You know what it's like to be "sorrowful" when you are young. What is your mind?
In the reading station of Children’s Home in Chenguang Community, Taihu Street, Changxing County, Huzhou City, Zhejiang Province, community party member volunteers explain children's picture books to children.
Xinhua News Agency
The theme of this year's World Mental Health Day is "Youth Mind, Youthful Youth". Not long ago, the results of the "Chinese Children and Adolescent Mental Disorders Epidemiological Survey" were announced, and the national prevalence rate of children and adolescent mental disorders was 17.5%. On October 15, the Ministry of Education responded to the CPPCC National Committee’s “Proposal on Further Implementing Measures for the Prevention and Treatment of Adolescent Depression”, clearly including depression screening in the content of student health examinations, establishing student mental health files, and evaluating students’ mental health. Give special attention to students with abnormal assessment results.
The health of young people is inseparable from the all-round development of the body and mind. Facing the increasing mental health problems of young people, how can schools, families and medical institutions work together to build a protective barrier for young people's "beautiful minds"?
Always depressed, is it sick?
Xiaoyu is a high school student with average academic performance. Recently, he has been depressed and loses his temper from time to time.
Both parents are busy with work and don't take Xiaoyu's situation to heart.
Until one day Xiaoyu suddenly complained of headaches as soon as he went to school, and was diagnosed with depression by the doctor, and he needed to suspend school and receive medication.
Xiaoyu's parents are confused, how come they are about to suspend school?
"This situation is very common among young people. We often question whether students are really depressed or an excuse to avoid studying. Especially because of this, there are many cases where they cannot take the high school entrance examination and the college entrance examination. As a teacher, it is inevitable to regret it." Qingdao Qi Said Guo Feng, a full-time psychology teacher at Yuan School.
Are depressions all depressions, and how are they defined in medical terms?
"The diagnostic criteria and diagnostic system for depression in adolescents are the same as those of adults. However, because the bodies and brains of adolescents are in a stage of rapid development, sometimes the symptoms are not as typical as adults." According to the introduction, in the diagnosis process, we first need to collect the medical history, usually from the parent to understand the child's main symptoms and developmental status, and then conduct a mental examination to understand the child's cognition, emotion and behavior and other psychological processes.
At the same time, carry out necessary psychological evaluation, including self-rating scale and other scale, to comprehensively judge whether the child is suffering from depression.
"Every disease has its own symptoms, and depression is no exception." Qu Shan, deputy chief physician of the Department of Psychiatry, Peking University People's Hospital, said, "There are three core symptoms of depression, one is depression, and the other is interest. Decrease, the third is a decline in physical energy; additional symptoms are conditions that usually appear in patients with depression, such as low self-evaluation, hopelessness for the future, self-crimination, abnormal appetite, sleep disorders, etc. We diagnose depression as one of the The basic bottom line is that there are two core symptoms and two additional symptoms, and if there are three core symptoms plus additional symptoms, it is a manifestation of severe depression."
"If the above symptoms are the same for most of the day and last for more than two weeks, we can make a judgment of depression." Qu Shan said, "Many people are in a bad mood today, and they will get better tomorrow, regardless of what happened at the time. No matter how serious it is, it cannot be called depression."
It can be seen that at the medical level, the diagnosis of depression is stricter.
The recent hotly debated statement "The detection rate of depression among adolescents in my country is 24.6%" is derived from the "Chinese National Mental Health Development Report (2019-2020)", which has clearly stated that the survey data comes from the frequency of depression symptoms in the past week. Depression here can only be defined as a depressive mood or state of depression, and cannot accurately judge the actual situation of adolescents’ mental health.
Juvenile’s troubles are not random thoughts
"Recently, a senior in high school often talked to me, saying that insomnia had tormented her for a long time, and sometimes she had auditory hallucinations, fearing that her family was worried that she never dared to tell her parents. It was not until a good friend persuaded her that she plucked up the courage to go to the hospital for an examination, and the diagnosis was indeed psychological. There are some problems." Mentioning a case that he had come into contact with, Guo Feng said, "The self-cognition of mental health and the level of attention of adults affect the mental state of young people."
