A form of therapy that uses activity to fight depression

Writer: Heather Artushin

Clinical Expert: Kimberly Alexander, PsyD

What You'll Learn

- What is behavioral activation?

- Why is it important to help kids identify activities they value?

- How does sticking to a schedule of activities help kids who are depressed feel better?

- Quick Read

- Full Article

- What is behavioral activation?

- Two approaches to behavioral activation

- How is behavioral activation implemented?

- A case study in behavioral activation

- Challenges in implementing behavioral activation

When kids are depressed, they often withdraw from activities that they usually enjoy. And missing out on things that make them feel good — spending a lot of time alone in their room instead of seeing friends, for example — makes their mood even more negative.

One technique therapists use to fight depression is called behavioral activation or BA. Behavioral activation is based on the idea that getting depressed kids to do things — even though they may not feel like doing them — can improve their mood.

In BA therapists work with the child or teenager to identify things they value doing, and steps they would need to take to do those things. These steps can be as simple as getting out of bed on time in order to go to school, or texting a friend. The child and the therapist make a detailed schedule for the child’s activities, and parents are enlisted to help make sure the schedule is followed.

Identifying what they value helps kids see how withdrawal and avoidance are not working for them, and how small steps towards goals that reflect those values can make them feel better.

BA can work for teenagers and kids as young as 7, though younger children usually need more support from parents to make and stick to the schedule. Sometimes rewards are used to help motivate kids to go through with activities.

When a child or teen is depressed, avoidance is often a symptom. Skipping family or social events, not being able to find the energy to get out of bed, neglecting school, passing on activities they used to enjoy: These are telltale signs that your child could be struggling with depression. And withdrawing from activities that normally make them feel good in turn reinforces their negative mood.

One technique therapists use to fight depression is called behavioral activation or BA. Behavioral activation is based on the idea that engaging depressed kids in activities — even though they may not feel like doing them — can improve their mood.

What is behavioral activation?

Behavioral activation involves working with a depressed person to increase activities that can reduce their depression. Research has shown that when someone engages in activities that generate positive feelings, the activities become intrinsically reinforcing, inspiring the person to do more of those things.

In BA, the therapist works with the child or teen to identify things they value and take steps towards those things they care about. “Let’s say you have a teenager who values spending time with their friends,” explains Kimberly Alexander, PsyD, a clinical psychologist at the Child Mind Institute. “But they’re so depressed they’re staying in bed, not going out, not responding to text messages, not engaging in social media. What we want to do is work with them on steps they need to take to get to be able to spend time with one of their preferred friends.”

Through focusing on the value they see in friendship, they might set goals like getting out of bed, taking a shower, and going to school where they will see their friends. “A goal might be to send just one text message today,” Dr. Alexander adds. “Or one text message in our session.”

Identifying their values helps kids see how withdrawal and avoidance are not working for them, and how small steps towards goals that align with those values — even if they’re as simple as getting out of bed and taking a shower — can make them feel better.

The therapist works with the child or teen, and their parents, to schedule activities. They also monitor how they’re doing on sticking to that schedule, and problem-solve together to resolve obstacles to increase their activity level.

Behavioral activation is often a component of broader treatment for depression or anxiety with cognitive behavioral therapy (CBT). But it has also been shown to be effective as a stand-alone treatment approach. BA is appropriate for children ages 7 and up, based on the individual child’s development and readiness. Readiness includes their ability to commit to engaging in treatment. “We have to gain the commitment from the patient to try,” explains Dr. Alexander, “or work on building commitment.”

How long does it take before a child doing BA experiences symptom relief? “I’ve seen change happen within about eight to 10 weeks of consistently meeting weekly and doing the work,” explains Dr. Alexander.

Two approaches to behavioral activation

There are two approaches to BA with distinct nuances. The first approach, called Behavioral Activation Treatment for Depression (BATD), is briefer, estimated to take 10-12 weeks. It emphasizes clarifying the child’s values, then basing activity goals on what matters most to the child. One child might value getting good grades, while another might value having friends who accept them for who they are.

Dr. Alexander notes, for instance, that for a transgender teen, being recognized as the gender they identify as can be an important value. “They often feel depressed whenever someone misgenders them. So for that teen, it would make sense to take steps towards having friendships with people who are gender affirming.”

By contrast, the second approach, traditional behavioral activation, typically includes something called a functional behavioral analysis (FBA). That’s a technique for analyzing things the child is avoiding — things they need to do, like getting ready for school on time in the morning, and things that they once enjoyed, like playing basketball with their friends — to see what may be contributing to the avoidance. The therapist gathers information about what happens before the avoidant behavior occurs as well as what could be reinforcing it — making the behavior reoccur in the future. For example, the therapist might notice that when the child refuses to get out of bed, a parent will come and sit with them until they do, providing attention that the child might seek out again the next day. By understanding the function of the behavior, the therapist can make a plan to help change it.

How is behavioral activation implemented?

Here is what you might expect during a child’s course of treatment with behavioral activation.

- Reflect on daily activities: BA begins with what is known as activity scheduling. The child or teen will work with the therapist and support from parents, to outline what their daily schedule looks like currently, from the time they wake up in the morning to the time they go to sleep at night.

- Identify activity goals: The therapist and child or teen work together to identify activities that they’re interested in, whether they are new activities or things that they used to do in the past, as well as steps to move toward those goals. In many cases, a step towards the things they value involves getting out of bed when the alarm clock goes off. “When I’m working with teens,” says Dr. Alexander, “I really want to tap into what the teen’s personal interests are.”

