Depression

Depression

 

Introduction

There are of course many forms of mental illness and many types of anxiety disorders.  This website cannot possibly address all of them.  However, depression is one of the most common  examples of an internalizing disorder and the discussion below is meant to be illustrative.  We could have  written similar pages on any of them — e.g.,  anxiety disorders, obsessive compulsive disorders, stressor-related disorders, bipolar disorders,  dissociative disorders, bulimia, and anorexia.  This list, too, is meant to be illustrative, not exhaustive.  

There continues to be what this reviewer perceives to be a paradox within educational circles.  Some believe (incorrectly) that there needs to be documentation of an internalizing disorder for a child to qualify as emotionally disturbed, while at the same time failing to recognize an internalizing disorder unless it manifests itself in socially unacceptable behavior.  The federal statutes recognize externalizing and internalizing disorders alike if the disorder is adversely affecting a child’s educational progress or has resulted in a substantial limitation in a major life activity.   

While it is also commonly believed that a child in public schools would only qualify for 504 protections and accommodations if the disability resulted in a substantial limitation in the major life activity of learning, that is also not the case.  Nothing in the American with Disabilities Act of 2008 suggests that a child’s right to protections is only triggered if the disability has resulted in a substantial limitation on the major life activity of learning.  The Office for Civil Rights was crystal clear in its Q and A on the ADAAA 2008.

 Is learning the only major life activity that a school district must consider in determining if a student has a disability under Section 504 and Title II?

A: No. A student has a disability under Section 504 and Title II if a major life activity is substantially limited by his or her impairment. Nothing in the ADA or Section 504 limits coverage or protection to those whose impairments concern learning. Learning is just one of a number of major life activities that should be considered in determining whether a student has a disability within the meaning of those laws. 28 C.F.R. § 35.104; 34 C.F.R. § 104.3(j)(2)(ii). Some examples include: (1) a student with a visual impairment who cannot read regular print with glasses is substantially limited in the major life activity of seeing; (2) a student with an orthopedic impairment who cannot walk is substantially limited in the major life activity of walking; and (3) a student with ulcerative colitis is substantially limited in the operation of a major bodily function, the digestive system. These students would have to be evaluated, as described in the Section 504 regulation, to determine whether they need special education or related services.

Scope of the Problem

The Science Daily (August 20, 2018) recently reported data from  The Anxiety and Depression Association of America that showed that as many as 2 to 3 percent of children ages 6-12 might have major depressive disorder. Now, researchers at the University of Missouri have found that children who show mild to severe symptoms of depression in second and third grades are six times more likely to have skill deficits, such as difficulties with social skills or academics, than children without symptoms. 

Although the legal implications for serving a child suffering from severe depression are discussed below, the fact that the suicide rate among children has been increasing cannot be ignored,  Mental Health America has provided estimates that the underlying disorder of depression is linked to 30 to 70 percent of suicides.  Although reported more often among adolescents, depression at any age can be devastating.  For additional information on depression and suicide, see our links below.   For our generic  resources on suicide prevention, see our Resources/Suicide Prevention page.

9 year old kills herself after being bullied  (11/17/2018)

 

Identifying Students with Depression

There are many warning signs that may indicate  a student is suffering from depression..   Aside from their potential for triggering civil and educational rights to appropriate services, many of those warning signs are the same that might be seen in a child thinking about suicide.  Therefore they should not and must not be ignored.  One handy chart from an online source is replicated below, but also see the references on Identification in the Resources and Help section at the bottom of this page.  Always remember that if a school suspects a child might have a disability entitling him or her to services under either the IDEA or Section 504, and if a school requires an evaluation to determine his eligibility, then the school must provide that evaluation at no cost to the parents.  

