Low mood and depression – guidance for 11-16 year olds

Depression is a mental health difficulty that involves persistent low mood (continuing for a long time). It impacts on the way people feel, think and behave. Depression can happen as a reaction to difficult experiences such as bullying, bereavement or family relationship difficulties. It can also happen without any obvious trigger or reason.

Young people with depression may feel a range of emotions including sadness, stress, hopelessness, loneliness, irritability (anger), emptiness or numbness. They may often have negative thoughts about themselves, other people, the future or life in general. It can be hard for them to carry out usual routines and tasks including self-care (showering/ brushing their teeth), eating and sleeping.

Young people with depression often stop enjoying activities or seeing friends as they can feel tired and have no energy or motivation. People with severe depression, and/or depression that has been going on for a long time, sometimes have thoughts or urges to harm themselves or to end their lives. It is important for them to tell someone so that a safety plan that supports the young person not to act on these thoughts can be put in place.

Depression isn’t something people can ‘snap out of’ or simply ‘cheer up’ from. It’s a medical condition that can affect many aspects of a person’s life if not treated. The good news is that depression is treatable and people can recover.

• Encourage the young person to talk to someone about how they are feeling so that they are not alone. They could talk to a parent/ carer, teacher, health professional (school nurse or their GP). This is particularly important if they are having thoughts or urges to harm themselves or end their life.
• Follow a basic daily routine and make 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. Get 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 you enjoy (or used to).
• Encourage them to look after themselves; eat well, sleep, get some fresh air daily, do exercise and avoid self-medication (for example using alcohol, drugs or caffeine).

This is a general guide to help you know how best to support your young person if they are experiencing low mood or depression. This is not an exhaustive list; young people may experience symptoms which may not be included in this guide.  If in doubt advice and guidance is available from the services listed below.

A parent’s guide to depression – This guide explains the warning signs of depression in children and young people and how to talk to children about their feelings.

These are experiences that most young people will have from time to time.

It is common for children and young people to experience episodes of feeling sad, low or down as they develop through childhood and adolescence. The typical mood issues children and young people experience tend to be situation specific, short term and can be managed with the love and support of parents/ carers.

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

If families or professionals are concerned that a young person is experiencing any of the issues above support is available, this includes:

Kooth

Kooth is a free online counselling and wellbeing support service, which is available to all young people aged 11-25 in Portsmouth.

Young people can access self-help resources, moderated peer support and professional support from counsellors.

There are no waiting lists or referrals, young people can visit Kooth.com and register anonymously.  The site is available 24/7 with counselling available 12pm – 10pm on weekdays and 6pm – 10pm on weekends, all year round.

Support in schools

All secondary schools have a named Mental Health Lead and within schools there is a range of pastoral support available.  Schools also work with other professionals in order to gain advice and guidance on how best to support children’s social and emotional needs. These services may include the Portsmouth Educational Psychology Team, the Multi Agency Behaviour Support Team and the Inclusion Outreach team.

Within many schools, pastoral support may be provided by Emotional Literacy Support Assistants (ELSAs)

ELSAs are teaching assistants or learning mentors in schools who have been trained by Educational Psychologists to work with children who are showing a wide range of emotional or social needs for example; anxiety, low self-esteem, problems with anger etc. Through individual (and small group) support programmes ELSAs help children to develop their social and emotional skills.

Support will also include Mental Health Support Teams (MHST’s) who are available in all secondary schools.

MHST’s support children and young people who are struggling with low mood. They use cognitive behaviour therapy informed interventions to make changes in the way young people think and behave, improving their outlook on life.

The school should make contact with MHST for consultation and support for MHST referral where appropriate.

For professionals such as GP’s they should encourage young people to register with Kooth and to link in with the school-based support described above.  The CAMHS Single Point of Access is also available for consultation and advice.

Available Monday to Friday, 9am-5pm

Contact: 0300 123 6632.

These are challenges that some young people experience and may need support with.

The degree to which a young person feels low or depressed appears out of context or disproportionate to the reason why they might be feeling sad. Episodes of low mood might be more frequent or prolonged and cause the young person distress or might have some mild impact on their ability to cope with everyday life such as going to or coping at school, seeing friends or taking part in leisure activities.

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 getting advice 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.

If families or professionals are concerned that a young person is experiencing any of the issues above support is available, this includes:

Kooth

Kooth is a free online counselling and wellbeing support service, which is available to all young people aged 11-25 in Portsmouth.

Young people can access self-help resources, moderated peer support and professional support from counsellors.

There are no waiting lists or referrals, young people can visit Kooth.com and register anonymously.  The site is available 24/7 with counselling available 12pm – 10pm on weekdays and 6pm – 10pm on weekends, all year round.

Support in schools

All secondary schools have a named Mental Health Lead and within schools there is a range of pastoral support available.  Schools also work with other professionals in order to gain advice and guidance on how best to support children’s social and emotional needs. These services may include the Portsmouth Educational Psychology Team, the Multi Agency Behaviour Support Team and the Inclusion Outreach team.

Within many schools, pastoral support may be provided by Emotional Literacy Support Assistants (ELSAs)

ELSAs are teaching assistants or learning mentors in schools who have been trained by Educational Psychologists to work with children who are showing a wide range of emotional or social needs for example; anxiety, low self-esteem, problems with anger etc. Through individual (and small group) support programmes ELSAs help children to develop their social and emotional skills.

Support will also include Mental Health Support Teams (MHST’s) who are available in all secondary schools.

MHST’s support children and young people who are struggling with low mood/depression. They use cognitive behaviour therapy informed interventions to make changes in the way young people think and behave, improving their outlook on life.

The school should make contact with MHST for consultation and support for MHST referral where appropriate.

For professionals such as GP’s they should encourage young people to register with Kooth and to link in with the school-based support described above.  The CAMHS Single Point of Access is also available for consultation and advice.

Available Monday to Friday, 9am – 5pm

Contact: 0300 123 6632.

These are difficulties that cause a significant impact and a young person may need specialist support.

Episodes of low mood/ depression are severe and enduring. 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). Despite trying advice in the green and amber stages, the young person still experiences depression symptoms.

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 or cause 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 getting advice and getting help 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.

Support available

If families or professionals are concerned that a young person is experiencing severe and enduring mental health issues that are impacting daily life then they should contact CAMHS Single Point of Access for consultation and advice. CAMHS provide evidenced based treatment for mental health disorders. This can include medication and talking therapies on a 1-2-1, group or family basis. They offer face-to-face, web based, and telephone support on a needs-led basis.

Available Monday to Friday, 9am-5pm

Contact: 0300 123 6632.