- Create a written plan: Dr. Alexander comes prepared with a printed daily schedule and invites the child or teen to write in their activities for each hour block throughout the day. Older kids may prefer to use the calendar or notes app on their phone. The important piece is getting the plan down clearly in writing, and then sharing it with parents for accountability and monitoring.

- Build skills needed for success: It’s important to note any skills that need to be developed in order for the child to be successful in carrying out their activity goals. “If one of the things the child needs to do is complete reading assignments, and the child is dyslexic,” Dr. Alexander explains, “the child will need some scaffolding. We have to figure out, is this book engaging enough? Is this book at their reading level? Do they need support or a reinforcer around that book in order to encourage their reading time?”

- Identify reinforcers: Using rewards can help motivate the child or teen to follow through with the desired behavior. For example, a parent could reward a child with extra screen time for engaging in a scheduled activity.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

A case study in behavioral activation

Harnessing the power of a child or teen’s personal interests can be the key to making BA most effective. When working with a 14-year-old girl with depression and suicidal ideation, Dr. Alexander discovered that her after-school activities were minimal. “She was actually experiencing a lot of conflicts with her peers in school and then after school, they weren’t interested in the same things that she was interested in. Her parents reported that she would stay in her room for hours on end.”

Dr. Alexander discovered that her patient loves basketball, but she had no one to play with and she didn’t want to go out by herself. The teen said that it was actually her dad who introduced her to basketball. “We were able to schedule time after school for her to shoot baskets with her dad,” Dr. Alexander says, “and having this to look forward to at the end of the day helped her get out of bed and go to school. She admitted that she didn’t even enjoy spending all day in bed, and her mood improved.”

Challenges in implementing behavioral activation

Sometimes underlying beliefs emerge as a challenge that stands in the way of a child or teen successfully meeting their activity goals. Dr. Alexander has noticed a fear of failure in some clients that makes the word “goal” aversive. “I’ve definitely had some patients tell me, ‘I don’t like the word goal. To me, it triggers a sense of failure, that I will likely not accomplish what it is that I’m setting out to do. And what if I don’t? What would that mean about me?’”

Dr. Alexander responds by reframing the thinking to what she calls “a growth mindset” that recognizes progress. “For example, I might say, ‘If you did a minute out of 30 minutes of reading, that’s not failing. That is a minute, and that is more than what you did yesterday,’ ” she says. Finding another word to replace “goal” can also be powerful. Dr. Alexander has used the term “guided intention” to help clients to feel more supported by the language being used.

Another important factor to consider is whether or not the family has the time and resources to support BA. “We also have to consider how feasible it is for the patient to access the resources they need for whatever the activities are,” explains Dr. Alexander. “If their parents are very busy, working multiple jobs and therefore may not be available at times when their support would be helpful — all of those other factors have to be considered in the treatment planning phase.”

Frequently Asked Questions

What is Behavioral Activation?

Behavioral Activation is a form of therapy that uses activity to fight depression.

How does Behavioral Activation work?

How does Behavioral Activation help depressed kids? https://standingabovethecrowd.com/?p=16335

James Donaldson on Mental Health - What Is Behavioral Activation?

A form of therapy that uses activity to fight depression

Writer: Heather Artushin

Clinical Expert: Kimberly Alexander, PsyD

What You'll Learn

- What is behavioral activation?
- Why is it important to help kids identify activities they value?
- How does sticking to a schedule of activities help kids who are depressed feel better?
- Quick Read
- Full Article
- What is behavioral activation?
- Two approaches to behavioral activation
- How is behavioral activation implemented?
- A case study in behavioral activation
- Challenges in implementing behavioral activation

When kids are depressed, they often withdraw from activities that they usually enjoy. And missing out on things that make them feel good — spending a lot of time alone in their room instead of seeing friends, for example — makes their mood even more negative.

One technique therapists use to fight depression is called behavioral activation or BA. Behavioral activation is based on the idea that getting depressed kids to do things — even though they may not feel like doing them — can improve their mood.

In BA therapists work with the child or teenager to identify things they value doing, and steps they would need to take to do those things. These steps can be as simple as getting out of bed on time in order to go to school, or texting a friend. The child and the therapist make a detailed schedule for the child’s activities, and parents are enlisted to help make sure the schedule is followed.

Identifying what they value helps kids see how withdrawal and avoidance are not working for them, and how small steps towards goals that reflect those values can make them feel better.

BA can work for teenagers and kids as young as 7, though younger children usually need more support from parents to make and stick to the schedule. Sometimes rewards are used to help motivate kids to go through with activities.

When a child or teen is depressed, avoidance is often a symptom. Skipping family or social events, not being able to find the energy to get out of bed, neglecting school, passing on activities they used to enjoy: These are telltale signs that your child could be struggling with depression. And withdrawing from activities that normally make them feel good in turn reinforces their negative mood.

One technique therapists use to fight depression is called behavioral activation or BA. Behavioral activation is based on the idea that engaging depressed kids in activities — even though they may not feel like doing them — can improve their mood.

What is behavioral activation?

Behavioral activation involves working with a depressed person to increase activities that can reduce their depression. Research has shown that when someone engages in activities that generate positive feelings, the activities become intrinsically reinforcing, inspiring the person to do more of those things.