Source:  Association for Supervision and  Curriculum Development

Characteristics of Depression in Children	What It Looks Like in School
Physical/somatic complaints	Complaints of feeling sick, school absence, lack of participation, sleepiness
Irritability	Isolation from peers, problems with social skills, defiance
Difficulty concentrating on tasks/activities	Poor work completion
Short-term memory impairments	Forgetting to complete assignments, difficulty concentrating
Difficulties with planning, organizing, and executing tasks	Refusing to complete work, missing deadlines
Facial expressions or body language indicating depression or sadness	Working slowly
Hypersensitivity	Easily hurt feelings, crying, anger
Poor performance and follow-through on tasks	Poor work completion
Inattention	Distractability, restlessness
Forgetfulness	Poor work submission, variable academic performance
Separation anxiety from parents or caregiver	Crying, somatic complaints, frequent absences, school refusal
Characteristics of Depression in Adolescents	What It Looks Like in School
Decreased self-esteem and feelings of self-worth	Self-deprecating comments
Mild irritability	Defiance with authority figures, difficulties interacting with peers, argumentativeness
Negative perceptions of student’s past and present	Pessimistic comments, suicidal thoughts
Peer rejection	Isolation, frequent change in friends
Lack of interest and involvement in previously enjoyed activities	Isolation and withdrawal
Boredom	Sulking, noncompliance
Impulsive and risky behavior	Theft, sexual activity, alcohol or drug use, truancy
Substance abuse	Acting out of character, sleeping in class

Can a School Psychologist Diagnose Depression?

As noted above, if a school suspects a child is suffering from depression and that it may be  adversely affecting educational performance or  limiting that child in a major life activity, it must provide that child with a comprehensive evaluation at no cost to the parents if it is needed either to determine eligibility or to determine the child’s current strengths and needs..   

While Section 504 doesn’t provide a specific timeline for a district to respond to a parent request to evaluate their child for  accommodations and/or related services, OCR seems to generally apply the 60-day timeline in the IDEA (or the state’s timeline)  in determining compliance.   Additionally, if the 504 Committee only considers one piece of the pie, e.g., a prescription pad diagnosis provided by the parent, without also  documenting that it reviewed the student’s disciplinary record and current health information before developing a 504 Plan, it could be found out of compliance by OCR

OSEP has always been clear in saying that a DSM 5 diagnosis is neither sufficient for or required for determining eligibility under the IDEA,. However, a diagnosis by a qualified professional is required to trigger Section 504 rights.  Nothing in any of the relevant federal statutes or regulations would limit  an appropriately trained  school psychologist in the pursuit of his or her duties from performing the prerequisite evaluation or providing  the school with a diagnosis.   

We recognize that some states and some SEAs do limit their school psychologists from diagnosing mental illnesses, but where such a prohibition does not exist, it would usually be in the school’s best interest to use the professionals it already employs rather than contracting with an outside service provider to provide that service. An appropriately trained school psychologist, state laws or regulations not prohibiting, would be qualified to provide a mental health diagnosis.  School psychologists, however, are for the most part not professionally qualified to prescribe anti-depression medications that may be helpful in counteracting changes in the brain or brain chemistry that seem to occur when people become depressed.  The other major treatment for depression is psychotherapy.  School psychologists may or may not have the training or the time to engage in what may become a long-term therapeutic relationship.

Is the child clinically depressed or merely sad?

Differentiating between depression and sadness requires the application of nationally recognized criteria..

The two most common systems of classification are the DSM 5 and the ICD 10.  DSM 5 criteria for the multiple forms of depression  can be reviewed at the link below (or at other links  on Google.)

Depression in Children   Source: Epocrates, an AthenaHealth company
A comprehensive listing of DSM 5 criteria for the various forms of depression.  A number of other online sources with informative discussions may only provide criteria for one of the subtypes.

Legal Implications based on the IDEA

Depression  is  a disorder explicitly mentioned in the IDEA in its definition of an emotional disability (one of the thirteen qualifying categories for services).  A child suffering from depression is however more likely to be overlooked by teachers and administrators  than a child whose emotional disturbance is manifested by inappropriate types of behavior.

Emotional disturbance means a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child’s educational performance:

(A) An inability to learn that cannot be explained by intellectual, sensory, or health factors.

(B) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers.

(C) Inappropriate types of behavior or feelings under normal circumstances.

(D) A general pervasive mood of unhappiness or depression. [Emphasis added]

(E) A tendency to develop physical symptoms or fears associated with personal or school problems.

(ii) Emotional disturbance includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance under paragraph (c)(4)(i) of this section

Just being depressed will not necessarily qualify a child for identification under the IDEA.   In order to qualify under the IDEA, a  child’s depression would need to be pervasive.  For example, a middle school student relied upon a psychiatric diagnosis of dysthymic disorder in order to qualify for IDEA protections as ED.  However, the court put the diagnosis within the context of a comprehensive review, and only one source indicated he was ever depressed.  So the court decided that, while he might be socially maladjusted, he was not emotionally disturbed.   For more details, see a decision by the Fourth Circuit in Springer v. Fairfax, 1998.

