DEPRESSION: ON THE EDGE

DISCUSSION GUIDE

On PBS (Check local listings)

A half-hour special from In the Mix, the award-winning PBS weekly series

Whoever said high school is the best years of your life? With all the pressures of adolescenceóschool, parents, friendsó everybody gets "the blues" at times. For some, these "blues" become something more serious, and potentially fatal: clinical depression. Knowing the difference between the two may mean the difference between life and death: suicide among young people has now reached epidemicóand heartbreakingly tragic Ė proportions in the U.S.

Co-hosted by popular music group Third Eye Blind, On the Edge stresses early identification and treatment as the most effective weapon in battling depression and the possibility of suicide, breaking down the social stigma of depression that leads many teens to deny and hide the problem. By speaking candidly and personally, this program shows teens that the sooner they learn the facts, the sooner they can help themselves and their peers.

How to Use this Program:

Studies conducted by RMC Research on earlier In the Mix specials have shown that these programs engage the interest of teenagers, deliver information, catalyze discussion on critical issues, as well as promote analytical thinking and a greater sense of self-efficacy among teens. We recommend that you show the entire special in one sitting and then revisit each section followed by discussion. The aim is to encourage thought and allow teens to generate their own creative solutions.

Did you know?

In the Mix Awards

ē1997 International Prix Danube for Children's Television

ē1997 New York Emmy for Children's Programming

ē1996 Finalist, The New York Festivals

ē1994 National Emmy for Community Service Programming

ē1993 Finalist, Prix Jeunesse

ē1992 CPB Gold Award

Depression: On the Edge contains three major sections, along with introductions and commentary by teens, In the Mix reporter Andrea Barrow, and musical group Third Eye Blind.

SECTION ONE

THE BEST YEARS OF OUR LIVES?

QUESTIONS

The teens of Pierre, South Dakota, where 14 suicides have shaken the community in recent years, speak honestly about life in a small town, the everyday pressures and problems that challenge them, along with ways they handle their "blues" and keep them from becoming something more serious. The members of Third Eye Blind also talk about how they keep up their spirits.

What are some things these teens like about their hometown?

itís a very safe place to grow up; itís a beautiful place to live

According to these Pierre residents, what are the downsides to living in a rural town of only 13,000 people?

everyone knows everyone else; thereís nothing around or outside the city; thereís very little choice or variety in social activities; heavy pressure to fit in and be popular; people separate into distinct cliques and often donít get along

Do these downsides sound different from what you feel are the downsides to living in your own town or city? If so, what do you dislike about where you live? What do you like about it?

These teens name some common pressures they feel theyíre under. What are these, and do you feel the same pressures? Name some additional pressures you have felt.

hard to find a balance between friends and girlfriends/boyfriends; friends sometimes pressure you to do things you donít believe in; criticism and rejection from the opposite sex; itís taboo for guys to show emotion around other guys; parents who push you to succeed at everything or do things you donít want to do; stress from whatís going on in family life, such as divorce

How do these teens relieve normal stress and anxiety, and keep from getting to the point where "every day is a bad day"?

find an enjoyable form of exercise to release stress and anxiety physically; focus on things youíre succeeding at rather than things youíre failing; play music; find someone to talk to when you need to unload; fight boredom by finding something you enjoy doing on a regular basis like playing softball with friends; write in a journal or notebook; volunteer or participate in community service activities

Exercise has been found to be a natural mood booster, because it increases the flow of endorphins to your brain. How can what youíre eating or not eating also affect your mood?

too much red meat, caffeine, alcohol, or salt can cause mood swings; if youíre dieting you may not be getting enough of the vitamins and minerals your body needs for energy and an emotional balance

How do the members of Third Eye Blind avoid feeling down?

play instruments to express whatever mood theyíre in; listen to their favorite music; make the decision to have a positive attitude and work at it

What advice do they have for people who might be feeling depressed?

Get professional help instead of suffering in silence because treatment works; have faith that emotional pain will end

SECTION ONE

THE BEST YEARS OF OUR LIVES?