In BA, the therapist works with the child or teen to identify things they value and take steps towards those things they care about. “Let’s say you have a teenager who values spending time with their friends,” explains Kimberly Alexander, PsyD, a clinical psychologist at the Child Mind Institute. “But they’re so depressed they’re staying in bed, not going out, not responding to text messages, not engaging in social media. What we want to do is work with them on steps they need to take to get to be able to spend time with one of their preferred friends.”

Through focusing on the value they see in friendship, they might set goals like getting out of bed, taking a shower, and going to school where they will see their friends. “A goal might be to send just one text message today,” Dr. Alexander adds. “Or one text message in our session.”

Identifying their values helps kids see how withdrawal and avoidance are not working for them, and how small steps towards goals that align with those values — even if they’re as simple as getting out of bed and taking a shower — can make them feel better.

The therapist works with the child or teen, and their parents, to schedule activities. They also monitor how they’re doing on sticking to that schedule, and problem-solve together to resolve obstacles to increase their activity level.

Behavioral activation is often a component of broader treatment for depression or anxiety with cognitive behavioral therapy (CBT). But it has also been shown to be effective as a stand-alone treatment approach. BA is appropriate for children ages 7 and up, based on the individual child’s development and readiness. Readiness includes their ability to commit to engaging in treatment. “We have to gain the commitment from the patient to try,” explains Dr. Alexander, “or work on building commitment.”

How long does it take before a child doing BA experiences symptom relief? “I’ve seen change happen within about eight to 10 weeks of consistently meeting weekly and doing the work,” explains Dr. Alexander.

Two approaches to behavioral activation

There are two approaches to BA with distinct nuances. The first approach, called Behavioral Activation Treatment for Depression (BATD), is briefer, estimated to take 10-12 weeks. It emphasizes clarifying the child’s values, then basing activity goals on what matters most to the child. One child might value getting good grades, while another might value having friends who accept them for who they are.

Dr. Alexander notes, for instance, that for a transgender teen, being recognized as the gender they identify as can be an important value. “They often feel depressed whenever someone misgenders them. So for that teen, it would make sense to take steps towards having friendships with people who are gender affirming.”

By contrast, the second approach, traditional behavioral activation, typically includes something called a functional behavioral analysis (FBA). That’s a technique for analyzing things the child is avoiding — things they need to do, like getting ready for school on time in the morning, and things that they once enjoyed, like playing basketball with their friends — to see what may be contributing to the avoidance. The therapist gathers information about what happens before the avoidant behavior occurs as well as what could be reinforcing it — making the behavior reoccur in the future. For example, the therapist might notice that when the child refuses to get out of bed, a parent will come and sit with them until they do, providing attention that the child might seek out again the next day. By understanding the function of the behavior, the therapist can make a plan to help change it.

How is behavioral activation implemented?

Here is what you might expect during a child’s course of treatment with behavioral activation.

- Reflect on daily activities: BA begins with what is known as activity scheduling. The child or teen will work with the therapist and support from parents, to outline what their daily schedule looks like currently, from the time they wake up in the morning to the time they go to sleep at night.
- Identify activity goals: The therapist and child or teen work together to identify activities that they’re interested in, whether they are new activities or things that they used to do in the past, as well as steps to move toward those goals. In many cases, a step towards the things they value involves getting out of bed when the alarm clock goes off. “When I’m working with teens,” says Dr. Alexander, “I really want to tap into what the teen’s personal interests are.”
- Create a written plan: Dr. Alexander comes prepared with a printed daily schedule and invites the child or teen to write in their activities for each hour block throughout the day. Older kids may prefer to use the calendar or notes app on their phone. The important piece is getting the plan down clearly in writing, and then sharing it with parents for accountability and monitoring.
- Build skills needed for success: It’s important to note any skills that need to be developed in order for the child to be successful in carrying out their activity goals. “If one of the things the child needs to do is complete reading assignments, and the child is dyslexic,” Dr. Alexander explains, “the child will need some scaffolding. We have to figure out, is this book engaging enough? Is this book at their reading level? Do they need support or a reinforcer around that book in order to encourage their reading time?”
- Identify reinforcers: Using rewards can help motivate the child or teen to follow through with the desired behavior. For example, a parent could reward a child with extra screen time for engaging in a scheduled activity.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

A case study in behavioral activation

Harnessing the power of a child or teen’s personal interests can be the key to making BA most effective. When working with a 14-year-old girl with depression and suicidal ideation, Dr. Alexander discovered that her after-school activities were minimal. “She was actually experiencing a lot of conflicts with her peers in school and then after school, they weren’t interested in the same things that she was interested in. Her parents reported that she would stay in her room for hours on end.”

Dr. Alexander discovered that her patient loves basketball, but she had no one to play with and she didn’t want to go out by herself. The teen said that it was actually her dad who introduced her to basketball. “We were able to schedule time after school for her to shoot baskets with her dad,” Dr. Alexander says, “and having this to look forward to at the end of the day helped her get out of bed and go to school. She admitted that she didn’t even enjoy spending all day in bed, and her mood improved.”

Challenges in implementing behavioral activation

Sometimes underlying beliefs emerge as a challenge that stands in the way of a child or teen successfully meeting their activity goals. Dr. Alexander has noticed a fear of failure in some clients that makes the word “goal” aversive. “I’ve definitely had some patients tell me, ‘I don’t like the word goal. To me, it triggers a sense of failure, that I will likely not accomplish what it is that I’m setting out to do. And what if I don’t? What would that mean about me?’”

