Running head: A TEACHERS GUIDE 1

A Teacher's Guide to Understanding Students with Depression

Chris Allard

University of Manitoba
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1. Depression is not a made up illness, it is a mental health disorder that can affect any
age group.

Although research has proven that depression is in fact an illness, some people continue to

view this debilitating mental disorder as a sadness or weakness that one can simply snap out of

(Canadian Mental Health Association British Columbia Division, 2013). Depression is not a

made up disease, it is a mental health disorder that can be caused by genetics, biochemical

imbalances in the brain, and traumatic/stressful life events (British Columbia Ministry of

Education, 2001). Another common misconception is that depression is an illness that only

affects the adult population. In reality, symptoms of depression are most likely to first appear

during middle to late adolescence (Crundwell & Killu, 2010). Due to the misunderstandings

surrounding this illness, youth are more likely than adults to suffer in silence. If symptoms of

depression are not recognized early enough in young people, the consequences can be as severe

as life-long mental health problems and suicide (British Columbia Ministry of Education, 2001).

For these reasons, it is crucial that educators use their positions to end the stigma and

misconceptions surrounding depression. This can be accomplished if teachers integrate mental

health awareness into their lessons. Teachers could begin by developing activities that address

questions such as: How is depression different from feeling sad? Why is it important for people

with depression to seek professional help? How do you tell if someone is feeling depressed? In

order to answer these questions, students could conduct research on mental health, create posters,

and even make their own videos to share with the school (The Nemours Foundation, 2016).

2. There are multiple types of depression that can affect children and adolescents.

Like adults, children and adolescents can experience different types of depression. In particular,

young people are most likely to be affected by either bipolar mood disorder, adjustment disorder
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with a depressed mood, or major depressive disorder (British Columbia Ministry of Education,

2001). With regard to bipolar mood disorder, children and adolescents will often experience

episodes of depression and intense excitement/happiness (Canadian Mental Health Association,

2016). This often involves a noticeable shift from angry/irritable behaviour to euphoric

behaviour (e.g. fast-talking, inflated ego, silliness). Bipolar mood disorder can be difficult to

diagnose in younger people because the symptoms can be associated with other disorders such as

ADHD (British Columbia Ministry of Education, 2001). Adjustment disorder with a depressed

mood, on the other hand, is a type of depression that is often caused by a severely traumatic or

stressful event in a persons life. This temporary depression might affect those who have lost a

parent, been involved in an accident, or relocated to a new country. People might display

symptoms such as heightened anxiety, low mood, and instability for up to six months after the

trigger event occurred (Baumeister, Maercker, & Casey, 2009; British Columbia Ministry of

Education, 2001). Unlike adjustment disorder with a depressed mood, major depressive disorder

(sometimes called clinical depression) is a much more chronic type of mental illness. Students

will often display agitated behaviour, lethargy, low motivation, and clumsy movements for an

extended period of time. With this type of depression comes a higher risk of suicidal thoughts

and low self-esteem (British Columbia Ministry of Education, 2001).

3. Students suffering from depression are likely to exhibit physical and behavioural
symptoms that are often associated with other illnesses or learning exceptionalities.

Children and adolescents dealing with depression are likely to display a range of symptoms that

can mimic certain developmental disorders and physical illnesses. Consequently, depression is

more difficult to identify in the youth population (British Columbia Ministry of Education,

2001). Younger children in particular may complain about stomach pains, nausea, and fatigue
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(Crundwell & Killu, 2010). It is possible that these could be the physical/somatic symptoms of

depression. Many children, however, will pretend to have these symptoms in order to avoid

school and/or social situations (British Columbia Ministry of Education, 2001). Older

children/adolescents are more likely to display irritability, defiance, sulking behaviour, and

distractibility. A symptom of depression that both children and adolescents share is poor

performance and follow-through on school work (Crundwell & Killu, 2010). It is clear to see that

some of these symptoms could very easily be associated with common illnesses (e.g. flu) and

developmental disorders (e.g. learning disabilities). If children and adolescents continue to

display some or all of these symptoms for an extended period of time, parents and/or teachers

need to investigate the possibility of depression. For a teacher, the first step in the investigation

process should involve observing the student and recording any behaviours that might indicate

depression. Once the teacher has gathered sufficient observation notes, it would be in their and

the students best interest to contact the school counsellor. It is of pivotal importance to involve

the school counsellor because they are the most qualified to discuss the concerns with the student

and his/her family. It is important for teachers to remember that they are in no position to make a

formal diagnosis. A counsellor, on the other hand, is often able to refer the student to a

professional (e.g. psychologist) to be assessed (British Columbia Ministry of Education, 2001).

