Mental Health U
Mental Health U is a podcast dedicated to demystifying and destigmatizing mental health issues. If you or someone you know is struggling with depression, anxiety, trauma, or some other mental health issue, then this podcast is for you.
Mental Health U
Exploring Childhood Depression: Signs, Support, and Expert Advice
Have you ever gazed into a child's eyes and witnessed something deeper than just the passing whims of youth? Megan Reinhart and Julia Manalukas rejoin us to shed light on the complexities of childhood depression, a topic too crucial to be overlooked. We uncover the intricate web of symptoms that indicate more than just fleeting sadness, including irritability and changes in social behaviors. Recognizing these subtleties can empower us with the understanding to identify when this mental health condition significantly disrupts a child's life and when to seek the guiding hand of professional help.
Our discussion takes a creative turn as we weave through the narrative of a young student who expressed his emotions using an innovative "Anger-O-Meter," highlighting the importance of nurturing strategies to help children articulate and manage their feelings. Megan and Julia share their wisdom on establishing quality time and routines that connect us with our children and create a bedrock of security and structure. These tales of family engagement are a testament to the transformative impact of intentional support on a child's emotional resilience.
As we conclude our conversation, we want to emphasize the importance of routines, good sleep habits, and finding a balance between expectations and support, especially for those dealing with anxiety or depression. We recognize the concerns and difficulties faced by caregivers, and we stress the importance of seeking professional help. Organizations like unisonhealth.org are valuable resources in the Northwest Ohio community, and our discussion serves as a heartfelt reminder of our shared commitment to nurturing the mental well-being of our youth. Join us for this meaningful conversation, where our dedication to children's mental health shines as brightly as the hope we hold for their future.
We called it Metro Park Monday and we would just pick a different metro park every Monday and go and explore the trails and the playground. But it was just a way for us to connect and she knew that every Monday that's what we were going to do. So I think, having looking for those opportunities to plan and spend time together, Hello and welcome.
Bill Emahiser:I'm your Bill ,Emahiser, and you're listening to Mental Health U, the podcast dedicated to demystifying and destigmatizing mental health issues. So if you or someone you know is struggling with depression, anxiety, trauma or some other mental health issue, then this podcast is for you. This episode is proudly sponsored by Unison Health, dedicated to making lives better through compassionate, quality mental health and addiction treatment services. Learn more at unisonhealthorg. Dedicated to making lives better through compassionate, quality mental health and addiction treatment services. Learn more at unisonhealthorg. Today, we've got the dynamic duo back in the studio Megan Reinhart and Julia Manalukas. These folks, they're real deal when it comes to helping kids wrestling with mental health issues. In this episode, we're diving deep into the world of childhood depression. Megan and Julia are going to give us the lowdown on what it looks like, how it affects our kiddos and, more importantly, what we can do to help them out. So let's get into it. Megan and Julia, welcome back.
Julia Manolukas:Thanks for having us back.
Megan Rinehart:Thank you, bill, we're glad to be here.
Bill Emahiser:Well, I am excited for you to be here and I'm excited about the topic and subject matter. But of course, before we get into that, in case there's listeners that don't know who you are, could you kind of give us a little bit of your professional background and experience?
Julia Manolukas:Sure, so I am Julia. I'm licensed as an LPCCS. I am currently the manager of Unison's school-based program.
Megan Rinehart:I've been with the program since I joined Unison in 2020 and I became their program manager this past fall, and I am Megan Reinhardt, also an LPCCS, and I am the director of child and family programming here at Unison. I rejoined Unison in 2020, but I've been in the field for 20 years this year mostly working with children and families and I became the director last fall.
Bill Emahiser:Well, for our audience that may not be familiar. Today is all about childhood depression. Could you maybe talk a little bit about what? Clinically, what's the definition of childhood depression?
