"In October 2021, I was diagnosed with severe depression and severe anxiety. My family and friends could not understand my pain. Regarding my various symptoms and manifestations, they thought I was 'pretending to be sick' and 'hypocritical.' Poor family relationships and interpersonal relationships made me fall into self-denial." This is the personal experience of Ren Yu (pseudonym), a senior high school student, after suffering from depression .
Every patient with depression has his or her own fuse, and Ren Yu's fuse is "bad relationship."
Ren Yu’s family is a typical one in which “men take charge of the outside world and women take charge of the housework.” The parents have a clear division of labor—the father runs a small business to support the family’s livelihood and is used to giving orders to family members; the mother is obedient to her husband and strictly follows the parenting philosophy of “a strict father produces filial sons, and a loving mother often fails.” "My father is strict and stubborn. Ever since I was a child, I have never been able to meet his requirements, and I will never do so. My mother rarely expresses love to me, and will only tell me with a straight face what I didn't do well enough." In Ren Yu's memories, her father is like a superior judge, and her mother is the executioner who kills her happiness.
Ren Yu clearly remembered that one night in the second year of junior high school when she was about to take the biology exam, she developed a high fever. She asked her mother to take an hour's rest before reviewing. As a result, her father came home and saw her lying on the bed early. After the mother explained to the father, the father not only did not apologize, but even complained that the mother was "spoiled." The last scene in her memory was of her sitting weakly at the desk, wiping away tears while listening to her mother nagging: "Your dad didn't mean to do this to you. After all, you are about to take the exam. He is doing it for your own good. Take some medicine and persevere."
Father said to Ren Yu has many unreasonable requirements, such as not being allowed to play with classmates who are not good at studying, not allowed to play with male classmates, and not allowed to buy things unrelated to her studies with pocket money... Once she violates the "family rules", her father will criticize her fiercely, and her mother will even go to teachers and classmates to "beg for explanations," which makes her feel extremely ashamed and guilty. Over time, Ren Yu developed a contradiction deep in her heart that was difficult to resolve. On the one hand, she loved her parents deeply because they were her closest blood relatives; on the other hand, she was full of anger towards her parents. The endless grievances she experienced on her growth path were buried in numerous past events, which were strong but powerless.
Following the "bad family relationship", it can be imagined that Ren Yu developed a character of sensitivity, low self-esteem, self-demanding, prone to pessimism, and strong self-esteem in the not-so-good family life. After entering high school, facing an unfamiliar environment, she urgently sought the asylum of "partnership". In order to "bundle" her life with her peers, Ren Yu appeared very humble in her relationships, always satisfying others unconditionally, and even got into fights just to "stand up" for her friends. Later, these so-called "friends" felt that she was "too clingy", "too boring", "unassertive" and "emotionally unstable", so they abandoned her one after another, leaving her completely alone.
The most embarrassing and helpless thing for Ren Yu is taking physical education classes. Whenever there are two-person or multi-person events, she can't find a partner to practice with, so she can only quietly hide in the corner and watch other people's activities. Ren Yu felt that she was "abandoned by the whole world". She began to escape from the sight of her classmates and teachers, becoming more cowardly, withdrawn, and always sensitive and suspicious. Whether it was female classmates discussing campus "gossip" in groups of two or two, or the slightly childish jokes of adolescent male classmates, she was extremely disgusted. She always vaguely guessed that the person being discussed behind the back of her peers was herself.
At first, Ren Yu did not feel that she was sick. She just thought that she was not suitable for high school life. In addition, she had some low self-esteem about her body and appearance, and had a sensitive and introverted personality, which made her not good at socializing.But slowly, this kind of self-denial became stronger and stronger, her thoughts became more and more extreme, and she had more and more conflicts with her family. She was tired of studying and even world-weary. In her words, "the whole person was surrounded by a huge sense of meaninglessness." Finally, after a self-assessment of depression index organized by the school, her mother took her to see a professional psychologist under the advice and supervision of the school psychologist. Eventually, Ren Yu was diagnosed with severe depression and severe anxiety.