Dr. Alexander responds by reframing the thinking to what she calls “a growth mindset” that recognizes progress. “For example, I might say, ‘If you did a minute out of 30 minutes of reading, that’s not failing. That is a minute, and that is more than what you did yesterday,’ ” she says. Finding another word to replace “goal” can also be powerful. Dr. Alexander has used the term “guided intention” to help clients to feel more supported by the language being used.

Another important factor to consider is whether or not the family has the time and resources to support BA. “We also have to consider how feasible it is for the patient to access the resources they need for whatever the activities are,” explains Dr. Alexander. “If their parents are very busy, working multiple jobs and therefore may not be available at times when their support would be helpful — all of those other factors have to be considered in the treatment planning phase.”

Frequently Asked Questions

What is Behavioral Activation?

Behavioral Activation is a form of therapy that uses activity to fight depression.

How does Behavioral Activation work?

How does Behavioral Activation help depressed kids?

https://standingabovethecrowd.com/james-donaldson-on-mental-health-what-is-behavioral-activation/

James Donaldson on Mental Health - How to Foster Resilience in Children and Adolescents

How to Foster Resilience in Children and Adolescents

In today's fast-paced and often unpredictable world, building resilience in children and adolescents is more important than ever. Resilience is the ability to navigate through challenges and bounce back from setbacks. As parents, educators, and caregivers, it's essential to equip the younger generation with the skills they need to thrive in the face of adversity. This blog post will explore practical ways to foster resilience in children and adolescents, helping them grow into well-rounded and emotionally strong individuals.

Table of Contents

1. Introduction

2. Understanding Resilience

3. Creating a Supportive Environment

4. Encouraging Positive Relationships

5. Teaching Problem-Solving Skills

6. Promoting Emotional Awareness

7. Building Self-Esteem and Confidence

8. Conclusion

9. FAQs

Understanding Resilience

Resilience is not a trait that children are born with; rather, it is a skill that can be developed over time. It involves a combination of internal strengths and external resources. Children who are resilient are better equipped to handle stress and recover from difficulties. Understanding the concept of resilience is the first step in helping children develop this crucial life skill.

Creating a Supportive Environment

A nurturing and secure environment is the foundation of resilience. Children need to feel safe, both physically and emotionally, to explore and take risks. Consistent routines, clear expectations, and a loving atmosphere provide the stability that children need to build resilience. Encourage open communication and let children know that they can rely on you for support and guidance.

Encouraging Positive Relationships

Building strong, positive relationships is key to fostering resilience. Encourage children to form connections with family members, peers, and mentors. These relationships provide a support network that children can turn to in times of need. Teach children the importance of empathy, active listening, and cooperation, which are all essential skills for maintaining healthy relationships.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Teaching Problem-Solving Skills

Problem-solving skills are vital for resilience. Children who learn how to identify problems, brainstorm solutions, and evaluate outcomes are better prepared to handle challenges. Encourage children to think critically and independently, and guide them through the problem-solving process. Celebrate their successes and help them learn from their mistakes, fostering a growth mindset.

Promoting Emotional Awareness

Helping children understand and manage their emotions is crucial for resilience. Teach them to recognize and label their emotions, and provide strategies for coping with difficult feelings. Encourage children to express themselves through words, art, or other creative outlets. Emotional awareness helps children build self-regulation skills, which are essential for navigating challenges.

Building Self-Esteem and Confidence

Children with high self-esteem and confidence are more resilient. Praise children's efforts and accomplishments, and encourage them to set realistic goals. Provide opportunities for them to succeed and build their confidence. Help them understand that failure is a part of learning and growth, and encourage them to persevere despite setbacks.

Conclusion

Fostering resilience in children and adolescents is a rewarding journey that requires patience, understanding, and commitment. By creating a supportive environment, encouraging positive relationships, teaching problem-solving skills, promoting emotional awareness, and building self-esteem, we can equip the younger generation with the tools they need to thrive in any situation. As they grow, resilient children and adolescents become resilient adults, ready to face the world with confidence and courage.

FAQs

Q: Can resilience be taught at any age?

A: Yes, resilience can be developed at any age. While it's beneficial to start early, older children and even adults can learn and strengthen their resilience skills.

Q: What role do schools play in building resilience?

A: Schools play a significant role by providing a supportive and inclusive environment, teaching essential life skills, and offering extracurricular activities that encourage teamwork and problem-solving.

Q: How can I help my child if they are struggling to develop resilience?

A: Be patient and supportive, and provide opportunities for them to face challenges in a safe environment. Encourage them to talk about their feelings and seek professional help if necessary.

Q: How do I know if my child is resilient?

A: Resilient children typically exhibit self-confidence, effective problem-solving skills, emotional awareness, and the ability to form positive relationships. They are also able to adapt to change and handle stress effectively.

https://standingabovethecrowd.com/how-to-foster-resilience-in-children-and-adolescents/

James Donaldson on Mental Health - Should parents force kids with depression to do things they don't want to do?

Writer: Jill Emanuele, PhD

Clinical Expert: Jill Emanuele, PhD

Question

My daughter is a bright person with a high GPA taking advanced courses. She is very hard on herself and has been diagnosed with major depressive disorder. She is in treatment taking medication and seeing a therapist. Even with all the support of us (her parents), her school and the medical professionals, she is still not feeling like it is helping. Today, in fact, she almost refused to go to school. Because she has missed so much school already I had to tell her a white lie and let her know that we were out of days she could miss school. My question is do you recommend forcing children with depression to do things they don't want to do? Do you let them stay home and rest for that day they are having their meltdown or do you encourage what I did — to do what you need to do to get them to where they need to be?