Julia Manolukas:So depression in its simplest terms is sadness, but there's more to it than just being sad. So when we're looking at it from a clinical perspective, we're looking for sad mood, we're looking for a loss of interest in things, we're looking for changes in appetite, changes in sleep, some maybe uncomfortable thought processes. Are we having thoughts of self-harm? Are we having thoughts of wanting to do something to hurt ourselves or under life? And then we're looking for how are those symptoms and things affecting you? So we're looking for changes or challenges at school, in your relationships, at your job. So when we look at clinical depression, we're looking for what are the symptoms, the behaviors you're experiencing, you're exhibiting, and then how is that affecting your life?
Bill Emahiser:In childhood depression, I would assume, manifests itself maybe differently than adults. Could you discuss some of the common ways that depression presents itself differently in children?
Megan Rinehart:Yes for sure. So a typical adult symptom for depression, like Julia said, might be the classic depressed moods or feelings of sadness. For depression, like Julia said, might be the classic depressed moods or feelings of sadness In a child or adolescent. What you might see is more irritability or crankiness, or isolating themselves, so maybe spending more time in their room, not wanting to come out and spend time with family, not wanting to do or engage in activities they used to really enjoy doing, like sports or extracurriculars at school. They just don't want to do those things anymore. The challenging thing, I think, is, though it can also be typical teen behavior, some of those things, and so it's looking at. You know, how much is it impairing their functioning, you know? And is it something that's like been a few days, or is it something that's been longer and maybe progressively getting more intense?
Bill Emahiser:If I'm looking at, maybe, a child who's nine or 10 versus a kid who's 15 or 16, what are some of those differences? What might I see?
Megan Rinehart:I think with teens it might be again going back to not wanting to do things that maybe they really like to do, like hanging out with friends, for example. They really were social. They like to hang out with their friends, spend time with their friends in person or on the phone, on electronics, and now they don't want to. They just don't want to do anything. Maybe their grades are suffering. Maybe they used to to do anything. Maybe their grades are suffering. Maybe they used to participate in school and get good grades and do their homework and now, all of a sudden, you're noticing their grades are suffering. They're struggling to do the things that they would normally have been able to do every day. They're tired all the time. Maybe their sleeping habits have changed, their eating habits have changed. So again it's looking at. Is it something that is not just a one-time thing, but something that's been occurring and maybe getting more intense? Julia, did you have something to add to that?
Julia Manolukas:Well, thinking from a personal perspective. So what I've noticed with the children that I work with, I think with the younger kids I see more of the anger and irritability and less of the like quote, unquote obvious sadness. And with the teens I feel like I see more of a mix. So we're irritated, we're angry and also we can identify that, we feel sad. You know we talk a lot with kids about the anger iceberg. Or I talked to my kids about the anger ice cream cone.
Julia Manolukas:So that idea that like have you ever had those ice cream cones Like Dairy Queen has them, where they have the hard chocolate on the of the ice cream, the dip, the dip, the dip, yes, the best part. So anger is sometimes like that hard chocolate shell. It's obvious, it's noticeable, maybe it's what you taste first. It's tougher, it's hard and underneath is the ice cream. That's the more sensitive emotions, like the sadness or the hurt or the fear or whatever. And I think with younger kids it's more of an ice cream cone that we haven't bitten into. We're just seeing a lot of anger and with teens maybe we've like taken a bite. So I can see the anger, but I can also see some of the sadness underneath.
Megan Rinehart:Julia, I think that's great. I've used the iceberg before, but the ice cream cone, that's really great.
Julia Manolukas:Thank you. That is a product of Julia's Brain LLC, free for use for all.
Bill Emahiser:That's a great way of thinking about it. I think it's a great way to describe it, for, actually, for adults as well as for kids, kids who are having these, these behaviors, I would assume it might be kind of difficult for parents, teachers, maybe even mental health professionals, to kind of distinguish. You know what? What is this? Because it sounds like that outer shell, that chocolate outer shell before we get into the ice cream is what we see. But there could be other causes other than depression, correct? How do you know that it's depression and not maybe some other behavioral issue or emotional issue?