So how does a child with depression become eligible for an IEP?

The criteria for eligibility are the same as for any child with an emotional disturbance as explained in the criteria above for the IDEA.  The condition must have been present  over a long period of time and to a marked degree that adversely affects a child’s educational performance.

In contrast to the Fairfax decision above, see the Eight Circuit’s decision from 2011 in J.H. v. Republic R-III School District. 

The court in this case applied the same principles as the Fourth did in Fairfax. In fact, the Eighth Circuit relied upon the Fourth’s decision (above) in helping it differentiate between social maladjustment only (the finding in Fairfax)  and emotional disturbance.

Despite a powerful plethora of evidence suggesting that J.H., unlike Springer, had had a long history of behavioral and emotional problems, the court found that he did not qualify as ED.   However, the child was also diagnosed with ADHD, a frequently diagnosed  comorbid disorder.  ADHD is a potential qualifier under the category of Other Health Impaired (OHI).

Another court decision offered another perspective.  In this case,  M.M. v. New York City Board of Education, district court, 2014.  In this case the child’s depression made her unable to attend school, sometimes for weeks at a time.  Even though they had provided her with homebound services during her extended absences (usually provided because a child has a disability) the school denied her an IEP  and the right to additional accommodations that could have been provided because when she was in school she got excellent grades.  The district court judge found that in determining whether or not the child was substantially limited, the SRO ignored the fact that she had failed to graduate because school policies kept her from getting the required number of credits and, also, that despite her good grades, those grades had been consistently falling.  He concluded “Few things could be more indicative of an emotional problem that “adversely affected” a student’s education than one that prevented her from attending school.”  Although the decision in this case was that the school had denied her FAPE because it denied her an IEP, there would have been no reason why the school could not have met her needs just as well through a 504 Plan.  The school offered her neither, whereas either could have saved them from years of litigation.  

Still more to consider.  Once a child is identified as eligible for services under the IDEA, the IEP, not the label, determines the services the child receives.  So  child’s needs that dictate the services s/he receives to meet the goals on the IEP.  Sometimes those needs are clearly related to a child’s disability, sometimes not. 

It can be a different story, however, when determining eligibility.  Both the Fourth and Eighth  circuits, citing the language in the 2006 Part B Regulations, determined that unless there is a  causal link between a child’s diagnosed disability and his/her deficits in  educational performance, then he or she would not qualify under the IDEA.   This is not, however, an issue that is frequently discussed when eligibility groups or IEP teams are meeting to determine eligibility.  (Forms dictate the process, and this reviewer has seen no state forms to date requiring the group or team to document such a connection.)

Part B Regulations are also quite explicit in answering the question,  “Can a student with an emotional disability such as depression  and good grades qualify under the IDEA?” The 2006 Part B regulations are quite explicit in telling us that schools must take more into account than grades in considering adverse educational impact.  The 2006 Part B Regulations say in Section 301 (c) that ” Each State must ensure that FAPE is available to any individual child with a disability who needs special education and related services, even though the child has not failed or been retained in a course or grade, and is advancing from grade to grade,”

In summary, there are two major take-aways from the above with respect to determining eligibility and a child’s strengths and needs:

(1) While grades are one factor to be considered in determining eligibility, they are by no means the only factor.

(2)  When a child with depression is also diagnosed with other (co-morbid) disorders, those disorders must also be considered both in determining eligibility and in determining the child’s strengths and needs.

 

When would a child suffering from depression qualify under Section 504? 

This section is predicated upon the assumption that the reader is familiar with the ADAAA 2008, knows the definition of a disability in the ADAAA 2008, and is knowledgeable in general about when services would be available under the first two legs of that definition.  However, if the preceding acronym and sentence  just sound like so much gibberish, you are, gentle reader, referred to our OCR, Section 504, and the ADA page.  The sections  on Other OCR References and the ADAAA of 2008 provide links to resources that are particularly relevant.