4. There is a strong correlation between depression in adolescence and thoughts about

suicide and self-harm.
According to the Canadian Mental Health Association Toronto (2016), suicide currently

accounts for twenty-four percent of all deaths among 15-24-year-old Canadians. Although

multiple factors can influence a young persons choice to take their own life, depression and

other types of mental illnesses are among the leading causes. Since educators spend a great deal
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of time with students who might display signs of depression, it is crucial that they know the

warning signs (Crundwell & Killu, 2010). In some cases, visible warning signs might include

isolation from peers, high irritability/aggression, mood swings, and complete loss of interest in

all school-related activities. It is important, however, that teachers understand that these warning

signs are classic symptoms of depression. This can make it very difficult for a teacher to

determine if a student is in danger of harming themselves. Sometimes a student might actually

talk of suicide to their teacher, but many times he/she will remain silent about their feelings. In

some cases, a teacher might notice indicators of self-harm (e.g. cuts on wrist) that could be

precursors to suicidal attempts or suicide. If approached by a suicidal student, a teacher can help

by listening without judging, asking the student if they have made any definite plans, and by

helping the student see all of the positives in their future (Canadian Mental Health Association

Toronto, 2016). In reality, suicidal adolescents are more likely to share their feelings with their

friends than anybody else. If an educator suspects that a student might be planning on

committing suicide, it is appropriate to contact that students close friends. In some cases,

concerned friends might even approach a teacher or other staff members (British Columbia

Ministry of Education, 2001). It is important to understand that a school counsellor can evaluate

suicidal risk if a student is depressed. If, however, there is any evidence that the student is

planning a suicide attempt in the very near future, the appropriate protocol would be for the

school to make immediate contact with the parents or guardians. At this point, the parents or

guardians would transport the student to a hospital emergency room for a psychiatric evaluation

(Crundwell & Killu, 2010).

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5. Depression will often affect a students ability to concentrate and complete school-related
tasks.

Students with depression will almost always have difficulty concentrating on anything that

requires sustained attention. It is important to understand that not all students with this mental

illness will display inattentiveness to the same degree. However, when a student has any

diminished ability to concentrate in school, they are more likely to experience problems with

information processing and retention (British Columbia Ministry of Education, 2001). It is

important to acknowledge that lack of concentration can also be attributed to sleep disturbances

caused by depression (Crundwell & Killu, 2010). As a result of all of this, students with

depression are more likely to submit unfinished work and receive poor academic grades. This

can be a vicious cycle, as students may become discouraged with their academic performance

and be even less motivated to concentrate and succeed (Forehand, Brody, Long, & Fauber,

1988). According to Crundwell & Killu (2010), low grades will often cause students with

depression to become overwhelmed and doubt their ability to complete any school-related tasks.

Educators can help improve students concentration and motivation by teaching them how to set

and monitor short-term goals, organize and execute school-related tasks, and use problem-

solving strategies (British Columbia Ministry of Education, 2001). Goal setting is especially

beneficial because many students with depression lack direction in their lives. It is important,

however, that teachers help students set goals that are attainable given their current state of mind.

If students are successful in achieving short-term goals, their self-confidence and motivation will

be more likely to increase (British Columbia Ministry of Education, 2001; Crundwell & Killu,

2010). Concentration and motivation are also improved when students engage in peer interaction

and receive frequent positive feedback from their teachers (Crundwell & Killu, 2010).
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6. Students with depression are more likely to suffer from chronic fatigue.

When a child or adolescent has depression, it is quite common for their sleeping habits to be

negatively affected. In particular, there is a strong correlation between depression and insomnia.

If a child or adolescent has insomnia, they will frequently have difficulty falling asleep and

staying asleep at night time. When others are sleeping, people with depression are sometimes

kept awake by their anxieties, feelings of hopelessness, and persistent negative thoughts. When it

comes to students, sleep deprivation often presents as poor attendance, low academic grades, and

lack of concentration in class (British Columbia Ministry of Education, 2001). It is important to

understand that many students with depression will exhibit tiredness even when they get

sufficient sleep. Dealing with the effects of depression will often make a person feel chronically

exhausted, both physically and mentally. Consequently, students with depression are more likely

to fall asleep, lose concentration, or experience mental fog in class (Crundwell & Killu, 2010).