When a child is struggling with major depressive disorder, it is stressful and upsetting for not only the person going through it, but also their family members. I can imagine how difficult this is for all of you. It is great that you have already gotten your daughter into treatment, which is a major step in dealing with depression.

People with depression exhibit a host of concerning symptoms including sad mood, lack of energy, poor concentration, and low motivation. Because of this it is not uncommon for kids with depression to not want to go to school. We don’t often recommend “forcing” children to do things they don’t want to do. That being said, we strongly and consistently encourage kids with depression to go to school every day, despite how bad they are feeling, because we know that when a person with depression remains active, it actually can help improve her mood or at the very least keeps it from going down further. On the contrary, if a child with depression avoids her regular activities, including school, it can contribute to the depression increasing in severity.

Looking at your particular situation, when your daughter has a “meltdown” in the midst of the struggle, it is particularly important for your daughter to still go to school because you don’t want to teach her that having a meltdown will allow her to stay home from school. So, in general, without knowing the particulars of your specific situation, you did the right thing in having her go. In addition, part of the work in treatment is to learn about what helps fight depression and to build an honest dialogue between you and your daughter so that you don’t feel that you have to tell a white lie to get her to go.

To help fight depression, try to encourage your daughter to be active in general. She doesn’t necessarily have to be physically active, but anything that sparks her mind or interest is a good thing. Engaging with her in a discussion or a game, for example, can be helpful. We want to keep kids with depression from lying in bed and not doing anything or staring at a screen for hours. This is called behavioral activation and is actually one of the parts of treatment for depression. So remind your daughter that staying active is a way of battling depression, and that you are supporting her in every way possible.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Without knowing the details of your daughter’s symptoms, I also wanted to note that when I hear of kids maintaining such a high average in the course of depression, I wonder if they may also be struggling with anxiety. Anxiety often occurs with depression and sometimes may even be the trigger for it. If your daughter is struggling with anxiety that is not being addressed in treatment, it may be one of the reasons why she isn’t getting better. If she hasn’t had a comprehensive diagnostic evaluation yet, you may want to have one performed to see if she is also struggling with anxiety.

Finally, cognitive behavior therapy (CBT) is the recommended and evidence-based treatment for adolescents with both depression and anxiety, so hopefully your daughter is engaging in CBT, as well as behavioral activation, with her therapist.

https://standingabovethecrowd.com/james-donaldson-on-mental-health-should-parents-force-kids-with-depression-to-do-things-they-dont-want-to-do/

James Donaldson on Mental Health - The Role of Laughter in Mental Health and Well-Being

Laughter is often described as the best medicine, but how true is that statement? In today’s fast-paced world, where stress and anxiety seem to lurk around every corner, understanding the role of laughter in mental health and well-being is more important than ever. This blog post delves into the profound impact laughter has on our mental health, its benefits, and how we can incorporate more of it into our daily lives for a healthier mind.

Table of Contents

1. Introduction

2. The Science Behind Laughter

3. Laughter and Stress Reduction

4. Boosting Mood and Enhancing Relationships

5. Laughter Therapy and Its Applications

6. How to Incorporate More Laughter into Your Life

7. Conclusion

8. FAQs

The Science Behind Laughter

At its core, laughter is a physiological response to humor. It’s a universal language, transcending cultures and borders. When we laugh, our brain releases a cocktail of chemicals, including endorphins, which are natural mood lifters. These endorphins interact with the receptors in our brain to reduce the perception of pain and induce a sense of euphoria.

Furthermore, laughter activates the ventromedial prefrontal cortex, which is responsible for producing feelings of reward and pleasure. This explains why a hearty laugh can make us feel so good, almost instantly.

Laughter and Stress Reduction

Stress is an inevitable part of life, but laughter is a powerful antidote. When we laugh, our body goes through physiological changes that can help reduce stress. The act of laughing increases our intake of oxygen-rich air, stimulates the heart, lungs, and muscles, and increases the endorphins released by the brain.

Additionally, laughter cools down your stress response. It can increase and then decrease your heart rate and blood pressure, resulting in a relaxed feeling. It’s like a mini workout for the body, without the sweat, and the effects can last for up to 45 minutes after the laughter subsides.

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle
Find out more about the work I do on my 501c3 non-profit foundation
website www.yourgiftoflife.org Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Boosting Mood and Enhancing Relationships

Laughter is a social magnet. It draws people together and fosters emotional connections. Sharing a good laugh with someone can strengthen relationships, build trust, and create a sense of belonging. In groups, laughter can diffuse tension, promote cooperation, and foster a positive environment.

Moreover, laughter shifts perspective, allowing us to see situations in a less threatening light. This cognitive shift can lead to a more optimistic outlook and increased resilience against challenges. It’s no wonder that laughter is often used in team-building exercises and conflict resolution scenarios.

Laughter Therapy and Its Applications

Laughter therapy, also known as humor therapy, is gaining popularity as a complementary treatment for various mental health issues. This therapy involves the use of humor to promote overall health and wellness, alleviate pain, and reduce stress.

Research has shown that laughter therapy can improve mental health in individuals suffering from depression, anxiety, and chronic stress. It encourages patients to laugh openly, which in turn helps them to express emotions, release pent-up feelings, and improve their mood.