Julia Manolukas:Well, I think the key in understanding any mental health concern and understanding your child a child is communication. Let's talk about it. So if I'm a 15 year old girl and I'm slamming doors and just struggling to get out of bed and doing all these things differently, and my mother wants to know what's happening, the easiest way for her to find out is to try to talk to me. But for that to be effective, we have to have a relationship where I feel I can share and it has to be a space where we feel comfortable. So, approaching things from a nonjudgmental perspective, having that unconditional positive regard, you know, thinking the best of your child.
Julia Manolukas:So, yeah, you did just throw all of the toys out of your toy box. So instead of getting angry at you for throwing them and breaking the baby, yoda stuffy, let's talk about why that happened. What happened, dude? We were just playing and then you threw it. Can you help me understand why we made that choice? And then, when they can share with you what's happening underneath, when they can, you know, take off the top of the chocolate and show you what's underneath, then we can figure it out. Okay, legitimately, it was a hormone thing. That happens, it's a part of being a human being or no. I've been feeling really sad lately, and being sad makes me mad at everybody, and then from there we figure out okay, what can we do?
Megan Rinehart:to help. And one thing I read recently kind of along that same line, because sometimes I'll get guardians saying like you know, I try to talk to them, they just don't want to talk to me, they tell me they don't know or just say none of your business, walk away. So one thing I read recently which I think some people might find helpful is even creating like a mood journal, like some kind of journal that the guardian and child can pass back and forth so it's not having to like in that moment identify and talk about how I'm feeling or what I'm struggling with, but I can put it in this journal and I can give it to mom, dad, grandma, caregiver, and they can read it and then they can respond to it. So we can pass it back and forth that way.
Megan Rinehart:Also, mood coloring sheets so like every month has a segment of the coloring page and then you can create a key of like mad, sad, angry, happy, joyful, disgust I'm looking at my inside out figures but and then color in that segment to identify how you were feeling that day. So then you can use that as a way to kind of gauge how they're feeling and then also sharing emojis. So I thought those were really cool because sometimes I think for guardians who are struggling to figure out how to communicate with their child or they're feeling like there's some kind of barrier in the way of being able to verbally talk about how we're feeling, I thought those were really good tips that they could use to help open up the lines of communication in a different way.
Julia Manolukas:I am casually obsessed with all three of those and plan to share them with some of my families. I particularly love the journal because I have found a lot of my older kids and teens do love to journal as a coping skill.
Megan Rinehart:So it's a way for them to use a coping skill they know already works but take the pressure off in the communication and then parent guardian is participating in the treatment and the care as well and it builds the relationship right, because then you're able to share things and create that trust and then you can use that as like a springboard to then being able to have verbal conversations and engage with each other more in a conversational way. But it gives that ability also if there's things I want to tell you, but I don't know how I can write them down here and give it to you and you can see that.
Julia Manolukas:Yeah, I don't want to see your face when I tell you I don't want to see your reaction. Right Well now I don't have to.
Megan Rinehart:Yeah, those are great. I know, I thought it was really good. I thought it was really good. I know, I thought it was really good.
Bill Emahiser:I thought it was really good. Those are amazing strategies and I think you know, depending on the age of the child, you might use different strategies, right? So maybe for an older child that can write, maybe they're writing. I remember working with a young person who actually had a lot of difficulty with anger. We couldn't figure out quite what was the ice cream from the chocolate right From that chocolate outside, but he had a a lot of difficulty managing his anger and it was. It seemed like it went from zero to 150, like right off the bat. Now we know that's not usually how it works, but I asked him what do you think? You know, how can we help you? And he came up with this amazing idea. I always am amazed at how smart the young people are that we work with.
Bill Emahiser:This was like I think this kid was maybe first or second grade. He came up with this great idea. He said he was very interested in robots and so I asked him if a robot has anger issues, what might you use? What strategy? You know? How would we know that the robot was getting angry? And he said, well, it would be the Anger-O-Meter.
