So young, so sad, so listen - Relaunched
By Royal College of Psychiatrists
Sep 2, 2005, 02:33

The Royal College of Psychiatrists is relaunching this highly popular cartoon-illustrated* book, first published in 1995, with a new Foreword by Philip Pullman, acclaimed author of the trilogy His Dark Materials and other works.

So Young, So Sad, So Listen was written for parents and teachers of young people with depression. The authors hope that social workers, health visitors and family doctors will also find it useful, as well as some teenagers themselves.

The aim of the book is to help those involved to recognise the signs of depression in the young and to understand the possible causes. The authors, psychiatrist Philip Graham and psychotherapist Carol Hughes, provide practical advice and information about the wide range of help and support available.

In his Foreword Philip Pullman describes depression as "a savage and merciless disease". "Whatever the cause and wherever it comes from, if depression strikes you when you're young it strikes very hard indeed."

Around 5 in 100 teenagers in the UK are seriously depressed, and at least twice that number show significant distress. In troubled inner-city areas, the level of depression among the young may be twice this. As many as 2 or 3 girls in every 100 make a suicide attempt at some time during their teenage years.

Carol Hughes underlines the importance of listening to the young person with depression. "Try listening with the heart and not just the ears... Behind every attention-seeker is a real problem that perhaps the child needs to dramatise in order to ensure an audience."

She gives some basic ideas on how to be emotionally available to young people (which is a surprisingly difficult task), and advises on how to access further specialist help if home, school and GP support prove not to be enough.

Carol Hughes also highlights the difficult area of 'secrets' or 'confidentiality', where for instance a young person begs a well-meaning friend to keep quiet about their depression. This can be a potentially very dangerous position to be in, with the confidante becoming isolated, out of their depth and overwhelmed perhaps with secret details of suicidal intentions.

So Young, So Sad, So Listen reviews the range of talking treatments available, from cognitive-behavioural therapy to family or group therapy, and individual psychoanalytic psychotherapy. Although physical treatments are usually less important than talking treatments, they are sometimes helpful and can occasionally turn out to be the most important part of the treatment.

There have been a number of concerns aired publicly about giving young people antidepressant tablets or other drugs used to treat depression in adults. Prof. Graham outlines the limited but definite place of medication in treating depression in the young, always taking into account the need for very careful monitoring.

What happens to depressed children and young people? Some, with milder forms of depression, will improve over weeks or months, especially if their problems are recognised and they receive sympathetic help. More serious forms of depression may not fare as well, and perhaps as many of half of those will go into adult life with a high likelihood of recurrence.

But the authors conclude that there is always much that can be done to help a depressed child or teenager, as well as other members of the family.

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