If an IEP team determines that a child diagnosed with depression does not qualify for services under the IDEA, it should then reconstitute itself as or refer to a 504 Committee to rule out the need for accommodations or related services in order to receive FAPE   

Although an IEP team and a Section 504 committee may be composed of the same individuals wearing different hats, when considering 504 eligibility the group of professionals with knowledge of the child need to clear their minds of the criteria applied to IDEA eligibility.  (Someone once suggested that everyone get up, walk around the table once, and sit down again to underscore that they are now operating under different rules.  A wonderful idea but not required by federal regulations.)

First of all, whether or not a disability is pervasive is irrelevant under Section 504.  The sole criterion is whether or not the disability has resulted in a substantial limitation in a major life activity . And it need only be in one major life activity.  OCR provided a non exhaustive list of 18 examples of major life activities in its Q and A on the ADAAA 2008.    

A diagnosis of major depression already implies that the disorder is neither transitory or minor.  The ADAAA 2008 would exempt children whose disability is both transitory and minor from 504 protections, but that is an exemption that would not be applicable here.  Should the issue arise somehow somewhere for some reason that this reviewer cannot conceive of even hypothetically, the decision that a child’s depression was both transitory AND minor would have to be based on objective facts, not a subjective opinion,  

While under the IDEA episodic disabilities normally would not qualify,  under Section 504, they would definitely qualify if the substantial limitation criterion was reached.  For example, a child with cancer in remission might need accommodations so he or she could make scheduled trips to meet with physicians for regular check-ups.  

As  OCR wrote, in itsgenerally discouraged by the Office for Civil Rights

“For example, a student who has dyslexia and is substantially limited in reading finds it  challenging to read the required class material in a timely manner. Alternatively, a student who has been diagnosed with depression may be substantially limited in her ability to concentrate while completing school assignments. In both of these cases, the student spends far more time preparing for class than other students and earns good grades because of the student’s intelligence and extreme efforts. The student would still be substantially limited in the major life activity of reading despite earning good grades

The ADAAA 2008 did not define the qualifying adjective, “substantial” but it was not intended to be a demanding standard.  While each decision must be made on a case by case basis, 504 committees must remember that “substantial” does not mean “prevents” nor is it synonymous with “significantly restricts.”   If a school has met its burden of ensuring a child has received a comprehensive evaluation, reaching a  decision should not be difficult, time-consuming, or burdensome.

For a more thorough discussion of how the ADAAA 2008  broadened the pool of children who could be considered for services under Section see our  OCR, Section 504, and ADA page. 

One of the obstacles in getting help for a child with depression is a myth that depression is a choice. No such doubt would attach to a physical disorder, but a person who is depressed may be told to “get ahold of yourself” or “You just need to look at the bright side of life.”  Whereas when confronted with a physician’s prescription pad diagnosis of ADHD, that same 504 Committee might leap to provide that child with every accommodation known to man or at least every accommodation their state’s handbook on accommodations allow for high stakes testing.. 

Depression is not a choice.  It isn’t even logical to think depression was a choice — who would ever choose to feel depressed?  A child diagnosed with depression should be accorded the same respect and access to services as a child with any other physical or mental disorder–the same consideration that would be afforded to any individual with a physical illness or ADHD.  Instead, individuals with depression may feel totally alone because, in reality, without support systems in place, they are alone.

Under Section 504, the burden of school systems is to provide children with disabilities FAPE, which is defined differently under 504 as “regular or special education and related aids and services that (i) are designed to meet individual educational needs of handicapped persons as adequately as the needs of nonhandicapped persons are met.”  For a much more extensive review and examples of how that plays out when applied to elementary and secondary schools, refer to our OCR, Section 504, and the ADA page.

 .

 

Individual Health Care Plans v.  504 Plans or IEPs

“Hey.  Let’s save some paperwork and meetings and instead of writing a 504 Plan for accommodations, let’s just stick them into an Individual Health Care Plan.” This bad idea, like the mole in a Whac-a-Mole game,   keeps resurfacing with surprising regularity.  If a child with a depression diagnosis needs accommodations or related services to receive FAPE, failure to inform the parents of their right to refer would be violation of the child’s civil rights.  For additional discussion, caselaw, and resources, click on our OCR, Section 504 and the ADA/Healthcare Plans vs. 504 Plans or IEPs section.