ACTIVITIES

ACTIVITY:

As a class, explore further the variety of daily, universal pressures that can lead to "the blues" and depression. Create different categories on a blackboard or easel pads, e.g. "Girls", "Boys", "Friends", "Family", "School and Teachers", "Self-Image", etc. Give each student the chance to add items to each category, then discuss as a group.

ACTIVITY:

Girls and boys can have different sources of stress. As a class, create a list of these. Set up columns for each gender on a blackboard or easel pads, and give each student the opportunity to add items to the appropriate category.

ACTIVITY:

Ask students to research how a nutritional or chemical imbalance can lead to depression by investigating the effects of various elements of their diet and lifestyle (e.g. too much red meat, sugar, salt, caffeine, excessive dieting, use of alcohol and marijuana, etc.). Then have students research the benefits of exercise and correct diet on improving overall emotional and mental health.

 

 

 

SECTION TWO

WHEN IT GETS SERIOUS

QUESTIONS

Paul, Shiloh, and Keely, three teens who were diagnosed with and treated for clinical depression, recount their battles with the disease. Psychologist Dr. Belisa Vranich, from the National Mental Health Association, identifies the symptoms of depression, outlines the important distinction between natural "blues" and diagnosable depression, and. provides practical, concrete ways to fight it.

What kinds of things were going on in their lives when Paul, Keely, and Shiloh first remember feeling depressed?

his parentsí divorce made Paul feel heíd never be happy again; death of a parent left Keely feeling angry; beginning junior high and feeling insecure, trying hard to fit in with popular kids kept Shiloh from being herself

What were the symptoms they felt as their depression deepened?

couldnít get up and leave the house; bad dreams; insomnia; feeling lethargic; grades dropping or failing classes; feeling alone and without friends; no desire to participate in school activities; feeling trapped within themselves; couldnít communicate their feelings to anyone; drinking or using drugs to hide the pain and make it look like they were having fun; acting rebellious as a cry for attention from family; uncontrollable crying; writing dark stories or their own obituary

According to Dr. Belisa Vranich, whatís the difference between "the blues" and serious, diagnosable depression?

When you just feel sad or have "the blues", you know you can pick yourself up, that it will pass; With serious depression, you feel powerless to do that, you have a feeling of utter hopelessness, that nothing will help, you lose motivation and this continues for several weeks

Besides these feelings, what other signs show itís necessary to seek help? How did these teens finally get the help they needed?

when your depression affects the way you function every day; instead of a normal curiosity about death and afterlife, you want to hurt yourself or end your life; sleeping too much or too little; Keely told a friend she wanted to die and the friend contacted a teacher; Paul found a support group through a high school counselor

 

SECTION TWO

WHEN IT GETS SERIOUS

QUESTIONS (CONTíD)

 

What are some of the clinical causes of depression?

Chemical imbalance. (Note to leader: Chemical imbalance is related to the flow of serotonin, the principal brain chemical. Other main chemicals include dopamine and norepinephrine. An imbalance among these chemicals disrupts the proper flow of brain messages. Depression also runs in the family; environmental stressors can bring out depression in kids with a genetic predisposition because their parents have experienced it. Depression also occurs in individuals without genetic predisposition but who have been exposed to environmental stressors such as child abuse, abandonment, poverty, exposure to violent acts. Hormonal changes during PMS can also bring about symptoms of depression.) One of the results of this chemical imbalance is manic depression, which Keely described as being down and crying then feeling happy for no reason a few hours later. (Note to leader: Manic depression is defined as an ongoing combination of extremely high and low moods, which may alternate or be experienced nearly simultaneously. Manic depression is also referred to as bipolar disorder.)

