Research Brief Imagine this with me: You are sitting in a classroom, it is an average day in high school. Your teacher is lecturing, birds are chirping outside, you are with all of your friends in class. All of a sudden, you feel like a ton of bricks has hit you. You begin to sweat, feel dizzy, your chest tightens, and it becomes hard to breath. You check your pulse and heart, it is beating so fast that you cannot count the beats. You look around for a way to get out, but if you run out of the room, everyone will see you and start to ask questions. This only makes your heart race faster and you start to panic. You begin to ask yourself, “Am I dying? Am I going insane? What if this never stops? Will this happen tomorrow?” Now, how has this made you feel? You have just experienced a simulated panic attack, a common mood disorder.
Mood disorders are impacting the children in our classrooms more and more each day. Anxiety disorders affect 25.1% of children between 13 and 18 years old and an estimated 15% to 20% will experience a depressive disorder by the age of 18 (Meredith, Stein, Paddock, Jaycox, Quinn, Chandra, & Burnam, 2009). Social Anxiety Disorders commonly begin around age 13, or about the seventh or eighth grade of United States middle school students. Suicide is a major concern: About 15% of individuals with mood disorders will commit suicide, depression is the cause of about 50% of all suicides (Hollon, Thase & Markowitz, 2002). According to the Center for Disease Control (CDC), in 2016, suicide was the number two cause of death for the ages of 5 to 18. A total of 2,032 suicides were reported that year for the age range (“10 Leading Causes,” n.d.). While not all of these are linked to anxiety and depression, it is a shocking statistic of the students sitting in our classrooms.
In the United States, depression disorders are the leading cause of disability for people ages 15-44. People who suffer from Major Depressive Disorder make habits of not coming to class or not attending activities that they once enjoyed and talked about in class (“Depression,” n.d.). The Association of Anxiety and Depression has noted that “research shows that untreated children with anxiety disorders are at higher risk to perform poorly in school, miss out on important social experiences, and engage in substance abuse” (“Facts & Statistics,” n.d, para 10).
Panic attacks affect one out of 75 people, and they generally begin in adolescent or young adult years (“Answers,” n.d.). Panic attacks are a major part of panic and anxiety disorders. Anxiety disorders are common in both adults and children. About 18 percent of U.S. adults and 25 percent of adolescents age 13 to 18 will experience anxiety, according to the National Institute of Mental Health. About four percent of adults, and nearly six percent of teens, have anxiety disorders classified as severe. (“Beyond Worry,” n.d.) Anxiety disorders are not one-size-fits-all. There are many major types, but I will be focusing on the following: Generalized Anxiety Disorder (GAD), Panic Disorder (PD), and Social Anxiety Disorder (SAD). Each of these have their own symptoms and specific criteria. GAD is a general term used for people with overwhelming anxiety. PD is similar to GAD, but this group experiences panic attacks, similar to what was described earlier. Another characteristic of PD is the worry of another panic attack, causing the anxiety of anxiety. SAD is characterized by anxiety in social situations. “People with this disorder are fearful of social situations in which they might feel embarrassed or judged. They typically feel nervous spending time in social settings, feel self-conscious in front of others, and worry about being rejected by or offending others” (“Beyond Worry,” n.d.). People with depression often has symptoms of anxiety, but not all people with depression have anxiety. Anxiety can cause depression in situations of agoraphobia, the fear of "irrational or disproportionate fear of a range of situations in which a person believes escape or access to help may be impossible, very difficult, or very embarrassing if he or she develops panic-like symptoms or some other incapacitating loss of control” (Bienvenu, Wuyek, & Stein, 2010). Hollon, Thase, and Markowitz (2002) describe the symptoms of depression as the following:
Depression typically involves negative affect, like sadness, and a pervasive loss of interest in things that were previously enjoyed. It is often accompanied by a profound sense of pessimism (including thoughts of suicide) and negative beliefs about the self. The individual is often less energetic than usual, en gages in fewer activities, withdraws socially, and is less productive. There also are often vegetative symptoms, such as difficulty sleeping, loss of appetite, and loss of interest in sex. (p. 40)
Depression, like anxiety, has many types. Two major types of depression are Dysthymic Disorder and Major Depressive Disorder (MDD)(Hollon, Thase, & Markowitz, 2002). The form of depression is determined by how often the symptoms occur. Symptoms must be “persist for two weeks or longer and represent a significant change from previous functioning. Social, occupational, educational, or other important functioning is also impacted” (“Depression,” n.d.).