Even today, when medicine is so popular and developed, Ren Yu's depression is still "demonized" by her family and classmates. Her parents think that her depressive symptoms are "moaning for nothing" and a deliberate resistance to parental authority; while those classmates who don't understand depression think that Ren Yu has a "mental illness" and dare not contact her. Because of this, she has a deep sense of "sense of shame" and is unwilling to disclose her illness to others. Fortunately, with the help of doctors and teachers, Ren Yu has gradually returned to normal life, and began to learn self-healing under the advice of doctors. Not long ago, she read a book called "Mr. Toad Goes to a Psychologist" and developed a strong empathy with Mr. Toad, who suffered from depression in the book. Seeing that Mr. Toad finally regained his life with the help of doctors and friends, she also gained a strong belief. That day, Ren Yu updated her circle of friends: "Ms. Mermaid is also going to see a psychiatrist. One day, I will be able to sing loudly in the sun."
Breaking through the "bad relationship" and going through the long journey of depression
planning | Cao Ji
"Depression in my heart is like a black dog, biting me every chance I get." Former British Prime Minister Winston Churchill once described depression this way. Depression is not a simple "bad mood", but a disease. Not long ago, the Depression Research Institute teamed up with multiple institutions to jointly create the "2022 National Depression Blue Book" and collected 6,670 valid questionnaires from the group of patients with depression. The survey data shows that: 50% of patients with depression are school students; patients with depression under the age of 18 account for 30% of the total sample. Among them, 77% and 69% of student patients said they were prone to depression in interpersonal and family relationships.
In order to better understand adolescent depression and help adolescents get out of the influence of bad relationships, "Educator" invited experts to interpret "relationship-type" depression among adolescents, with a view to promoting the mental health of adolescents in our country.
Zhang Ronghua
Deputy Director of the Department of Ideological and Political Education, School of Marxism, Wuhan University
Deputy Director of the Institute of Development and Educational Psychology
Sun Ling
Director of the Child and Adolescent Psychology Department of Tianjin Mental Health Center
Member of the Children's Special Committee of the Chinese Mental Health Association
Wang Yiyi
Professor of the School of Psychology and Cognitive Sciences, East China Normal University
Researcher of the Shanghai Key Laboratory of Mental Health and Crisis Intervention
Why can relationship crises easily cause depression?
Wang Yiyi: People are social and need to establish relationships to satisfy social needs and establish a sense of belonging. For teenagers, the most important interpersonal relationships are family relationships and peer relationships.
As far as family relationships are concerned, the parent-child relationship in adolescence itself faces certain challenges, because during this period teenagers will have independent development needs, have their own ideas and secrets, and may alienate their parents intentionally or unintentionally. If parents cannot well adapt to and respect their children's independent development needs at this time, such as blindly asking their children to report everything to them in detail, arranging everything in their children's life or study, or not respecting their children's privacy, it will cause harm to the parent-child relationship. Therefore, during adolescence, parents' meticulous care and guidance may become a challenge to the parent-child relationship at this stage.
As adolescents grow older, the importance of peer relationships increases day by day. They need to satisfy their belonging needs by establishing positive and reciprocal peer relationships, or obtain important social support by exercising their social skills. However, it is not easy to establish and maintain a positive and reciprocal peer relationship. Since teenagers are in the stage of self-awareness, they are emphasizing self-awareness while also getting rid of "self-centeredness". Conformity, rejection, rejection, isolation and even bullying that may occur in this process can easily evolve into major stressful events and cause psychological trauma to teenagers. In addition, adolescents' "Waterloo" in peer relationships may cause them to develop negative attribution bias, such as feeling that they are failures and unworthy of the support and care of others. This negative perception of the self is also a trigger for depression.