At present, the exact cause of adolescent mental disorders is not yet clear, but it is clear that the mental health of adolescents is the result of the interaction of biological and environmental factors.
He Fan said: "Biological factors include genetic factors. For example, some mental disorders may cluster together in families, as well as neuroendocrine abnormalities. Studies have shown that inflammation-related factors are also related to depression."
"Among them, there is a family history of depression or mental illness, and the risk of suffering from depression is 2 to 4 times that of normal people." said Zhang Caiyi, deputy chief physician of the Neuropsychological Clinic of the Affiliated Hospital of Xuzhou Medical University.
Biological factors are generally difficult to foresee, while environmental factors are relatively easy to observe and interfere with, the most direct of which is the family environment.
"Some families have improper parenting methods, such as excessive spoiling and laissez-faire parenting. Some parents think that as long as the child learns well, others can do the work or laissez-faire. This can easily lead to self-centeredness, poor self-care ability, lack of empathy, etc. Problem. In a collective environment, if you don’t know how to deal with setbacks, you are prone to social difficulties and experience more negative emotions; some families still have abuse and neglect of children, including physical and emotional aspects, and children lack self The ability to regulate emotions; now some parents have too high expectations for their children, and various interest classes occupy their children’s rest time, and even take up their sleep time, which are not conducive to the development of their children’s mental health.” He Fan explained, “ The development of children’s mental health depends on a healthy ecosystem. Unhealthy ecosystems, such as unstable parent-child relationship, unharmonious parent-child relationship, poor teacher-student relationship, campus bullying, etc., all induce depression, anxiety and other negative emotions in adolescents. High-risk factors."
"In addition, it also includes some unique factors of puberty, such as sex hormone fluctuations, low self-evaluation during puberty, confusion and instability of self-cognition, etc." Zhang Caiyi said.
Young people are still in the process of forming stable values, and they are also vulnerable to the wrong guidance of negative values in the surrounding environment.
“A girl who was diagnosed with moderate depression often told her deskmate that she was tired from studying, her parents didn’t understand herself, life was unhappy, etc. As a result, her deskmate began to have similar emotions.” Guo Feng said, “ Of course, there is a certain degree of contingency, but it also shows that teenagers with the same characteristics and life backgrounds are easy to group and warm up, and students who are not independent enough are often easily involved in other people's stories."
Problems can neither be ignored nor exaggerated
The Juvenile Mental Health Clinic of the Second People's Hospital of Gansu Province receives nearly 5,000 people each year, of which 60% are junior high school students and 30% are high school students.
"Children's mental illness is mainly depression, as well as anxiety, obsessive-compulsive disorder, learning disabilities, and interpersonal disorders." said He Ruifang, vice president of the Second People's Hospital of Gansu Province.
According to He Ruifang, teenagers are facing pressure from studies, entering schools, and making friends, but they are in a state of instability both physically and mentally during adolescence. They often feel hesitant and confused, and their parents are not sufficiently prepared for this change, and they will inevitably suppress them unconsciously. The child’s negative emotions lead to an increase in the psychological pressure of adolescents.
"Some children can recognize that there is a problem with their emotions, and even take the initiative to ask their parents to take themselves to a psychologist or psychiatrist for help. There are also some children who realize that they may have some problems in the early stage, but do not know the problem is. Where, until the gradual loss of self-insight and social function impairment, this has aroused the attention of parents and teachers." He Fan said.
"Students who come to consult are mainly worried that their psychological problems will burden their parents, and they are also worried that their help-seeking behavior will be treated differently by teachers and classmates. This kind of'stigma' prevents them from seeking help in time." Guo Feng said, “The opposite is excessive display. Some students talk about depression in public places without shying away from them, and even publish their diagnosis reports in their circle of friends. This reflects the complexity of children and adolescents’ mental health problems. sex."
Parents still do not pay much attention to their children’s mental health.
