This is the second of a two-part series on teen suicide and what the Jewish and general communities are doing to prevent it.

Depression is the common cold of the psyche. Left untreated, it can turn into pneumonia. That's the image that Sherry Small, school counsellor at Talmud Torah high school, would like to get across to parents and teens.

Among teenagers, depression is disturbingly prevalent, according to a recent British Columbia study. So it is urgent that educators, parents and health-care providers be aware of the signs of depression - especially when they become so overwhelming that they lead to thoughts of suicide.

When dealt with, Small said, depression is a minor ailment.
"It is so treatable," said Small, a counselling psychologist who also has a private practice. "Depression can be cured. It's the easiest thing to get rid of."

Many cases of depression can be overcome with exercise, nutrition and improved sleep patterns. Good counselling will help victims of depression assess their personal relationships to see what is working and what is not, in addition to correcting self-defeating ideas.

If those remedies do not work, the new generation of anti-depressants marks a revolutionary turn in the treatment of what was once seen as a weakness of character and is now generally accepted to be due to physiological factors.

When a student comes to Small with depression, she has a
standardized, one-page test that she generally asks them to complete. The questions include "Has there been a time when nothing was fun for you, even things that you used to like?" and "Have you been more down on yourself than usual, when you felt that you couldn't do anything right?" It then asks about specific actions or thoughts about suicide.

Depending on the results of the questionnaire, Small will determine a course of action. She likes to contact parents as soon as possible. Although she acknowledged that there are confidentiality issues and that she must have the trust of the student, she finds most young people are relieved to have their parents working with them to iron out their problems.

In her work with the Jewish community, through Talmud Torah, she has found families especially willing to participate in a young person's recovery from depression. Although there is often pressure for a Jewish family to maintain the outward impression of ideal family life, Small said that families always seem willing to confront the problems and attempt to make them better.

In fact, the stereotypes can be reversed in a sense, she said. Some non-Jewish cultures are known for their reticence to discuss personal issues. Jewish families, she said, may be more open to frank, emotional discussions, thereby aiding in the healing process. Yet, the very fact that consideration is given to "image" in the
discussion of depression is notable. Small said that people do not hesitate to get treatment for physical health issues, but mental health issues still evoke a strong taboo, something that must be changed.

"It's a whole process of de-stigmatization," she said. Discussion of suicide - to take the stigma issue further - has been officially forbidden in some sectors. Generations of educators, parents and professionals were led to believe that suicide should not be discussed because of the view that talking about it will have the perverse effect of encouraging it.

"It's like, 'Don't teach about birth control because they'll use it,'  she said. "That's a myth." Small also takes on the view that there is something pathological about young people's reactions to the world around them. Josh Platzer, a young Vancouverite who committed suicide in 1999 and whose family's story was featured in last week's Bulletin, was deeply troubled about the state of the world.

Small said that, as young people develop a more sophisticated
understanding of the world around them and see the injustice and pain suffered by people next door and around the world, they have every right to be upset about those conditions. "Usually, they're reacting really normally," she said. There is a line though, she acknowledged, between determining the proper emotional response to everyday events and identifying a potentially dangerous depression.

STARTLING STATISTICS

A recent, comprehensive study of youth health issues painted a picture that may be startling to some parents and educators. Among the findings of the study was the discovery that urban-rural differences are significant factors in the health of young people.  Vancouver and Victoria have the lowest rates of teen suicide in the province. This parallels lower rates of smoking, sexual activities and drinking and driving.

The report, by the McCreary Centre Society, a non-profit adolescent health agency, also noted that young people with strong family connections are less likely to experience emotional distress or to attempt suicide. Predictably, factors such as sexual or physical abuse have a dramatic impact on increasing a young person's risk for depression and suicide.

The study was the largest youth health survey ever done in this province and involved a 127-item questionnaire completed by more than 25,000 students in Grades 7 to 12. Of these students, 14 per cent had thought about suicide, 11 per cent had actually planned a suicide, seven per cent had attempted suicide and two per cent were injured in a suicide. In 1999, the last year for which statistics are available, there was a total of 496 suicides in this province.

In 1999, the McCreary Centre raised warning flags about the shocking results of a similar survey of gay and lesbian youth. Of this group, 25 per cent had attempted suicide in the previous year, and almost half had low self-esteem. Gay young people overwhelmingly reported feeling isolated, unsafe at school and subjected to homophobic remarks. Interestingly, there has been a dramatic rise in awareness of the dangers of bullying, especially since the suicide of Hamed Nastoh, a Surrey high school student who jumped to his death from a bridge after intolerable harassment from schoolmates. His mother has begun a courageous battle against school bullying.

There are many complex factors that can lead a young person to depression and to take their own lives and parents, friends and educators must watch for warning signs. All people who work in the field of depression treatment and suicide prevention agree that the most important thing is awareness and openness to approach the issue. Removing the stigma of depression is a first step in preventing the tragedy that affects too many British Columbian families.