Depression (low mood)

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.

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

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 to tell someone so that a safety plan that supports the 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.

Top Tips
1

It is important to tell someone how you are feeling so that you are not alone. You could talk to a parent/ carer, teacher, health professional (school nurse or your GP). This is particularly important if you are having thoughts or urges to harm yourself or end your life.

If you are feeling unsafe or in crisis, click on the red ‘Help I’m in Crisis’ button at the top right hand corner of the page.

2

Following a basic daily routine and making sure that you still do the activities you need to do and do some other activities that you used to enjoy but have perhaps stopped doing because you are feeling depressed. Plan activities for the morning, afternoon and evening and try to stick to these even if you do not feel like it. Avoiding or withdrawing from activity is known to lower mood so make sure that you see friends, go to school/ college, do things you enjoy (or used to).

3

Look after yourself; eat well, sleep, get some fresh air daily, do exercise and avoid self-medication (for example using alcohol, drugs or caffeine).

4

YoungMinds crisis messenger

This service provides free, 24/7 crisis support across the UK. If you are experiencing a mental health crisis and need support, you can text YM to 85258.

They will listen to you and help you think through how you’re feeling, and will aim to help you take the next steps towards feeling better.

Texts are free from EE, O2, Vodafone, 3, Virgin Mobile, BT Mobile, GiffGaff, Tesco Mobile and Telecom Plus.

CAMHS Depression (low mood) Referral Guidance

 What we do, what we don’t do and what you can do if you are worried about your child

All young people will feel low in mood from time to time. Here’s a guide to help you know how best to support your young person if they are experience symptoms of low mood or depression. This is not an exhaustive list; young people will experience other types of mood issue and symptoms which may not be included on this guide

Mild

These are experiences of low mood that most young people will have from time to time

Type and nature of mood issue

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

Things to try, support and Next Steps

  • Normalise that feeling sad or down is a natural emotion particularly in response to a sad, disappointing or difficult event
  • Activity helps; encourage a young person to do a range of tasks and activities including one they need to do such as school work to fun things.
  • Keep a routine and have nice things planned
  • Break things down into small steps and do one at a time so tasks do not seem so overwhelming
  • Use distraction techniques, here are some strategies to try;

A-Z of coping strategies: https://youtu.be/5EXpkVw3fh

How to make and use a coping box: https://youtu.be/OyfgodSSdV4

  • Role model and demonstrate that you can do things even when you’re feeling sad or down
  • Be compassionate by validating how a young person is feeling
  • Support a young person to problem solve any obvious triggers
  • Watch our parent/ carer workshop on Coping and Resilience Skills here:  (to be uploaded)

Useful Resources:

  • Stuff That Sucks, by Ben Sedley

Needs Some Support

These are episodes of low mood/ depression that some young people experience and may need some support with

Type and nature of mood issue

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 Green, 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.

Things to try, support and Next Steps

As well as the steps in Green the following might be helpful:

  • Support your young person to access self-help resources (podcasts, videos, downloads, links) on the Hampshire CAMHS website: www.hampshirecamhs.nhs.uk
  • Watch our parent/ carer workshop on how to support a young person with self-harm or in crisis here: https://youtu.be/qBAZQVjSmQU
  • Share concerns with your child’s school/ college
  • See your child’s GP
  • Access pastoral support from school
  • Consider accessing help from a local counselling service
  • Seek advice, guidance and support from Young Minds Parent Helpline:

08088025544

  • Depending on the context and/ or the origins of the low mood being experienced, other services may be helpful e.g., family guidance if there is family breakdown or conflict

Useful Resources:

  • Stuff That Sucks, by Ben Shelly
  • Am I Depressed? And What Can I Do About It? by Shirley Reynolds and Monika Parkinson
  • Beyond The Blues; A Workbook To Help Teens Overcome Depression, by Lisa Schab
  • Stopping The Pain; A Workbook For Young People Who Cut and Self-Injure, by Lawrence Shapiro

High Level

These are episodes of depression and crisis that cause a significant impact and a young person may need specialist support for

Type and nature of mood issue

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/ cause/ contributory factor 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 Green and Amber, 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.

Things to try, support and Next Steps

As well as the steps in Green and Amber the following might be helpful:

  • Speak with your child’s GP
  • Speak with the School Nursing Team
  • Depending on the context and/ or the origins of the low mood/ depression being experienced, other services may be helpful. There may be a role for other services such as Children’s Services or other statutory or voluntary organisations that can support if there are clear triggers for anxiety e.g., abuse, domestic violence, bullying, being a young carer etc.
  • Seek advice, guidance and support from Young Minds Parent Helpline:

08088025544

  • Access the “Help I’m in Crisis” Button on our website during times of stress
  • Consider making a self-referral to a CAMHS Service. If your young person is at risk of harm, please make this clear when making the referral.

Useful Resources:

  • Stuff That Sucks, by Ben Edley
  • Am I Depressed? And What Can I Do About It? by Shirley Reynolds and Monika Parkinson
  • Beyond The Blues; A Workbook To Help Teens Overcome Depression, by Lisa Schab
  • Stopping The Pain; A Workbook For Young People Who Cut and Self-Injure,  by Lawrence Shapiro
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Watch: Previous Next Video 1 of 4

  • I had a black dog, his name was depression - credit World Health Organization
  • Supporting a young person with depression in crisis who may self-harm
  • A-Z Coping Strategy
  • Coping box
  • I had a black dog, his name was depression - credit World Health Organization
  • Supporting a young person with depression in crisis who may self-harm
  • A-Z Coping Strategy
  • Coping box