How to Incorporate More Laughter into Your Life

Adding more laughter to your life doesn’t have to be complicated. Here are a few simple ways to bring more joy and laughter into your daily routine:

1. Surround yourself with people who make you laugh. Engage with friends or family members who have a good sense of humor.

2. Watch comedy shows or movies that tickle your funny bone.

3. Follow comedians and humor writers on social media for a daily dose of laughter.

4. Attend a laughter yoga class, which combines laughter exercises with yoga breathing techniques.

5. Don’t take life too seriously. Allow yourself to find humor in everyday situations.

Conclusion

Laughter is more than just a reaction to a joke; it's a profound tool for enhancing mental health and well-being. By understanding and harnessing the power of laughter, we can reduce stress, improve our mood, and strengthen our relationships. So, go ahead, giggle, chuckle, or let out a hearty belly laugh. Your mind and body will thank you for it.

FAQs

Q: Can laughter really improve mental health?

A: Yes, laughter can reduce stress, improve mood, and enhance emotional connections, all of which contribute to better mental health.

Q: Is laughter therapy effective?

A: Laughter therapy has been shown to be effective in reducing symptoms of depression, anxiety, and stress, and is used as a complementary treatment in various settings.

Q: How can I laugh more in my daily life?

A: Surround yourself with humorous people, watch comedies, attend laughter yoga classes, and follow comedians on social media to incorporate more laughter into your routine.

https://standingabovethecrowd.com/the-role-of-laughter-in-mental-health-and-well-being/

Writer: Jill Emanuele, PhD

Clinical Expert: Jill Emanuele, PhD

Question

My daughter is a bright person with a high GPA taking advanced courses. She is very hard on herself and has been diagnosed with major depressive disorder. She is in treatment taking medication and seeing a therapist. Even with all the support of us (her parents), her school and the medical professionals, she is still not feeling like it is helping. Today, in fact, she almost refused to go to school. Because she has missed so much school already I had to tell her a white lie and let her know that we were out of days she could miss school. My question is do you recommend forcing children with depression to do things they don't want to do? Do you let them stay home and rest for that day they are having their meltdown or do you encourage what I did — to do what you need to do to get them to where they need to be?

When a child is struggling with major depressive disorder, it is stressful and upsetting for not only the person going through it, but also their family members. I can imagine how difficult this is for all of you. It is great that you have already gotten your daughter into treatment, which is a major step in dealing with depression.

People with depression exhibit a host of concerning symptoms including sad mood, lack of energy, poor concentration, and low motivation. Because of this it is not uncommon for kids with depression to not want to go to school. We don’t often recommend “forcing” children to do things they don’t want to do. That being said, we strongly and consistently encourage kids with depression to go to school every day, despite how bad they are feeling, because we know that when a person with depression remains active, it actually can help improve her mood or at the very least keeps it from going down further. On the contrary, if a child with depression avoids her regular activities, including school, it can contribute to the depression increasing in severity.

Looking at your particular situation, when your daughter has a “meltdown” in the midst of the struggle, it is particularly important for your daughter to still go to school because you don’t want to teach her that having a meltdown will allow her to stay home from school. So, in general, without knowing the particulars of your specific situation, you did the right thing in having her go. In addition, part of the work in treatment is to learn about what helps fight depression and to build an honest dialogue between you and your daughter so that you don’t feel that you have to tell a white lie to get her to go.

To help fight depression, try to encourage your daughter to be active in general. She doesn’t necessarily have to be physically active, but anything that sparks her mind or interest is a good thing. Engaging with her in a discussion or a game, for example, can be helpful. We want to keep kids with depression from lying in bed and not doing anything or staring at a screen for hours. This is called behavioral activation and is actually one of the parts of treatment for depression. So remind your daughter that staying active is a way of battling depression, and that you are supporting her in every way possible.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Without knowing the details of your daughter’s symptoms, I also wanted to note that when I hear of kids maintaining such a high average in the course of depression, I wonder if they may also be struggling with anxiety. Anxiety often occurs with depression and sometimes may even be the trigger for it. If your daughter is struggling with anxiety that is not being addressed in treatment, it may be one of the reasons why she isn’t getting better. If she hasn’t had a comprehensive diagnostic evaluation yet, you may want to have one performed to see if she is also struggling with anxiety.

Finally, cognitive behavior therapy (CBT) is the recommended and evidence-based treatment for adolescents with both depression and anxiety, so hopefully your daughter is engaging in CBT, as well as behavioral activation, with her therapist. https://standingabovethecrowd.com/?p=16331

What parents need to know about therapy, medication and finding a good clinician

Writer: Rachel Ehmke

Clinical Experts: Jill Emanuele, PhD , Wendy Nash, MD

https://www.youtube.com/watch?v=BAR08BMELAk

What You'll Learn

- How does treatment for depression work?

- What kinds of therapy can treat depression?

- What kinds of medication can treat depression?

- Quick Read

- Full Article

- What to expect from a clinician

- Therapy for depression

- Cognitive behavioral therapy (CBT)

- Dialectical behavior therapy (DBT)

- Interpersonal psychotherapy (IPT)

- Mindfulness-based cognitive therapy (MBCT)

- Medication treatment

- Dosage and side effects

- Monitoring for suicidal thinking

- Going off medication

- Family involvement

Getting treatment for children with depression may seem daunting, but it really can help. Treatment for depression almost always involves therapy, and it can include medication as well.

