6 The Hampton Roads Messenger


Volume 8 Number 12


August 2014


Youth Depression Thrives on Silence - Data Show Shocking Impact of Mental Disorders


BY ANNA CHALLET


When Amber Cavarlez was in high school and her mother died of colon cancer, she and her Filipino Catholic family went to church and lit candles every day. But, she says, “After she passed, nothing was said about it. No one talked about it.”


In her home, she says, sadness was an “invisible subject.” And when she cried at school and sought help, she received an anonymous message through Facebook that said, “Don’t cry at school because no one cares.”


to herself, but her family’s struggles weren’t


She learned to keep her feelings over – her brother


was


diagnosed with bipolar disorder and attempted suicide several times in the following years. By then attending college in San Francisco, she often found


herself emotionally unable


to go to class, and was told by the administration that she’d have to improve academically or drop out.


She sought the help of a therapist on campus and eventually graduated. Now 23, she is a mentor with the Peer Wellness Program at Edgewood Center for Children and Families in San Francisco. Though doing well herself, she wishes her brother had had someone to talk to when he was in school. Young people “need someone there to ask about [their feelings], to make it valid,” she says.


Cavarlez spoke with other young people at a media forum organized by New America Media in San Francisco last


week on challenging stigmas


around youth depression. Alongside the youth storytellers, a panel of experts in the mental health field weighed in on the views of depression across different cultures and a fractured system for delivering mental health services. They agreed that youth depression is more widespread than many people realize, and that it thrives on silence.


But both advocates over and


practitioners were above all optimistic about the future of mental health in children and youth, and expressed a growing excitement


treatment


options – in the words of Patrick Gardner, founder of the Young Minds Advocacy Project, “We have a moment of opportunity to change some things.”


“The public is engaged in a way that I have never seen before around children’s mental health,” he said.


A fractured system, opportunities for treatment Gardner says that access to


mental health coverage has increased dramatically because of the Affordable Care Act, and that “we can expect these resources to continue to grow.” But, he says, “We aren’t especially effective at systems in delivering services to children.”


He points to long waiting lists for


services – “Because we delay access to the system, [people] drop out,” he says – as well as the need to improve the quality of care.


And the need is high, especially


in California. Gardner says that mental health problems account for 85 percent of the disease burden for people between the ages of 15 and 25.


but new


Dr. Regan Foust, the data manager at the Lucile


Packard


Foundation for Children’s Health, agrees. In 2012, she said, mental diseases and disorders accounted for the largest share of hospital admissions among children under 18 in California – some 12 percent of all hospitaliza- tions. Statistics from kidsdata.org (the program that Foust manages) show that mental health problems are the most common primary diagnosis for a hospital stay for kids under 18, more common than bronchitis or fevers.


Depression in the very young Dr. Manpreet K. Singh, an


assistant professor at Stanford School of Medicine who works in the university’s Pediatric Mood Disorders Program, stressed the importance of parents and educators being able to recognize early warning signs. “These signs can be evident even as early as infancy and early childhood, especially if the child has been exposed to family stress, chaos, conflict, or trauma,” she said.


Young children who are depressed, she says, might withdraw from activities that are normally fun for them, easily anger or become irritable, have difficulty with relationships, or be extremely sensitive


to rejection


or failure as compared to other kids. They also might decline academically, have headaches or stomachaches that don’t respond to treatment, or change their eating or sleeping patterns. She cautions that depression tends to run in families and can transmit from parent to child.


Like Gardner, Singh is optimistic about the future of treatment. “We now know for a fact that [depression] is treatable in children,” she said.


A 19-year-old woman who spoke on the panel was one such person who was depressed from a young age. Lena’s parents are immigrants from China. Her biological father had another family in China; he brought them to the United States when she was 6 years old and kicked Lena and her mother out of the house.


“No one would acknowledge


me as family. That was very hard for me to deal with,” she said. “I really had nobody growing up … I asked, ‘Why didn’t I have a father? Why was everybody else so lucky?’ I realized I didn’t like doing things anymore. I had no interest in things.”


She went to a teacher when she was in 6th grade and asked to talk to a therapist. “I would cry through the entire session,” she said. She would often think about “What [she] was taught, how [she’s] not supposed to share anything.”