“There are not many parents who can detect their children’s psychological problems early. Most parents pay more attention to their children’s social functions, such as whether their children’s academic performance is significantly affected, and many parents will It is understood that the child may have reached the rebellious period of youth, and it will be fine after puberty has passed.” He Fan told reporters that after some medical history collection, mental examination and related auxiliary examinations, the child was diagnosed with depression, and some parents believed that the child was playing truant from school. And pretending to be sick.
At present, the society attaches great importance to the mental health of young people. However, in Qu Shan's view, this emphasis still lacks some objective and rationality.
“Now there is a tendency to over-exaggerate the mental health problems of teenagers, and if a little bit of trouble, children will be labeled as mentally ill. Some people think that they can adjust themselves at home without seeing the doctor. This is a very bad phenomenon. "Qu Shan said.
Qu Shan told reporters that depressive disorders are also divided into different degrees. Patients with mild symptoms cannot prematurely label major depression. Even severe depression can be treated and can be treated very well. The most important thing is to provide timely psychological and spiritual treatment. The doctor asks for help.
Help children stay away from negative emotions and take precautions
In recent years, under the background that the country advocates the whole society to pay attention to the mental health of adolescents, more and more adolescents and parents go to professional institutions to consult about mental health problems.
"This is a positive sign, which shows that young people's awareness of self-care has been strengthened, and parents have also developed a more scientific attitude." Qu Shan said.
So how should depression be treated?
"If it is mild depression, under the premise that psychotherapy resources are available, psychotherapy is the first choice, and the evaluation lasts for 3 months. If it is moderate or above, it should be based on medication and supplemented by psychotherapy. Treatment requires comprehensive intervention to help children recover their social functions as soon as possible." He Fan introduced.
Of course, everyone's situation is different, and a personalized and targeted treatment plan is needed.
"Sometimes it is supplemented with diet, exercise, light and other treatments, and more serious ones require physical therapy." Zhang Caiyi said.
Compared with treatment, helping young people get rid of the negative emotions in their daily lives can prevent problems before they happen.
"In the real environment, there are more or less pressures, including learning, life, social relations and other aspects. As parents, we must first allow young people to have negative emotions. After discovering that their children have negative emotions, avoid panic or even complaining. Parents should do the most Yes, we must first accept and understand the children’s various emotions, and help them find the source of negative emotions, and help them solve the pressure sources that cause negative emotions. At the same time, encourage children to do some activities they like to enhance their emotion regulation ability." He Fan Said, "Adolescents have insufficient awareness of negative emotions and stress and their ability to solve problems. Parents, teachers, etc. are required to participate and help. Parents should cultivate their children's ability to regulate negative emotions and relieve stress from an early age."
"From the school's perspective, it is necessary to carry out scientific work related to mental health knowledge for all students, and at the same time, organize more thematic activities that are beneficial to the physical and mental development of students, create a sunny campus atmosphere, and formulate detailed crisis intervention procedures. Once a psychological crisis occurs, work must be carried out immediately in accordance with the process." Guo Feng said.
The reporter learned during the interview that starting from 2020, the Gansu Provincial Mental Health Center will cooperate with the Lanzhou Municipal Education Bureau to build a psychological crisis prevention, early warning, and intervention system in Lanzhou primary and secondary schools, and set up a team of psychological crisis experts to help young people resolve psychological crises in a timely manner .
Many schools in Lanzhou have also joined the Gansu Provincial Mental Health Specialty Campus Alliance, so that students with psychological barriers can enjoy the green medical treatment channels of professional medical institutions. At the same time, psychologists organize special trainings to encourage more parents and teachers to master psychological crisis response strategies. .
Many psychologists believe that helping young people to shape "beautiful hearts" is ushering in more favorable external environments.
Among them, the liberalization of the "three-child policy" will allow more only children to have family playmates, which will help to exercise children's comprehensive abilities; and the introduction of the "double reduction" policy will reduce the burden on young people and help them even more. Their physical and mental health development.
(Reporter Qin Weili)