Bill Emahiser:And I'm like what's an Anger-O-Meter? And he goes on to tell me it's a meter that has on one end it's cold and that's when he's calm, and then when it gets into yellow he's starting to get more agitated, more irritated, and then when it goes into red it's explosion time. It's really he can't control his behavior anymore. So we actually I had him draw one, and then we use some art supplies and actually created an engram meter that we put on his desk and periodically the paraprofessional or the teacher could come over and kind of tap the, the, the angler meter, if you will, and he could move the, the hand on it to show where he was at, where he was feeling. And we knew that we had certain strategies, that when he was in the yellow we needed to do certain things, and he came up with those ideas. I thought it was amazing, but it's just another way of communicating with somebody at a different developmental level. Oh, I love that.
Megan Rinehart:I thought it was amazing.
Bill Emahiser:But it's just another way of communicating with somebody at a different developmental level.
Bill Emahiser:Oh, I love that First, or second grader right, probably isn't going to be able to verbally tell you, but they can definitely show you right. Mental Health U is brought to you by Unison Health. Unison Health making lives better. Yeah, are there any other specific? I mean, you guys came up with some great strategies there. Are there any other strategies that come to mind that that maybe a parent could use at at home um as well, to help, uh, maybe, a child who's struggling with other symptoms of of depression? Maybe they're, they are, they're isolating, um, or they are, they're kind of pulling back, they're staying in bed. Do you have any ideas or strategies that you might be able to share with parents that are experiencing those kinds of symptoms? I?
Megan Rinehart:think one thing that comes to mind for me is spending time together. So, like Julie talked about communication, but also figuring out ways to engage them in different activities, like a family mindfulness or some type of activity schedule where, like every week, we're going to do this thing. So, and it doesn't have to be something that costs a lot of money, it could be low cost or no cost, but things like you know, we're going to everybody's going to turn off their electronics and we're going to spend one hour together and maybe we're going to play a game, or we're going to watch a TV show or watch a movie, watch something that we all want to watch together. Or we're going to read a book together and everybody's going to take a turn reading something. We're going to eat a meal together.
Megan Rinehart:Go find a new park there's lots of lovely, amazing parks in Toledo. So maybe choosing one and visiting and exploring that that was something that I did with my daughter on Mondays. We called it Metro Park Monday and we would just pick a different Metro Park every Monday and go and explore the trails and the playground, but it was just a way for us to connect and she knew that every money, that's what we were gonna do so. I think having looking for those opportunities to plan and spend time together as a family is important, helpful.
Julia Manolukas:I liked how you talked about planning and routine. I know we've talked about this before and we've discussed anxiety, but I think routine can just be helpful for young people in general. So having a routine and being intentional about the time so Metro Park Monday is an intentional thing that Megan would do with her daughter In my family before all of us got old and left the nest is we would do like during the pandemic, we would do like takeout Fridays. So we would always go masked up and get something out to eat on Friday and eat as a family. So being intentional and planning that time.
Julia Manolukas:Similarly, thinking about routines you can set. So Megan and I in the past have done a group with teenagers and one of the things we talked about was having a bedtime routine, a sleep hygiene routine. Sleep hygiene and traditional hygiene can be interrupted and negatively impacted by depression. Creating a routine with your child that you participate in, something you do together, but that's encouraging them to make healthy choices can be another way to try to help address and support them through their symptoms or what they're experiencing.
Megan Rinehart:That was on my list of things too, and I was thinking of what? And it was a sleep routine, you know, creating a routine and not involving electronics that encourages or enhances relaxation, some type of thing that they can do at the end of the day to help wind down and find that ability to calm and relax. I think sometimes too, when caregivers or guardians have children that are struggling with depression, they might feel like they want to back off on some of the limits or the expectations, the rules at home. But you really, like you were just talking about with routine trying to stick with that routine and keep in it as much as as much as possible to maintain that structure as helpful.
Julia Manolukas:And then maybe doing things together, right? So if your chores are emptying the dishwasher and you're struggling to do that, then instead of being like, well, you never have to do that chore again, it's like let's empty the dishwasher together, let's do it together then instead of being like, well, you never have to do that chore again.