The first step is finding the right clinician. Your child’s clinician should help you understand the treatment and take your questions seriously. It’s common for people with depression to be reluctant to try treatment, so it’s important for your child or teenager to comfortable with the clinician, too.

One of the most effective therapies for depression is cognitive behavioral therapy (CBT). CBT helps kids learn how their thoughts, feelings and behavior are connected. They learn to catch unhelpful thought patterns and build coping skills. For more severe depression, dialectical behavior therapy (DBT) can help kids learn to manage intense emotions. Interpersonal psychotherapy (IPT) and mindfulness-based cognitive therapy (MBCT) have also been shown to help teenagers and young adults with depression.

When therapy alone isn’t enough, kids can also take medication for depression. The most common medications for depression are called SSRIs (like Zoloft and Prozac) and SNRIs (like Strattera and Cymbalta). It’s very important for kids who take medication to work closely with a doctor. The doctor can make sure your child is taking the right amount and look out for any side effects.

Finally, it’s essential for the family to be involved in a child’s depression treatment. Parents can learn how to support their child and help them practice new skills at home. Having a child with depression can be hard on families, and getting support from the therapist often makes a big difference.

Getting treatment for depression can feel daunting. Often the depression itself gets in the way. A child who is depressed might be feeling overwhelmed, tired, and hopeless. They might also be unfairly blaming themselves or their circumstances for the way they feel. These are some of the characteristic symptoms and thoughts that accompany depression, and they can make it hard for someone who’s depressed to speak up and ask for help, or believe concerned parents when they say treatment for depression can help them.

But treatment can really help children and adolescents struggling with depression, including several different kinds of therapy and medication that have all been proven to be effective. Research shows that the most effective treatment is a combination of therapy and medication.

Wendy Nash, MD, a child and adolescent psychiatrist, says she considers therapy “nearly a requirement” when she is prescribing medication for depression, explaining that the skills taught in therapy are essential. Part of the advantage with therapy is that the skills children learn will always stay with them.

What to expect from a clinician

Having a good relationship with your child’s clinician is essential, because the more engaged and committed your child is in treatment, the more likely it is to be successful. A good clinician should make sure you understand the goals of treatment and make you feel like your questions are being taken seriously. You should also feel that you can be honest about how your child is doing.

Jill Emanuele, PhD, a clinical psychologist who specializes in mood disorders, says one of the first things she does with a new patient is try to establish a good rapport. “You get to know the person, you make them comfortable. You establish a safe space where you show them that you’re listening and you care. Often enough we’re the first person that’s actually listening to them in a way they haven’t experienced before, or have not experienced often.”

If a person is resistant to treatment, Dr. Emanuele says she tries to address that. “Maybe they’ve had a difficult experience with therapy before, or they don’t really trust adults, or perhaps they are shamed by their behavior or what they’re feeling, and they don’t want to show it to another person.”

If your child hasn’t received a formal diagnosis yet, their clinician should begin with an evaluation. This is to confirm that your child actually does have depression, and also to determine if they have another mental health or learning disorder as well. It isn’t that uncommon for kids with undiagnosed anxiety, ADHD, learning disorders and other issues to develop depression. If your child has multiple disorders, then their treatment plan should include getting help for all of them.

Therapy for depression

There are different kinds of therapy that are considered “evidence-based” for treating depression, which means that they have been studied and clinically proven to be effective. Here is a breakdown of some of them:

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy is the gold standard therapy for treating children and adolescents with depression. CBT works by giving people skills to cope with symptoms like depressed mood and unhelpful thoughts (like “no one likes me” or “things will always be like this”). In CBT the child and their therapist collaborate to meet set goals, like catching those unhelpful thought patterns and improving problem-solving ability.

Central to the treatment is teaching kids that their thoughts, feelings and behaviors are all interconnected, so changing one of these points can change all three. For example, one technique called “behavioral activation” encourages them to participate in activities and then observe the effect it has on their mood. In Dr. Emanuele’s words, “We set up a hierarchy of activities they can start to engage in. The idea is to get moving and active, so you not only get that physical momentum, but you also start to experience more positive thoughts from having success and interacting more with others.”

Behavioral activation helps counter the isolation that teenagers with depression often experience, which can reinforce their depressed mood.

Dialectical behavior therapy (DBT)

For teenagers with more severe depression, dialectical behavior therapy can be helpful. DBT is a form of CBT that was adapted for people who have trouble managing very painful emotions, and may engage in risky behavior, self-harm like cutting, and suicidal thoughts or attempts.

To manage intense emotions, people participating in DBT learn to practice mindfulness (being fully present in the moment and focusing on one thing at a time, without judgment) and develop problem solving skills like tolerating distress, handling difficult situations in a healthy way and interacting more effectively with friends and family. DBT is a highly structured treatment that includes individual therapy and skills groups. DBT for adolescents includes sessions with parents and their child learning skills together.

Interpersonal psychotherapy (IPT)

Social relationships can sometimes influence and even maintain depression. When a person is depressed their relationships can also suffer. Interpersonal therapy works by addressing a child’s relationships to make them more healthy and supportive. In this therapy children learn skills for better communicating their feelings and expectations, they build problem-solving skills for handling conflicts, and they learn to observe when their relationships might be impacting their mood.

IPT has been adapted for adolescents with depression to address common teen relationship concerns including romantic relationships and problems communicating with parents or peers. Called IPT-A, this specialized form ofinterpersonal therapy is typically a 12- to 16-week treatment. Parents will be asked to participate in some of the sessions.