 

School Interventions

Public schools are responsible for providing medical evaluations when needed for identification but not for evaluations for medical treatment by a physician or in a hospital.  Short of that, the services and accommodations a school can provide are limited only by the student’s need for those services and the staff’s creativity in finding ways to address those needs.  A student with a 504 Plan may, for example, be eligible for accommodations due to absenteeism resulting from the disorder just as he or she would under the IDEA — up to and including exceptions to the school system’s policies regarding required minimal days of attendance in order to progress from one grade to the  next or to receive a passing grade in a course, even if the student displayed mastery of the content.

Trying to address the presenting problems without identifying and addressing the underlying causes can  be an exercise in futility. Major causes of depression include medical problems (serious illness), genetics, drug  abuse, side effects from prescribed medications, physical, sexual, or emotional abuse, a death or deaths in the family, or even poor nutrition.  That list is far from exhaustive.  

For example,  in some cases being bullied may be a precipitating cause.  For our resources on bullying see our section on Resources/Bullying.    At worst, without intervention, victims may commit suicide, as reportedly happened in 2007 when a thirteen year old  girl committed suicide after bullying from another parent online.  Alternatively, the victim may  become the victimizer  with the bully ending up gravely injured or dead as in this  horrific story from the New York Post in 2014.   These are not isolated incidents, but these individual tragedies tend to become lost in the seemingly continuous spate of mass school shootings we have witnessed in recent years.

A 504 Plan is not limited to accommodations for absenteeism or high stakes testing.  For example, if the 504 Committee determined that non-medical treatment provided by someone other than a physician was required for the student to receive FAPE, the school system would be required to provide appropriate treatment either from school personnel or under contract with a private service provider.  

Although it may seem obvious, it is equally important for administrators and staff to create an atmosphere of acceptance.  That they might not be so inclined would suggest the need for some staff training in handling these kinds of cases, another intervention that could be added to a 504 Plan or IEP.  Inconceivable as it might sound, there have been instances where the teachers and school administrators not only have failed to help a child with depression but whose actions have actually exacerbated the problem in ways that may have exceeded the standard under ADA/504 and state laws regarding available damages for intentionally inflicting emotional distress on a child.  

Although hopefully an isolated type of case, the Fourth Circuit case brought by Baird against Rose, Cohen, and Fairfax County in 1999 continues to provide an illuminating example.  It began simply enough with the child suffering from recurrent sinus infections that caused her attendance to suffer.  That in and of itself could have triggered 504 protections. Ultimately, however, her problems evolved into severe depression accompanied both by suicidal ideation and several actual attempts at suicide.  Despite this, the school not only failed to provide appropriate modifications to its attendance policies, but the music teacher publicly announced in front of the child to the whole class that she would be required to meet their attendance requirements and that she would be prohibited from participating in school musical events because she had not met those requirements.  Instead of honoring requests to ensure that the child would not be publicly embarrassed again, the principal barred the mother and grandmother from school premises unless invited.  It didn’t get better, and for more details, click on the link above.  The school alleged that Baird was excluded from school performances because of an attendance policy needed to ensure that the students knew their routines that was applicable to all children — hence no discrimination.  They were just treating her like everybody else.  Unfortunately for the school, the “equal treatment” argument failed on the face of it because they’d never enforced that rule on anybody at any time previously.  So the judges reinstated the parents’ claims alleging the intentional infliction of emotional distress.  This reviewer has found no record of a subsequent district court hearing, so the parties may have settled out of court.  What is, however, crystal clear is that extensive litigation could have been avoided with a simple 504 Plan providing accommodations for her absenteeism.  A little bit of humanity would have gone a long way as well.  

The Resources and Help section directly following includes links to several sources of suggestions regarding accommodations for children diagnosed with depression.  Readers are cautioned, however, that it would be overly simplistic to rely upon any of them for providing a comprehensive  potpourri of options that would necessarily meet any of their children’s needs, much less all children who are chronically depressed.