Name some common misconceptions people might have about depression.

itís a weakness; the person brought it on themselves and is to blame; you could fix it if you really wanted to

Do anti-depressant medications make you high and happy all the time?

no; they are designed to control your moods and take away the extreme lows and mood swings, stop suicidal feelings, help you sleep

The doctor stresses that anti-depressants must be used in combination with therapy. What are some of the myths about therapy? According to Shiloh, what are the benefits?

myths: lying on a couch and having someone psychoanalyze you, being treated like a crazy person; benefits: counseling was a way to get feelings out without being embarrassed, someone to talk to whom you can trust and you know itís confidential

What did Paul, Shiloh, and Keely learn and gain from therapy in their battles with depression?

that depression is common and curable; that people did love and care for them; a sense of self-worth; how to control feelings of depression instead of letting them control you

 

 

 

SECTION TWO

WHEN IT GETS SERIOUS

ACTIVITIES

 

ACTIVITY:

Ask a local psychiatrist or psychologist to visit and speak to the class about depression, and about their job. Have them discuss their job in terms of confidentiality, ethics, their relationship with patients, etc. They should also explain what type of therapy and medication treatment are now used for teens with clinical depression. The idea is to show students that people who provide professional help are not threatening or weird, but trustworthy and capable of being a confidant.

ACTIVITY:

Ask students to take this self-test, which will help them to examine and recognize potential feelings of depression. Have them write down "yes" or "no" in response to each of the following questions: For the last two weeks or longer, (1) I have been feeling extremely sad all or most of the time. (2) I seem to have no energy. (3) Iíve lost interest in most of the activities I used to enjoy. (4) Iíve been sleeping much more (or much less) than usual. (5) Iíve been eating much more (or much less) than usual. (6) Iíve been having trouble concentrating, remembering, and making decisions. (7) Iíve been feeling hopeless about the future. (8) Iíve been feeling worthless. (9) Iíve been feeling anxious. (10) Iíve been thinking about easy death and suicide would be. Suggest that if a student has answered "yes" to two or more questions, they should consider seeking help.

ACTIVITY:

Ask students to research where to get help in your local community; for example, hotlines, youth services, churches, mental health clinics, a local chapter of a mental health association, etc. Have them consult both the blue and yellow pages in the phone book, and eventually create a "help sheet" for distribution in the school.

 

 

 

SECTION THREE

SUICIDE: THE ONLY IRREVERSIBLE CHOICE

QUESTIONS

Third Eye Blind explains why they wrote their hit song "Jumper" and the themes behind it. The teens from Pierre talk about the string of 14 suicides in their town, and how they were affected both individually and as a community. Kelsey, whose brotherís death was one of these suicides, talks about her own attempt and what happens to those left behind. Epidemiologist Madelyn Gould, Ph.D., explains why some communities experience "suicide clusters". We see how Pierre has joined together in the face of tragedy to address the issue and prevent future deaths.

What are the members of Third Eye Blind trying to convey to listeners with their song "Jumper"?

that everybody deserves redemption, that is, a chance to shed your pain and start fresh; itís normal for everyone to have demons and feel shame about things; you have to put the past away and move forward

How did Pierre residents react to the series of suicides in their town?

they saw it as a loss of the townís innocence; became numb to it; people finally saw and admitted that there was a problem

Dr. Gould talks about "suicide contagion". Based on what happened in Pierre, what can cause this?

some envy the attention suicide victims get even though itís a fleeting, false attention; the first suicide made it seem like a more viable solution to others who were considering it; after a while, people started getting numb to the deaths and taking suicide less seriously

What were some of the things Kelsey went through after her brotherís death? She says that despite an attempt at suicide, she "did not want to die". Why else would she and others like her make such a dangerous attempt on their own lives?

embarrassment at school; felt depressed herself; hated the way she looked; started drinking and smoking; her overdose was a cry for attention, similar to that which her brotherís suicide received

What kinds of action did Pierre teens take to prevent more suicides? What advice do they have for others to prevent the same tragedy from happening in their own town?

as part of the Yellow Ribbon Campaign, they formed an activist group that created banners to keep teens aware of the issue and performed improv skits to act out pressure situations and initiate discussion of feelings; distributed cards that young people could use when needing to seek help. Their advice: listen to others, share your gripes and stories with friends; watch for signs that someone might need help; donít be afraid to reach out to them; donít be afraid to reach out if youíre the one who needs help

 

 

 

 

 

 

SECTION THREE

SUICIDE: THE ONLY IRREVERSIBLE CHOICE

ACTIVITIES

 

ACTIVITY:

Pass out index cards to the class and ask each student to write down who they would feel comfortable talking to if they felt seriously depressed and needed help (i.e. friend, parent, teacher, minister, neighbor, etc.). Collect the cards, read the answers anonymously, and discuss the options.