Major Depressive Disorder is characterized as a single episode or recurrent episodes. The Anxiety and Depression Association of America characterizes MDD as showing the following:
At least five of the diagnostic symptoms of which at least one of the symptoms is either an overwhelming feeling of sadness or a loss of interest and pleasure in most usual activities. The other symptoms that are associated with major depression include decrease or increase in appetite, insomnia or hypersomnia, psychomotor agitation or retardation, constant fatigue, feelings of worthlessness or excessive and inappropriate guilt, recurrent thoughts of death and suicidal ideation with or without specific plans for committing suicide, and cognitive difficulties, such as, diminished ability to think, concentrate and take decisions. (“Depression,” n.d, para 6)
Dysthymic Disorder is a less severe but more chronic type of MDD (Hollon, Thase, & Markowitz, 2002). Dysthymic disorder is more mild than Major Depressive Disorder. It includes depressed mood and at least two other depressive symptoms. Dysthymic disorder is “chronic (depressed most of the day, more days than not, for at least 2 years) and persistent (no symptom-free periods of longer than 2 months) and has an insidious onset (no major depressive episode within the first 2 years of the disturbance)” (Klein, 2010, pp. 96-97). While MDD symptoms are present in Dysthymic Disorder, but there are more cognitive, affective, and social-motivational symptoms. These symptoms are more common than the vegetative symptoms of MDD (Klein, 2010).
Teachers see children on a daily basis which makes it easier for them to identify signs of distress. Through the guided education of these mood disorders, teachers can bring an awareness to students, faculty, and families. This is one of the ways that can be used to spread awareness about these mood disorders. Identifying signs of these disorders is also important to alert parents or guardians about possible distress before it becomes overwhelming, or in an extreme case, too late.
Plan of Action For the first step of this plan, I would need to get parental/ guardian permission to use their child in my research. Those who will not be participating will continue to complete their assignments as discussed in the beginning of the school year. After getting the permission, I would move on to presenting the class with key information in the Research Brief to give them background information on the topic. Some of the students are diagnosed with the mood disorders discussed, so this work will have a more personal effect on them. I will be very open to the students and show them work from other artists about similar topics, including my own work from my high school photography class.
Students in my advanced photography classes (Photo 3 & 4) do not have a stated set of curriculum they must follow, so the use of this assignment will fit in with their standards. They will photograph a series of images for the topic. Students who do not personally have these mental health struggles, will be encouraged to interview friends or family members that may suffer from these mood disorders.
The images would have a cause and effect. The cause would be what makes them or a peer feel anxious (example: Public speaking), and the effect would be how it makes them feel (example: Group of people surrounding the speaker, looking down on them).
At the end of the project, we will have a peer critique. Students will be able to see their classmates work and have an open discussion about the work. They will have a facilitated critique about the subject matter and the techniques used in the photographs.
I would like to hold a “pin up show” that would be up for a few weeks that anyone can come see, I would need to further discuss this with my administration. I will have slips of paper that students can write what makes them feel anxious or depressed to then anonymously and place in a box. I will go through them for screening and post them on the wall around the photographs, documenting the comments and creating a pie chart for similar ideas to gain more understanding of what is causing these feelings within the environment that I work in.
References Answers To Your Questions About Panic Disorder. (n.d.). Retrieved from http://www.apa.org/topics/anxiety/panic-disorder.aspx Beyond Worry: How Psychologists Help with Anxiety Disorders. (n.d.). Retrieved from http://www.apa.org/helpcenter/anxiety.aspx Bienvenu, O.J., Wuyek LA, Stein MB, 2010. Anxiety disorders diagnosis: some history and controversies. Curr Top Behav Neurosci ;2:3-19. Depression. (n.d.). Retrieved from https://adaa.org/understanding-anxiety/depression Facts & Statistics. (n.d.). Retrieved from https://adaa.org/about-adaa/press-room/facts-statistics# Hollon, S. D., Thase, M. E., & Markowitz, J. C. (2002). Treatment and Prevention of Depression. Psychological Science in the Public Interest,3(2), 39-77. Klein, D. N. (2010). Chronic Depression: Diagnosis and Classification. Current Directions in Psychological Science,19(2), 96-100. Meredith, L. S., Stein, B. D., Paddock, S. M., Jaycox, L. H., Quinn, V. P., Chandra, A., & Burnam, A. (2009). Perceived Barriers to Treatment for Adolescent Depression. Medical Care,46(6), 677-685. 10 Leading Causes of Death, United States. (2016). Retrieved from https://webappa.cdc.gov/sasweb/ncipc/leadcause.html