IEP teams and 504 Committees are reminded that children diagnosed with depression often suffer from co-morbid disorders that may also need to be addressed.  No two children are alike, and depression has been found to be co-morbid with many other disorders such as anxiety (60 percent overlap) attention deficit hyperactive disorder, learning disabilities, and physical disorders.  If that wasn’t complicated enough, even when there are no identified co-morbid disabilities, children with chronic depression may display very different behaviors arising out of that condition — each potentially needing a very different sort of intervention. Needs arising out of those conditions would also need to be addressed.  While the ESSA requires interventions to be evidence-based, even behavioral interventions, most of the interventions in the links below are not supported by any research provided by the links’ authors.  Therefore teams or groups writing them into an IEP or 504 Plan should not assume they’re working as designed without also periodic monitoring to see if they are really working.  The best place to start looking for accommodations is, of course, your own state’s testing handbook.  (Some state IEP forms have listed all approved modifications for high stakes testing.  Schools are not prohibited from providing other accommodations, but they must have prior state approval to insure no clarifying comment will be required next to the child’s scores.)  But testing is just a small part of school life . . . and selecting those accommodations to level the playing field on exams only addresses one small part of a child’s learning environment. 

Accommodating Psychiatric Service Dogs

Parents have been making good use of psychiatric service dogs in an effort to address their children’s problems, and making accommodations for children with emotional disorders.  Schools can set standards, but generally speaking, they must make appropriate accommodations for the child and his or her dog.  If a dog is well trained, and the assumption here is that the dog is well trained, the only accommodation, realistically, that school would have to make would be to appoint some staff member to accompany the child and dog when it had to go outside to urinate or defecate.   A psychiatric service dog it must be noted is NOT the same as an emotional support dog.  Schools would not be required to accommodate a dog that was not specifically trained to address needs arising out of the child’s disability.  Nor would a school be required to allow a child to bring a dog to school that was very disruptive, e.g., a dog that barked incessantly during lectures (as compared to a dog that yipped once when someone poked him.) The laws and regulations (and the caselaw) affecting the rights of children with emotional disabilities fall with a much broader range of ADA rights held by all individuals with disabilities, and those rights, along with some applicable caselaw, is discussed in much greater detail in the Service Dogs section on our OCR, Section 504, and the ADA page.  At least one state has broadened the definition to include service animals, which would therefore make it possible to have a service monkey or service horse.  However, the same rules would apply, and even if a service money was trained (a theoretical example) to recognize seizures twenty or forty minutes before they actually occurred, if that same monkey defecated on the school room floor it could be banned from the premises.  This reviewer knows of no state that recognizes an emotional support dog as qualifying under the definition of service dog or service animal.  However interested parties can review the details of their own state’s regulations (as of 2016) by visiting this web page, Table of State Assistance Animal Laws.    (When state laws refer to support dogs, they are almost always referring to a specially trained assistance dog providing physical support to a child with a physical, not emotional, disability.)

Updated 11/21/2018

 

 

Resources  for Parents and Professionals

Depression is Not a Choice

Stop Telling People to Snap Out of It:  Depression is Not a Choice.   Bustle
“Just how common is depression? Psychology Today reports that depression affects more than 300 million people globally, but less than 50 percent ever get treatment”

Depression is Not a Choice.  Psychology Today
“”There are a lot of myths surrounding depression, the two most common being that  depression is triggered by a negative life event, and that people who are depressed should find something that makes them happy so they can “snap out of it.” Neither misconception accurately portrays the condition, and both feed into its stigmatization.”

Depression is Not a Choice.  The Mighty.com
“People should recognize there a lot of work goes into maintaining your life when you live with depression. Even brushing your teeth in the morning can become difficult. Then, you also have a job, food, bills and every other burden of life.”

To The Person who Thinks Depression is a Choice.  The Mighty.com
A personalized first person account of what it is like to suffer from depression

Myths and Concepts about Depression — from the American Depression Association of America
The Internet abounds in information and misinformation about panic attacks, phobias, and other anxiety disorders — including promises of quick cures that require up-front payment. When chronic anxiety disrupts your life, you may be willing to try anything. But how can you learn what’s trustworthy? And how can you find help that will work for you? 

Depression and Suicide

Mayo Clinic Study Shows Suicide Rates Overstated in People Diagnosed with Depression.   EurekAlert
While overall the estimates for suicide rates ranged from two to nine percent.  The highest rate was for individuals with a previous record of hospitalization for a suicide attempt.

