It takes a village

Parents and schools are a critical safety net for children who might be suffering from depression
By Bridget Pringle

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When our children are little we cure their ‘owees’ with a quick kiss, and cuddle their nightmares away. But as they move towards the teen years and beyond, the pain they suffer isn’t always so obvious, and the fixing of it even less so – particularly when it comes to mental illness. According to statistics from the South African Depression and Anxiety Group (Sadag), up to 20% of South African youngsters are suffering from depression – so it’s a hard, cold fact that a sizeable proportion of our children need our support.
 
Burden of a modern world
Depression is not a modern affliction, but the pressures of our time seem to be bearing down on our youth more heavily than ever before, and affecting children at a younger and younger age.
 
Mark de la Rey, a clinical psychologist and unit head at the Akeso Kenilworth Clinic in Cape Town, says that raised levels of anxiety are driving this trend: “I believe that there is a higher incidence of anxiety levels, which are contributing to more difficulty in social and family settings. In most cases, the increased anxiety levels are precursors to depression, rather than the other way around.”
 
Sadag’s Operations Director Cassey Chambers echoes this, saying the organisation is seeing increased cases of depressed young children and teens, and that it is receiving more and more calls from children who feel helpless and hopeless, and even suicidal.
 
The role of tech
The use of technology and a breakdown in family structures are common refrains when it comes to the factors contributing to anxiety and depression among children and teens.
 
“The stress and anxiety created by the ‘always online’ lifestyle we as parents allow our children to engage in at increasingly early ages is a major factor,” says De la Rey. “They can never switch off from being available to friends, being bullied even when away from school, and being open to other predatory elements that are designed to look 'benign' to them and us.”
 
Rondebosch Boys' Preparatory School head Tony Ryan agrees: “Technology, which obviously has many benefits, is a reality that’s not going to go away and it presents new challenges to our children’s wellbeing. Parents have a responsibility to educate themselves, and monitor what their children are doing online.”
 
A lack of support
And then there’s the breakdown in family structures, and a consequent decline in the trusted parties that children can confide in, contributing to their sense of isolation.
 
“It takes a village to raise a child. But for many, that village does not exist, meaning there’s not a support structure for children,” says Ryan. “Mom and/or dad may be absent, and so it’s critical that there are other people for children in need to talk to.”
 
De la Rey also notes the fact that parents are increasingly unavailable because of work and social demands. “The time we spend with our children is being replaced by the electronic nanny (television, the internet, gaming, etc).”
 
First line of defence
It is against this background that those closest to children from an emotional and physical point of view – parents and teachers – become critical in providing the safety net for those who might be suffering from depression and need intervention.
 
For parents, there are a number of signs that can indicate a child needs help, although a complicating factor is that all children, and especially teenagers, exhibit ‘red flag’ behavior at some point or another.
 
“Children, preteens and adolescents can exhibit behavioural and mood symptoms that mimic depression, but are in fact appropriate for their developmental phase or age,” says De la Rey. “A general rule of thumb would be if the behaviour is prolonged and out of character for your child, then you should be sitting up and taking note. Start by having a talk with your child about how they are feeling and doing. If you feel uneasy about anything, then a visit to the GP might be the first point of call. I believe that prevention is better than cure.”
 
As is so often the case, open communication is an important ally for parents. “Hearing and understanding what your children think, feel and say doesn't mean you have to agree with it,” says De la Rey. “However, open dialogue makes it more likely that they will tell you when things go wrong.”
 
The role of schools
Schools – which is where our children spend the majority of their young life – are critical partners.
 
According to De la Rey, they play “an increasingly vital role in identifying, if not necessarily treating” children who are at risk. Educational psychologist Heidi Theo agrees: “Teachers are in an excellent position to identify when children are depressed, if they are sensitive to changes in their pupils’ behaviour.”
 
For those children who do require professional help, De la Rey suggests that school support could extend to facilitating time for learners to attend programmes, either as in- or out-patients. They can also encourage information sessions for parents and teachers with professionals, who are mostly open to doing talks, often free of charge.
 
Creating community
Some schools introduce initiatives to replicate a sense of family within the school, such as Rondebosch Prep’s ‘Bosch Buddies’. This sees groups of seven boys (with one boy from each grade) making up ‘a family‘. “It gives the seniors greater responsibility, and younger boys appreciate the interest the older boys show in them. It has also had an incredibly positive impact on the sense of community and connection for the boys,” says Ryan.
 
Ultimately, it is ideal for schools and parents to work together, says Theo. “A collaborative approach is the most valuable approach when dealing with children who are at risk. Regular meetings between parents and staff to help with the early identification of concerns are invaluable. Talks hosted by schools can also help both parents and staff recognise and identify the early warning signs.”
 
Red flags for teachers
Educational psychologist Heidi Theo lists the warning signs that can indicate a learner is suffering from depression:
 
  • no participation in previously enjoyable school activities
  • weight loss (and less frequently, weight gain), due to changes in appetite
  • lethargy
  • telltale bags under his/her eyes because of a lack of sleep
  • signs of demotivation, for example, not completing homework or remembering to bring sports kits
  • a lack of participation during classroom discussions
  • a drop in marks
  • difficulty sustaining concentration
  • an increase in social isolation (a depressed child is likely to be found alone during break)
  • an irritable mood, disengaged and/or apathetic
  • a flat and sad demeanour, and quick to cry
  • physical indicators: they may walk with stooped shoulders and may take less pride in the way they look and in their general self-care routine
 
Red flags for parents
Sadag provides this list of behavioural signals that can indicate a child needs help:
 
Preadolescents
  • inexplicable decrease in academic performance
  • increasing social isolation
  • loss of interest in sports
  • development of unusual physical complaints for no medically sound reason
  • increased childish and dependent behaviour
  • being excessively demanding
 
Teenagers
  • marked moodiness
  • overreactions to frustrations out of all proportion to the provocation
  • marked self-isolation and social withdrawal
  • unrealistically low self-esteem
  • unwarranted belief that others dislike or reject him or her
  • unrealistic belief that one’s personal appearance is ugly or offensive
  • loss of interest in hobbies, sports, and personal self-care
  • development of delinquent activities, in particular the abuse of drugs and alcohol
 
Where to go for help
Sadag runs a Teen Suicide Prevention School Programme in schools that involves speaking to individual classes about the symptoms of depression, warning signs of suicide and how to get help. Schools can also contact their nearest psychologist or psychiatrist, or a unit offered by groups such as Akeso
 
Parents parents can try a GP as a first stop, or their nearest psychologist or psychiatrist. Sadag can also provide direction (011 234 4837)
 
A must-read for parents
Every parent should read ‘Teenage suicide: a perfect storm’ by Kate Shand, who had to experience the unimaginable when her son committed suicide. 

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