Bill Emahiser:It's like, well, let's empty the dishwasher together, let's do it together. We look a lot on the anxiety side about parental accommodation. It sounds like you're kind of hinting on that for depression as well, I think sometimes and you tell me if I'm wrong on this but I think sometimes parents experience feelings of guilt or shame or self-blame when their children are experiencing a mental health issue like depression. It sounds like having these prescribed schedules, being intentional about our time building that rapport with your child, is super important, but would you happen to have any words of wisdom or encouragement for parents that do feel that guilt or self-blame or shame around their child struggling with a mental health issue?
Julia Manolukas:Well, I think the important thing to remember is that parents are people too, and parents struggle and they make more sense, and caregivers too, right?
Julia Manolukas:You know, not every adult caring for a child is necessarily their biological parent. So I think understanding when you need support, when you need a break, and seeking that out so maybe that's finding a therapist for yourself or having someone in your life you feel like you can rely on that can give you extra support. So I think taking care of your mental health is important as well, but I also think trying to depersonalize it in the sense that it's not necessarily your fault. We know from the research that there's tons of factors that contribute to the development of a mental health diagnosis, like depression. Out some education, reading some books, listening to podcasts, talking to your child's therapist or their pediatrician or whoever to try to get information so that you have the knowledge to understand that it's not something that you need to carry and blame yourself for, but then also identifying when you need to get extra support. Not even extra support just like support. You just have support. It doesn't have to be extra, just having support for you.
Bill Emahiser:What point in time?
Julia Manolukas:should a parent seriously consider seeking professional help for their child. So you know, we talked at the beginning of the podcast about when there starts to be that effect on their life. So the isolation, the school, the grades, their relationship with you, whatever the case may be. So you know, looking for those moments of impairment is always a good time where you're saying, okay, this is past, just being 15, it's starting to affect in different ways. Let's talk to somebody.
Julia Manolukas:But also being aware if your child makes comments you know about I wish I wasn't here or things like that that might hint because suicidality is a component of depression, it often is a symptom, it's connected and so taking those comments seriously. I know that sometimes people we encounter a lot kids say that and they're actually trying to tell us something else. But I always tell the kids anytime you say it I'm going to take it seriously. So, as a parent or a caregiver, taking it seriously every time and not from a scary perspective but from a wow, it sounds like you're in a lot of pain. Can we figure out how to help with that? So looking for that impairment and then listening, listening clearly to what your child is telling you so that you can help them stay safe. Um would be the two things that come to mind for me.
Bill Emahiser:Well, where could parents or families who are at that point where they're thinking you know what, my child, this is going on. It's been several weeks, they're not getting better, they're having a difficult time when can they turn for help and support if they suspect their child is struggling with depression?
Julia Manolukas:So they could check out our website, unisonhealthorg, which outlines all of the services and programs that we offer to help support children and families, and if you want to start with something else we talked last time too about you can talk to your child's school counselor so they can connect you with a place like Unison, or they can give you some extra resources too. And we always tell parents and tell our families, like when in doubt any emergency room, like it's okay to just take your child to the nearest medical professional and have someone talk to them. So I always think it's better to err on the side of caution, of getting your child support in a situation where they might end up not needing it, as opposed to not.
Bill Emahiser:Well, thank you both so much. I feel like you have given just a wealth of information, some very specific strategies and techniques for parents to help their children that might be struggling with depression or really, I think, any other mental health issue as well. I think that's just really great advice for folks, so I really appreciate you coming on Mental Health U again.
Julia Manolukas:Thanks for having us, Bill. It's always a pleasure to get to talk with you and to talk about this thing we're passionate about, which is children and their mental health.
Megan Rinehart:Yeah, we appreciate you giving us the opportunity to do that, so thank you for having us again.
Bill Emahiser:This podcast has been brought to you by Unison Health. Unison Health is a nonprofit mental health agency dedicated to serving the Northwest Ohio community for the past 50 years.