ACTIVITY:

Put some of the lyrics to "Jumper" on a blackboard or easel so the whole class can see:

"I wish you would step back from that ledge my friend,
You could cut ties with all the lies that you've been living inÖ
The angry boy, a bit too insane
Icing over a secret pain,
You know you don't belong,
You're the first to fight, You're way too loud,
You're the flash of light on a burial shroud,
I know something's wrong,
Well everyone has got a reason to say
Put the past awayÖ

Well he's on the table, and he's gone to code,
And I do not think anyone knows,
What they are doing here,
And your friends have left, You've been dismissed,
I never thought it would come to this, And I want you to know,
Everyone has got to face down the demons"

Review the lyrics line by line and ask students to interpret them in terms of everyday teen problems, depression, and how it is a strongly anti-suicide message.

ACTIVITY:

Organize a "Depression Awareness Day" at your school.* Ask your students to create and display banners with positive messages about depression, e.g. "You Are Not Alone". Have them write and perform sketches, or do improvisational scenes with suggestions from audience, depicting common anxieties and pressures. Arrange for local members of the hospital, suicide hotline, etc., to speak to the school.

 

SECTION THREE

SUICIDE: THE ONLY IRREVERSIBLE CHOICE

ACTIVITIES (CONTíD)

 

ACTIVITY:

Start a Yellow Ribbon Campaign in your school. Contact the Light for Life Foundation of America (see Resources) to receive ribbons, information, and copies of the Yellow Ribbon Card, which is used in Pierre. Or, ask your students to design and produce their own card and develop a program for depression awareness. Distribute cards to schools in your community, displaying the cards in easy access locations so students can get them anytime without embarrassment (e.g. main office, counseling center, commons area).

*During the first week of October, Thursday is set aside as National Depression Screening Day. It is part of Mental Illness Awareness Week activities nationwide. This is an opportunity to volunteer with a mental health association or NAMI affiliate to fight depression and promote screening for depression in your community.

DEPRESSION: ON THE EDGE

RESOURCES

Hotlines

Helpline

Part of Contact USA, a nationwide organization

(212) 532-2400

(212) 684-4480 (Administrative office)

Open 9 am to 10pm EST

Staffed by volunteers trained in non-judgmental, active listening; refers seriously at risk callers to experts who can help them.

National Alliance for the Mentally Ill Helpline

(800) 950-6264

Covenant House

(800) 999-9999

Open 24 hours a day, 7 days a week. Refers to shelters, available in Spanish.

Boys Town National Crisis Hotline

(800) 448-3000

Open 24 hours a day, 7 days a week

Trained professionals give advice and refers callers from a database of 20,0000 different services across the U.S.

 

Organizations

The National Mental Health Association

1021 Prince Street

Alexandria, VA 22314-2971

(800) 969-NMHA

www.nmha.org

The National Institute of Mental Health

Depression-DART Program

Rockville, MD 20857

(800) 421-4211

www.nimh.org

The National Foundation for Depressive Illness

P.O. Box 2257

New York, NY 10116

(800) 245-4305

www.depression.org

American Foundation for Suicide Prevention

120 Wall Street, 22nd Floor

New York, NY 10005

(888) 333-2377

www.afsp.org

The Samaritans

P.O. Box 1259

Madison Square Station

New York, NY 10159

(212) 673-3000

The National Alliance for the Mentally Ill

2101 Wilson Boulevard, Suite 302

Arlington, VA 22201

(703) 524-7600

www.nami.org

Suicide Prevention Advocacy Network (SPAN)

5034 Odinís Way

Marietta, Georgia 30068

(8888) 649-1355

www.spanusa.org

Light for Life Foundation (Yellow Ribbon Program)

P.O. Box 644

Westminster, CO 80030-0544

(303) 429-3530

www.yellowribbon.org

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c 1998 In the Mix. Depression: On the Edge is a production of Castle Works Inc. In the Mix was created by WNYC Radio. This special was funded by the Corporation for Public Broadcasting.