The stigma across cultures Katherine Kam, a journalist who


has reported on depression and suicide in Asian American adolescents, added that “Among parents, especially in traditional


immigrant households,


there’s not a lot of understanding about mental illness and about depression … Parents often rejected the diagnosis because they felt that it was a very embarrassing


diagnosis. shame to their families.” Counselors who work with


Asian American families told her that depression is often seen as a personal


It brought


Valerie Klinker (center), a NAM videographer, presents a short film as part of a panel on youth depression. On the left is Sonya Mann, and on the right are Amber Cavarlez and Robert Cervantez. (photo credit: Zoe Kaiser)


weakness or a moral failing in Asian cultures, and that if a person works hard enough he or she can overcome it.


Jeneé Darden, the and host of


Mental Health and Wellness Radio at P.E.E.R.S. in Oakland (Peers Envisioning


Engaging in


Recovery Services), spoke of a similar experience having depression in the African American community.


She would sometimes hear from


family and friends, “Black women are supposed to be strong, or depression is a white thing, that going to a therapist is a white thing.”


“I would hear, ‘You’re not praying


hard enough,’” she added. “Our first step to getting help is the pastor, is the church … [I would hear] ‘Don’t take your problems to the therapist, take them to Jesus.’”


Different ways of finding help


A 20-year-old Indian American woman going by “Leela” (she didn’t want her parents to know that she had spoken publicly about her experiences) recalled having been depressed for most


of her life. Her depression


worsened, though, after she was sexually assaulted in college.


“My tendency is to become


immobile, and I barricaded myself inside my dorm room for the rest of the year,” she said. “I did not leave. I told my parents that I was going to school but I was not.”


“When I tell my parents, I sort


of feel like I have to justify the way I’m feeling,” she said. “[I say] ‘I’m not doing well in school because I’m scared.’ ‘I’m not doing well in school because some days I cannot leave the house.’”


She says that what helped her was


finding other people who feel the way she does.


Robert Cervantez, 19, said that


talking about his depression doesn’t help. For him, it’s being a musician that helps him cope – it gives him “an outlet to express [his] depression and [his] anger.”


Sonya Mann, also 19, called herself “genetically unlucky” coming from a family with a strong history of mental illness. She feels lucky to have had professional medical support while she was growing up, but she continues to feel shame over her depression: “Even though I’ve been told so many times that it’s not my fault, that’s it’s not a personal weakness … I don’t believe that it’s not my fault.”


She’s had to come to terms with the fact that she will likely have to manage her depression all her life. She agrees that it’s treatable, she says, but “I don’t think it’s curable. It’s something you have that you learn how to deal with.”


New ways of


looking to the future Rob Gitin,


youth, thinking, the said


reaches that


and


and executive director of At The Crossroads, which homeless


to current


trends around the way services are delivered need to change.


conditional, are


“Services are becoming more more


outcome-focused,


shorter-termed and more disciplined,” he said.


When kids act out in ways that consistent


with symptoms youth depression, such as of skipping


school and getting into fights, “These are things that will get you kicked out programs,” he said. “You’re not doing what you’re told to, you’re being with


violent, you’re not engaging services.” In their search


for


evidence-based results, programs end up shutting out the kids who need help the most, because those kids don’t live up to strict expectations.


And, he says, the outlook of many service providers needs to change.


“I think that a lot of the time the


people doing the work make a mistake. They think that it is your job to make people feel better. It’s not your job to make people feel better, it’s your job to make people feel okay about however they’re feeling,” he says. “If you try to do that all you’re going to do is force them to deny their feelings and suppress whatever they’re going through.”


“There is no model on how you


help people,” he adds. “How you help people is you listen to them, you get to know them as an individual. You learn what’s great about them and what’s awful about them, and you help them accept whoever they are and help them figure out who they want to be.”


supervisor of the South County Youth Team at


Ziomara Ochoa, LMFT, is the Behavioral


Health


and Recovery Services in San Mateo. She primarily provides services to a Latino population, many of whom are immigrants or undocumented. Her work, she says, is moving from a focus on treatment into the realm of prevention, with programs like Mental Health First Aid, a public education


YOUTH DEPRESSION PAGE 11


co-founder out


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