When a student comes to class with depression induced fatigue, it is important for the teacher to

be considerate of their situation. With regard to academics, teachers need to be willing to give

mentally and physically exhausted students extra time and help to complete school-related tasks.

After all, depression induced insomnia and fatigue affects a students information processing and

retention skills (British Columbia Ministry of Education, 2001). It is also a good idea for

teachers to incorporate relaxation activities, such as meditation, into their classes. Not only will

this give mentally/physically exhausted students time to rest and rejuvenate, but it will help the

entire class improve their mental state of mind.

7. Students with depression are more likely to isolate themselves from their peers.

If a student is living with depression, they are more likely to avoid social interaction and put less

effort into maintaining relationships with their peers (Crundwell & Killu, 2010). In some cases,
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the mental and physical fatigue caused by the illness is enough to make individuals avoid social

situations all together. In many cases, however, adolescents with depression will experience low

self-confidence, insecurity, and feelings of worthlessness. Consequently, the student is more

likely to feel socially incompetent and be less motivated to interact with others (British Columbia

Ministry of Education, 2001). In some cases, the child or adolescent might avoid school all

together. In order to help students with depression become more outgoing and confident

individuals, teachers need to help them develop support networks. This could be accomplished in

class by giving students ample opportunities to interact in small group or one-on-one activities.

Collaborative activities can in fact help students maintain contact or reconnect with their friends

(British Columbia Ministry of Education, 2001; Crundwell & Killu, 2010). Teachers can also

encourage students to interact with peers outside of class time. This might involve finding a

friend to sit with at lunch or joining an extra-curricular activity that is of interest to the student

(British Columbia Ministry of Education, 2001). It is important, however, that the teacher does

not encourage the student to take on something that will make them feel extremely overwhelmed

or uncomfortable. The teacher has to remember that they are dealing with a student who has a

mental illness. With that being said, it never hurts for a teacher to show a student with depression

that they care about their well-being and want to be their ally. It is also beneficial for students to

expand their support networks by letting school counsellors in. Although teachers may have to

encourage this, some students might also take it upon themselves to seek help.

8. Students with depression will often lose interest in activities that once brought them
pleasure.

Children and adolescents with depression will often refrain from engaging in the activities that

once brought joy to their lives. In many cases, feelings of hopelessness and helplessness
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consume the persons life, leaving them with no energy or desire to experience enjoyment

(Crundwell & Killu, 2010). Students may lose any motivation to engage in physical activities,

hobbies, or extra-curricular activities. In the classroom, students with depression might display

less interest in activities that others find exciting and fun. Unfortunately, students only

exacerbate their depression symptoms when they avoid any opportunities to experience

happiness. Among other things, this can lead to isolation and loss of friendships (British

Columbia Ministry of Education, 2001). Teachers can try to improve the situation by

encouraging the students to take part in school-related activities such as intramurals and school

clubs. Collaborative learning is also beneficial, as socialization can act as a distraction for people

with depression or other mental illnesses. It is also helpful for teachers or school counsellors to

ask the student what they find interesting or enjoyable. If the student is encouraged to engage in

an activity that they used to find fun and exiting, they will be more likely to achieve some

happiness from trying it again. Although the teachers efforts may not be completely successful,

the student will at least know that someone else cares about their well-being.

9. It is not uncommon for adolescents living with depression to self-medicate.

When an adolescent is living with depression, they may try to numb their symptoms with

alcohol, prescription medication, or illegal drugs. Using alcohol as a coping mechanism is both

dangerous and counterproductive. Since alcohol is a depressant, the student can actually end up

exacerbating their mental and physical symptoms of depression. Unless the student comes to

class visibly inebriated, it can be difficult for educators to recognize when a student is abusing

alcohol to relieve their symptoms (British Columbia Ministry of Education, 2001). Self-

medicating can also involve abusing prescription and/or illegal drugs. In some cases, physicians

may prescribe antidepressants (e.g. Fluoxetine) or benzodiazepines (e.g. Valium) to older

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children/adolescents living with depression. Although sometimes necessary, prescription

medications can become dangerous when students purposely take more than the recommended

dosage. If students cannot access prescription drugs, they may turn to illegal substances (e.g.

marijuana, cocaine) to dull their symptoms (Canadian Mental Health Association British