Suicide and Depression: FAQs SAVE
Research has consistently shown a strong link between suicide and depression, with 90% of the people who die by suicide having an existing mental illness or substance abuse problem at the time of their death.

Suicidal and Depression in Children.  Very well mind
“Suicidal thoughts, also known as suicidal ideation, may not always be completely obvious to others…not even to a child’s parents. Part of the reason for that is that children with suicidal thoughts will probably not speak directly about them as an adult might.”

Supporting Students at School

Responding to a Student’s Depression.  ASCD Leadership
Depression is significantly correlated with poor academic grades, and students with higher ratings of depression are less likely to graduate from high school (Forehand, Brody, Long, & Fauber, 1988). Cognitive issues may include low tolerance for frustration and negative patterns of thinking. Depressed students often give up more quickly on tasks they perceive as daunting, refuse to attempt academic work they find too difficult, and quickly doubt their ability to independently complete academic tasks or solve problems. Memory, speech, physical and motor activity, and the ability to plan may also be affected. Many depressed children and adolescents are lethargic, speak laboriously, and have difficulty completely expressing thoughts and ideas.”

Depression: Supporting Students at School   A NASP publication
Left unidentified and untreated, depression can have pervasive and long-term effects on social, personal, and academic performance. When school personnel know how to identify and intervene with children who have depression, they can provide them with opportunities for effective support

Diagnosing Depression:  Your Guide to Depression in the UK
Some useful information about depression and treatments from the United Kingdom

Parent Support Groups

There are parent support groups in most states for parents of children diagnosed with depression.   The target audience for most if not all, however, is for parents of children with a variety of mental health issues, or combinations of mental issues, such as depression and bipolar disorder.  We make no claim that any of these groups will meet a particular parent’s or particular child’s needs.

NAMI Support Group Finder  National Alliance on Mental Illness
A more generic resource for families and relatives of individuals suffering from mental illness.  Click on the link above will lead to a group locator page (Scroll to the bottom of the page.)

Families for Depression Toolkit  Families for Depression
This is NOT a group locating site, but it does provide a variety of resources and printable pamphlets that may be helpful.  

Find Your Parent Center   Center for Parent Information and Resources
 Again a change of pace.  Office of Special Education Programs (OSEP) sponsored state centers.  These centers  help parents  navigate the special education maze and provide them with the information and tools they need to be a informed and active participant their your child’s education!   A resource for all parents of all children with disabilities, not just parents of children with mental health disabilities.  

Treatments

The two major forms of treatment for depression are psychotherapeutic and pharmaceutical, but a number of self help remedies are also suggested by reputable sources online.  They’re usually suggested as a supplement, not a substitute, for getting treatment from a qualified professional.  There are many (possibly hundreds) of online resources providing information on the treatment of depression.   While the links below are to some of the more authoritative sources, appearance on this page does not constitute an endorsement by any of the editors.  NAMI’s cautionary statement,  below,  is repeated here:  “”Many treatment options are available for depression, but how well treatment works depends on the type of depression and its severity.”

10 Natural Depression Treatments   —  WebMD
Being depressed can make you feel helpless. You’re not. Along with therapy and sometimes medication, there’s a lot you can do on your own to fight back.

Depression — Mayo Clinic
An overview of depression disorder, but scroll down to their review of available treatments.

Depression Treatment and Management – Anxiety and Depression Association of America (ADAA)
The ADAA has a major presence on the Internet, has support groups in almost every state, and provides a prolific amount of information on anxiety and depression.  “Medication alone and psychotherapy (cognitive-behavioral therapy, interpersonal therapy) alone can relieve depressive symptoms. A combination of medication and psychotherapy has been associated with significantly higher rates of improvement in more severe, chronic, and complex presentations of depression.”

Treatment – Depression  National Alliance on Mental Illness (NAMI)
Similar information to that available from the websites above, but also includes a section on experimental treatments.  (Again, appearance here does not constitute an endorsement by the editors.)   Their opening cautionary statement is, however, applicable to the consideration of any treatment.  “Many treatment options are available for depression, but how well treatment works depends on the type of depression and its severity.”

Talk with Your Doctor about Depression  — healthfinder.gov.  This page is maintained by the United States Government Department of Health and Human Services
Their basic theme is consistent with the page title:  “If you think you might be depressed, talk with a doctor about how you are feeling.”