Zhang Ronghua: According to the self-determination theory proposed by American psychologists such as Desi and Ryan, people have three basic psychological needs: a sense of relationship, a sense of capability and a sense of autonomy, that is, feeling that they are well connected with others, feeling that they are capable, and feeling that they are free. If the three basic needs are destroyed, it will easily affect mental health and lead to depression.
Poor parent-child relationship, such as parents' psychological control over children during the discipline process, will destroy their sense of autonomy and competence. If it continues for a long time, it will lead to children's learned helplessness: "No matter what I say, you don't listen, no matter what I do, it's useless", making them feel hopeless and helpless. Studies have found that the comorbidity rate of anxiety and depression is about 60%. Heavy academic work coupled with high-pressure management by parents puts children in constant stress and anxiety, which can easily lead to depression in the long run.
Poor relationship between husband and wife will make children feel that the home is full of conflict, indifference and violence. If they are in this environment lacking warmth and care for a long time, children's sense of relationship will be seriously damaged, so that they often feel isolated and helpless in interpersonal interactions. In the school environment, if children lack peer interaction and lack of social support when encountering pressure and difficulties, it will also affect children's sense of relationships and abilities; poor peer relationships can also lead to children's loneliness, which are all factors that trigger depression.
Sun Ling: One of the key causes of depression is "unsafe intimate relationships." To put it simply, it means being in a long-term relationship where you are attacked by someone you trust very much but cannot resist (or leave). This contradiction triggers the depression switch. For example, being betrayed or slandered by a good friend, being denied or insulted by parents for a long time, etc. Among these intimate relationships, the most difficult to escape is the parent-child relationship. Judging from clinical cases, most of the causes of children's psychological problems are related to parents' improper training methods.
The parent-child relationship is the most direct environmental factor in a child's growth. If it is not handled well, it will directly or indirectly affect the child's physical and mental health, making the child feel depressed, aggrieved, not understood and trusted, and even irritable, angry, self-injurious, and aggressive. If the child is in a bad parent-child relationship for a long time, it may also affect the child's objective judgment of self and future growth. The child will not know how to establish and maintain close relationships with others, leading to a series of problems in the future workplace, making friends, and marriage, and increasing the risk of psychological disorders.
What are the symptoms of depression in children and adolescents?
Sun Ling: Depression will cause serious damage to children and adolescents’ subjective feelings, learning, interpersonal interaction and quality of life. Children usually have more hidden symptoms, fear and behavioral abnormalities in clinical manifestations, and their overall social functions are severely damaged, thereby increasing the burden on their families and society. Many reports have pointed out that depression in children and adolescents is more severe, has a longer duration, has worse curative effects, and has a higher suicide rate than adults. The importance of early detection, diagnosis and ongoing treatment of depression in children and adolescents is self-evident.
The manifestations of depression are also different at different ages: preschool children, because their language and cognitive abilities have not yet been fully developed, lack the ability to verbally describe emotional experiences, often manifest themselves as a lack of interest in games, decreased appetite, decreased sleep, crying, withdrawal, and decreased activity; children of school age may manifest as inability to concentrate, thinking, etc. Decreased dimensional ability, low self-evaluation, memory loss, self-blame, disinterest in various activities organized by school and class, irritability, sleep disorders, aggressive behavior and destructive behavior, etc. In severe cases, it may manifest as headache, abdominal pain, physical discomfort and other hidden depressive symptoms; the depressive symptoms of adolescent patients have increased significantly, manifested as low mood, slow thinking, decreased understanding and memory, etc. Unlike adults, children and adolescents often complain of irritability rather than depression. Anxiety and agitation are more common, often accompanied by abnormal behaviors such as aggressive or destructive behavior, hyperactivity, truancy, lying, poor partnership, and self-injury.
What many parents and teachers think of as "children being disobedient" may actually be due to poor neurodevelopment in the child's development process or suffering from certain neurodevelopmental disorders and the inability to control himself. It is not a subjective and intentional behavior, such as ADHD (Note) Lack of concentration, impulsiveness, lack of discipline, etc.), tics (involuntary blinking, grinning, making strange noises), developmental learning disabilities (dyslexia, difficulty in calculation, making the same mistakes after talking many times), autism spectrum disorder (poor social interaction, unable to look), etc. In addition, when children suffer from mood disorders, they may appear lazy or irritable, and lose their temper easily. This is all caused by the disease.