Columbia Division, 2010). Unfortunately, any type of substance abuse can be difficult for a

teacher to recognize. According to the British Columbia Ministry of Education (2001), alcohol

and drug themes can sometimes be portrayed in a students writing, taste in music, and taste in

clothing (e.g. a shirt displaying a cannabis leaf). If a student is under the influence of either drugs

or alcohol, they may appear sluggish, irritable, disoriented, or even giddy. Teachers must also be

concerned when a student is slurring his/her speech, as this can be an indicator of alcohol use

(Canadian Mental Health Association British Columbia Division, 2010). If a teacher suspects

that a student is self-medicating to relieve symptoms of depression, they must share their

concerns with the school counsellor and the students parents. It is always important for teachers

and school counsellors to maintain contact with parents of students with mental illnesses (British

Columbia Ministry of Education, 2001). By sharing observations, teachers and parents can

sometimes determine if the student is using substances to numb the pain of depression.

10. There is a correlation between childhood/adolescent depression and generalized anxiety

disorder.

If a child or adolescent has a generalized anxiety disorder, it is not uncommon for them to

develop depression as a result. A generalized anxiety disorder is characterized by uncontrolled

and persistent worrying about daily life or future outcomes. In young people, this excessive

worrying can result in obsessive behaviours, perfectionism, separation anxiety, low self-

confidence, and panic attacks. When a child or adolescent becomes overwhelmed with their
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anxieties, they may begin to feel hopeless and helpless about their situation. This is when

symptoms of depression can set in (Huberty, 2012). When a student has both anxiety and

depression, it is crucial that they feel comfortable and safe in their school. One way to achieve

this is to create a predictable classroom that has clear rules and routines. Students with anxiety

and depression can become easily overwhelmed, so giving them structure and routine can help

improve their academic success and emotional well-being. Teachers can also help ease students

anxiety and depression symptoms by incorporating soft music, quiet time, and meditation into

the school day. Adding humour to lessons and speaking in a positive tone can also help put

anxious/depressed students minds at ease (Government of Alberta Education, n.d.). Since

anxious students sometimes get overwhelmed and depressed about completing their school work

perfectly, it can be beneficial to give them extra time and help to do assignments. It is important,

however, for teachers to not make a habit of making accommodations like this for students. A

teacher could sit down with a student and help them set short-term goals for combatting their

perfectionism and school work-related anxieties. Lastly, teaching students organizational

strategies can help students feel less overwhelmed about assignment expectations, due dates, and

time management (British Columbia Ministry of Education, 2001).

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References

Baumeister, H., Maercker, A., & Casey, P. (2009). Adjustment disorder with depressed mood: a

critique of its DSM-IV and ICD-10 conceptualisations and recommendations for the

future. Psychopathology, 42(3), 139-147. doi: 10.1159/000207455

British Columbia Ministry of Education. (2001). Teaching students with mental health disorders

resources for teachers: Volume 2 depression [PDF file]. Retrieved from

http://www.bced.gov.bc.ca/specialed/docs/depression_resource.pdf

Canadian Mental Health Association British Columbia Division. (2010). Depression, anxiety,

alcohol and other drugs. Retrieved from https://www.cmha.bc.ca/documents/depression-

anxiety-alcohol-and-other-drugs-2/

Canadian Mental Health Association British Columbia Division. (2013). Depression. Retrieved

from https://www.cmha.bc.ca/documents/depression-2/

Canadian Mental Health Association Toronto. (2016). Suicide and youth. Retrieved from

http://toronto.cmha.ca/mental_health/youth-and-suicide/

Canadian Mental Health Association. (2016). Depression and bipolar disorder. Retrieved from

http://www.cmha.ca/mental_health/facts-about-depression-and-bipolar-disorder/

Crundwell, R., & Killu, K. (2010). Responding to a students depression. Educational

Leadership, 68(2), 46-51.

Forehand, R., Brody, G. H., Long, N., & Fauber, R. (1988). The interactive influence of

adolescent and maternal depression on adolescent social and cognitive functioning.

Cognitive Therapy and Research, 12, 341350.

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Government of Alberta Education. (n.d.). Depression. Retrieved from

http://www.learnalberta.ca/content/inmdict/html/depression.html

Huberty, T.J. (2012). Anxiety and depression in children and adolescents: Assessment,

intervention, and prevention. New York: Springer Science and Business Media.

The Nemours Foundation. (2016). Grades 9-12 health problems series: Depression [PDF file].

Retrieved from

https://classroom.kidshealth.org/classroom/9to12/problems/emotions/depression.pdf