Mindfulness-based cognitive therapy (MBCT)

While its efficacy is still being measured in adolescents, mindfulness-based cognitive therapy is another treatment that has been shown to work for young adults and adults with depression.

MBCT works by combining cognitive behavioral therapy (CBT) methods with mindfulness. Mindfulness teaches people to be fully present in the moment and observe their thoughts and feelings without judgment. This can help them interrupt undesirable thought patterns that can maintain or lead to a depressive episode, like being self-critical or fixating on negative things in ways that are not constructive.

MBCT was originally developed to help people with recurring episodes of depression, but it can also be used for treating a first episode of depression.

Medication treatment

Children and adolescents with depression can also benefit from medication, and clinicians often prescribe medication for more severe depression or when therapy alone isn’t providing effective treatment.

Medications most often prescribed to treat depression are selective serotonin reuptake inhibitors (SSRIs) like Zoloft, Prozac, and Lexapro, and serotonin-norepinephrine reuptake inhibitors (SNRIs) like Strattera and Cymbalta. These medications are also known as antidepressants. Your child’s clinician may also prescribe an a typical antidepressant like Wellbutrin.

Dr. Nash says that sometimes young people (and their families) are worried about taking medication for depression. People often worry that medication will change their personality, or they will feel “drugged.” They also worry that they might become addicted to the medication.

She takes these concerns seriously, and talks to patients and their families about what to expect. The right medication at the right dose won’t make a child feel drugged and it won’t change who he is, but it should help his symptoms of depression. She also explains that antidepressants are not addictive. “You don’t have an urge to take them, or seek them out to the detriment of your relationships,” she says. When it is time to stop taking antidepressants, it is uncommon for people to have ongoing symptoms of withdrawal if they taper off the medication carefully, and under the supervision of their doctor.

Dosage and side effects

It is rare for a person to stay on the same dose she is initially prescribed. Instead, doctors adjust dosage once every week or every two weeks in the beginning, as the medication builds up in the brain to reach an effective level. During this time your child’s clinician will ask questions about how she is tolerating the medication, including side effects she might be experiencing.

“Most uncomfortable side effects will present early,” says Dr. Nash. “I tell patients you might experience side effects before the desired effects.” Clinicians should stay in touch with families during these first several weeks, monitoring how children are feeling and providing guidance because, as Dr. Nash says, “It can be a hard time for patients, who might feel headaches orinsomnia, but not feel better yet.” She says the side effects can go away after one to two weeks.

It can take a while for a patient to start feeling the full effect of an antidepressant medication. “The medication might start to work at two to four weeks, but you can still be feeling more benefit at six weeks further out,” says Dr. Nash.

Monitoring for suicidal thinking

The Food and Drug Administration has issued a warning that children and adolescents taking some antidepressant medications may experience an increased risk of suicidal thoughts. Many studies have shown that the benefits of antidepressant medications outweigh the risks of going without treatment, so they are still prescribed to young people. To keep patients safe, a protocol has been developed for prescribing clinicians to help them closely monitor patients for any worsening in depression or emergence of suicidal thinking as they are adjusting to a new medication.

#James Donaldson notes:Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticleFind out more about the work I do on my 501c3 non-profit foundationwebsite www.yourgiftoflife.org Order your copy of James Donaldson's latest book,#CelebratingYourGiftofLife: From The Verge of Suicide to a Life of Purpose and Joy

Click Here For More Information About James Donaldson

Click here to follow James Donaldson's Blog

Going off medication

To avoid a recurrence of depression, Dr. Nash says it is a good idea to stay on medication for at least a year after a child has stopped feeling any symptoms of depression. She also warns that it is important to think about the “optimal” time to stop taking medication. For example, it isn’t a good idea to stop taking medication right before the SATs or when going off to college.

To avoid unpleasant side effects, your child shouldn’t stop taking medication cold turkey. Tapering off antidepressants gradually, with the guidance of a clinician who is monitoring them to make sure they are healthy, is important.

Family involvement

Both Dr. Nash and Dr. Emanuele emphasize that families should always be involved in the treatment of a child’s depression. “Part of treatment, especially in the beginning, is to teach parents about depression and how therapy works, says Dr. Emanuele. “It’s really important that parents understand the concepts behind the treatments so that they can coach their child, day-to-day, to use the skills that they’re learning.” Dr. Emanuele adds that parents often find that they benefit from learning the skills as well.

Clinicians can also be helpful in giving parents tips on interacting with a child with depression, which can sometimes be difficult. Children with depression might try to isolate themselves from family, or interpret even well-meaning parental concern as critical rather than loving. Knowing how to be supportive is important. Dr. Emanuele says that she helps parents develop a situation-specific plan to help them know when to lean in and when to back off. Clinicians can also give advice about fostering more positive interactions.

For parents who are struggling because of their child’s illness, getting this support can be a big relief. And, of course, as soon as a child starts feeling better, their parents will start feeling better, too.

Frequently Asked Questions

What is the most effective way to treat adolescent depression?

Treatment for adolescent depression almost always involves therapy and can include medication as well. One of the most effective therapies for depression is cognitive behavioral therapy (CBT). For more severe depression, dialectical behavior therapy (DBT) can help kids learn to manage intense emotions.

What are the best medications to treat adolescent depression?

Is it important for parents to be involved in treating their adolescent’s depression? https://standingabovethecrowd.com/?p=16329