Anxiety and depression
Mood disorders and anxiety are the general names for a range of conditions including major depressive disorder, dysthymia, bipolar disorder, post-traumatic stress disorder, obsessive-compulsive disorder and phobias. Each condition shares some similar characteristics: an extended period with feelings of depression, exaggerated anxiety or fear, and/or low self-esteem. Like many other mental disorders, kids struggling with mood disorders and anxiety often also have additional long-term medical needs, such as insulin resistance.1
Depression and anxiety are commonplace, but not equally shared.
Not many children under the age of 12 experience depression. Mood disorders, thought to be linked to brain chemistry, are much more prevalent among adolescents. More than one in four (28.5 percent) high school students reported feeling so sad or hopeless for every day in the previous two weeks that they stopped doing some usual activities. These experiences are more common among adolescent girls, kids from low-income families and Hispanic youth.
Anxiety affects around one in 20 children between the ages of 3 and 17. Patterns for anxiety are different from depression. First, anxiety is linked to specific parts of the brain related to emotional memories. This partly explains why traumatic experiences can trigger anxiety. Older children, kids with insurance coverage, and those in low-income families are more likely to be diagnosed with anxiety. It’s also more prevalent among boys and black children.[1]
School personnel are well-placed to identify students who may need more support.
Depression is a treatable illness. School personnel can help students to see and name what’s happening, and to get them appropriate care. In their own words, children might say they are “sad” or “unhappy,” or possibly “tired.” Additionally, you might notice:
- Absences;
- Decreased interest in activities, including past favorites;
- Efforts to run away from home, or talk about running away;
- Extreme sensitivity to rejection;
- Frequent complaints about physical illness, such as headache or stomachache;
- Hopelessness;
- Irritability, anger, hostility;
- Low self-esteem and guilt;
- Major changes in eating or sleeping patterns;
- Persistent boredom or low energy;
- Poor concentration or fatigue;
- Relationship challenges;
- Sadness, tearfulness or crying;
- Social isolation and poor communication; and
- Suicidal thoughts or expressions, or self-destructive behaviors.
Once diagnosed by a health professional, a student with depression may seek talk therapy, medication or herbal therapy, brain stimulation or other care.[2]
Anxiety is a normal reaction to stress, and often occurs in short bouts, such as on a first date, or when we are asked to speak in public. Anxiety disorders are different because symptoms are excessive and long-term, negatively affecting daily life. School personnel may notice a child frequently struggling with fear, dread or uncertainty in atypical situations. Once diagnosed, anxiety, like depression, can be treated by trained health professionals. Medication and talk therapy are typical care options.[3]
School staff can reduce stigma around mental disorders and support care teams.
Unlike the common cold, flu or a concussion—all fairly common physical health issues—mental illness is often stigmatized in our culture. Understanding mental disorders, their causes and their typical impacts on behavior can help students move away from isolating, bullying or denigrating people with mental health issues, and toward safe and supportive behaviors. AFT’s partner, Share My Lesson, has great resources about mental illness for educators, including some specific lessons on anxiety and depression; the National Institute of Mental Health also prepares excellent resources on specific disorders.
Beyond knowledge, some practices among school staff that benefit all students are especially helpful to children who have an anxiety disorder. For example, social support from trusted friends can help children with clinical anxiety manage their symptoms. That means thinking about ways to ensure that students have high-quality non-academic time with self-selected peers. Stress management, meditation and aerobic exercise can help, too. These initiatives can be added to, or encouraged in, academic time, recess, physical education courses, after-school activities and class meetings.
[1] Centers for Disease Control and Prevention. May 17, 2013. Mental Health Surveillance Among Children—United States, 2005-2011. [Report.] Morbidity and Mortality Weekly Report.
[2] National Institute of Mental Health. 2011. Depression. NIH Publication No. 11-3561. Retrieved from http://www.nimh.nih.gov/health/publications/depression/index.shtml.
[3] National Institute of Mental Health. Anxiety Disorders. Retrieved from http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml.