.
- If you live in Hampshire or on the Isle of Wight, the NHS 111 mental health triage service can provides advice, support and guidance, 24 hours a day, seven days a week. The Mental Health Triage Team has a wide range of skills, including on the phone brief psychological support and has access to key services and organisations that can offer mental health support to you and your child in your time of need. Just dial 111 or online at www.111.nhs.uk
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