Wang Episode: For parents, teachers, children and adolescents who do not have professional knowledge, it is not easy to identify and distinguish depression, but there are traces to follow. At present, for children and adolescents, intermittent "depressive mood" is more common than "depression", and the two must be strictly distinguished. However, if depression is not relieved for a long time, it is likely to affect the normal life functions of teenagers as the situation worsens, and eventually transform into depression.
Although the causes of depression in children and adolescents vary, most are closely related to their family of origin, parent-child relationship, etc. The symptoms are also similar, mainly including persistent low mood, negative evaluation of oneself, being easily agitated and tired, and having no interest in anything. Once troubled by their own depression, children and adolescents are more likely to develop social withdrawal, creating a vicious cycle of bad interpersonal relationships and depression.
Zhang Ronghua: Depression is mainly characterized by persistent low mood, lack of energy, and feeling depressed. Depression in children and adolescents mainly manifests as being tired of studying, which may gradually develop into dropping out of school; being tired of the world, which may develop into suicidal thoughts and actions in severe cases. In addition to these obvious negative manifestations, we often find that some seemingly happy children also suffer from depression. That is because the opposite of depression is not happiness, but vitality. Lack of energy, lack of interest in things, and feeling bored are prominent features of depression.
How to make "good relationship" create a good future?
Zhang Ronghua: Whether it is family or school, parents and teachers must pay attention to awakening vitality, which means that the relationship is not static, let alone one-sided suppression or sacrifice. By satisfying the three basic psychological needs of a sense of relationship, a sense of competence and a sense of autonomy, depression in adolescents and adolescents can be effectively prevented and improved.
Looking at from family education , in parent-child relationships and communication, parents must listen to and respect their children's opinions, avoid psychological control, and meet children's needs for a sense of autonomy. This does not mean that there are no rules or discipline, but that in the process of formulating rules, consensus must be reached based on equality and democratic communication. In the face of rules, parents should be "gentle and firm" and avoid being "irritably firm" that destroys children's sense of relationship. The relationship between husband and wife should be harmonious and create a warm, harmonious and secure family atmosphere for the children. Good connection between family members is the key factor in improving children's depression.In addition, parents should also respond to the call of " double minus " to allow children to fully develop morally, intellectually, physically, artistically, and physically, to avoid excessive academic pressure on children, and to give children their "personal time" and "growth space" to themselves.
Looking at from the perspective of school education, we must adhere to and give equal emphasis to the five aspects of education. In particular, we must not put academic performance first in students' growth and adulthood. Teachers cannot blindly "suppress" students with authority or empiricism, nor can they evaluate and manage students based on personal likes, dislikes or subjective impressions. Instead, they must advocate an equal, democratic, and cooperative teacher-student relationship. When students have persistent low mood, sleep problems, dislike of studying, and interpersonal problems, parents and teachers should pay more attention, actively learn psychological knowledge, and achieve early detection, early treatment, and scientific prevention and treatment.
Sun Ling: Sick children often have sick families. Many parents only see their children’s behavior, but fail to see the emotional and mental factors behind it. They simply characterize the problem as not liking to learn, being rebellious or having weak willpower. If things go on like this, the child will have a long road to depression, and may even develop tendencies such as self-mutilation and suicide. We fully understand parents’ educational anxiety, as well as competition anxiety and survival anxiety about their children’s future, but we must not ignore the nature of education and the law of growth.
First, we must re-examine the educational goals for children , and shift from excessive attention to learning to attention to the overall growth of the child. You know, what we want is a child who is physically and mentally healthy, sunny, and well-adjusted, not a child who is forced to become a learning machine and loses the ability to be happy. Second, follow the objective laws of children's physical and mental development. Brain development and psychological development vary from person to person. Parents should accept all of their children and wait for the flowers to bloom with hope and development. Third, respect children's individual preferences and do not easily deny children's interests, ideas and friends, so that communication becomes smooth ; respond to recognition in a timely manner so that children can continuously gain a sense of value and accomplishment and build self-confidence. Fourth, parents should develop their own interests and hobbies. Only by maintaining a positive attitude towards life can they provide their children with a relaxed and pleasant growth environment. Fifth, no matter what age group, a healthy lifestyle is the prerequisite for physical and mental health. Family members must maintain a healthy lifestyle, which includes stable and quality sleep, not staying up late, a reasonable diet, and moderate outdoor exercise.
Adolescent children face a shift in "attachment emotion", gradually shifting from attachment to parents to attachment to classmates, partners and friends of the opposite sex. The desire for partnership is a manifestation of adolescent growth, but many parents cannot correctly view their children's "alienation" from them. They are constantly chasing rumors and worrying too much, leading to excessive interference, protection and restrictions on their children, and parent-child conflicts are inevitable. If parents can realize that partnership is necessary for their children's growth, encourage their children to interact more, express their concerns in a timely manner on the basis of trust when faced with their children's bad relationships, and maintain a good interactive relationship, then the children's growth must be warm and pleasant.
Companions are social support for children and adolescents, tree holes for emotional catharsis, and fellow travelers in psychological development and ideological evolution. Teachers should encourage students to interact more with their peers and establish various forms of groups, such as football teams, interest groups, etc. In addition, teachers should not let go of the details of how students get along with each other, pay timely attention to students who are isolated, bullied, and bullied, correctly guide students to develop healthy peer interactions, and guide parents to establish a scientific view of parenting.
Wang Episode: A healthy relationship is positive and reciprocal. Children can be nourished by this relationship and become better versions of themselves. It is very important for children and teenagers to learn to distinguish between positive and benign relationships and negative and malignant relationships.
In our research, we found that it is difficult for children with deficiencies in social skills to establish long-term and stable peer relationships, so they are more likely to look for peers with similar situations to satisfy their need for belonging , such as children who are also rejected by others, children who have an unhappy family life, etc. We call this type of relationship "deviant peers". Groups composed of "deviant peers" can cause mutual reinforcement of problems and are detrimental to the long-term development of children and adolescents. In this regard, parents and teachers need to treat this scientifically, solve the problem from the root, give more care and attention to children, and help them establish peer relationships that accept each other, respect each other, seek common ground while reserving differences, support each other, and be positive and reciprocal. This requires the joint efforts of families, schools, and all sectors of society to correct bad campus and social atmosphere, and tolerate and understand the multiculturalism of children and adolescents. Parents and teachers need to constantly adjust their parenting methods and respect their children's every idea. Similarly, respect does not mean full acceptance, but reasonable correction on the basis of understanding, allowing children to find solutions through their own strength.
In addition to creating a harmonious growth environment and nurturing atmosphere, we also need to pay attention to the rehabilitation environment of young patients. Although the public is now more and more aware of depression, many myths and stereotypes about depression are still popular, and there is an urgent need to strengthen scientific popularization. By strengthening cooperation between medical schools and societies and setting up corresponding courses, students can help themselves identify illnesses as early as possible or provide support for the recovery of others, and teachers and parents can learn to deal with them scientifically. In addition, recovery from depression does not mean that the patient's impaired life functions and social cognition will naturally recover. Therefore, in addition to prescribing the right medicine for the disease, it is more important to provide corresponding intervention to the patient's impaired life functions and social cognition, such as encouraging them to participate in social activities, increasing healthy interpersonal interactions, etc., to help patients return to normal life.
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Source | This article was published in the December 2022 issue of "Educator", Issue 1, with the original title "Breaking through "Bad Relationships" and the Long Journey Through Depression"
Planning | Cao Ji
Design | Zhu Qiang
coordinator | Zhou Caili
