“BP Me” by Kareem, age 13, from The Storm in my Brain: Kids and Mood Disorders, 2003.

The signs at any age can be difficult to spot. Then finding a diagnosis and getting the right treatment—not to mention dealing with the stigma—can seem insurmountable. With a collection of resources ranging from faith communities and teachers to counselors and doctors, though, families can intervene before a child harms himself or others. Together they can begin to fight the illness.

And it is a medical disorder, as defined by the National Institutes of Health and most scientific and research organizations.

“You did not cause this illness. It is not your fault,” the reader is told on a page in The Storm in my Brain, a booklet for kids from the Chicago-based Depression and Bipolar Support Alliance. The alliance’s president, Sue Bergeson, who was consecrated as a Lutheran deaconess at Valparaiso [Ind.] University, said, “Depression results from a combination of genetic, biochemical, environmental and psychological factors. Parts of the brain responsible for regulating mood, thinking, sleep, appetite and behavior appear to function abnormally.”

Unless more people understand the genesis of depression and related disorders, the collective battle against them will be a losing one, said Gary E. Nelson. The United Methodist minister and pastoral counselor wrote A Relentless Hope: Surviving the Storm of Teen Depression (Cascade, 2007) to openly share his family’s battle against son Tom’s depression.

“This isn’t teens just being moody teens; we’re talking about medical illnesses,” Nelson said. “That’s the radical perspective shift that parents and other adults have got to make if we’re going to fight this.”

Trying to get that word out goes all the way to Capitol Hill, where Lois Capps, a member of Grace Lutheran Church, Santa Barbara, Calif., is a U.S. representative. Perhaps the only school nurse ever to be elected to Congress, she is a champion of mental-health parity, which has a majority of support in the House and Senate. “Whether a broken bone or brain disorder, all illnesses should be considered the same for insurance qualifications,” Capps said. “[And] in the health-care system, it needs to be clear that depression cuts across all ages.”

Indeed, more than 2 million teens alone experienced a major depressive episode in the past year, according to a May report from the Substance Abuse and Mental Health Services Administration, with 12.7 percent of all teen females and 4.6 percent of males reporting conditions—a depressed mood or loss of interest or pleasure lasting two weeks or longer.

Symptoms are different in everyone, and they can be especially difficult to link to depression in teens, whose normal behavior can be crabby or moody. Common signs include tiredness, self-mutilation, and changes in weight or grades. Bergeson added that depression is a “spectrum illness,” so some people will live with mild depression and others may live with deep depression followed by intense mania.

Like teens, signs in younger children can reflect what is normal for their age, making diagnosis difficult. But they might be more irritable than usual or complain of boredom, or, on the manic side, fight or be unable to sit still and therefore diagnosed—or misdiagnosed—with attention deficit disorder or attention deficit hyperactivity disorder.

Nelson became tuned in when Tom, then 14, hurled three fastballs into the wall after they had a disagreement. Tom began to lie. He became more belligerent. And Nelson found an essay Tom had written that said he felt as if he was “being beaten from the inside.”

Tom also attempted suicide. In fact, more than 90 percent of people who die by suicide have depression or another diagnosable mental or substance-abuse disorder, according to the Suicide Prevention Action Network USA, founded by Gerald and Elsie Weyrauch, members of the Lutheran Church of the Resurrection , Marietta, Ga.

Although suicidal thoughts or attempts aren’t present with every depressed young person, it is something to watch for. Literally: If you see something, say something. It could save one life—or more, if that person is capable of mass violence.

It takes the proverbial village to watch our young people. Parents might see signs first, or they might be too close to notice. Staying involved is one key. And families can chart their mental-health tree. The Nelsons have a history of depression, and there is widespread anecdotal evidence of genetic links though definitive scientific studies have not been completed.

Parents need to take depressive behavior observations to any number of professionals right away. Schools psychologists can be among the first. They are trained as mental-health professionals to watch critically for signs of mood disorders and violence. Also at school, art and English teachers—while not medical professionals—can help determine through their expressive assignments if changing, disturbing works are a pattern.

Making an appointment with the child’s medical doctor for testing is critical. And if parents aren’t satisfied, they need to make another appointment or find another doctor. “It’s extremely important that if something is going on, you seek treatment early,” Bergeson said. “The longer it takes to get treatment, the more likely the child will have this chronic illness his whole life.”

Treatment and support for depression or a mood disorder comes in many forms, from psychotherapists to medication to art therapists—and often a combination of these and others. Pastoral counselors, mental-health professionals with theological training, understand a patient’s “faith commitment and use that as a resource for support and care,” said Douglas Ronsheim, a Presbyterian minister and executive director of the American Association of Pastoral Counselors.

What of the faith and support of congregations? The possibilities are endless and openness is crucial. Gather and advertise resources, or plan events for Mental Health Month (in May) or Suicide Prevention Month (in September). Pastors can preach about depression. Confirmation and Sunday school teachers can be trained to watch for signs of mental illness and violence. Youth groups and adult forums can learn about suicide prevention and mental health.

Be creative. Which is what Nelson said about families combating depression: “The point is not to tell parents everything to do but to get them to turn on their creativity in not just how to control their child but how to work with him to fight through this illness.”

Resources help when youth face depression

These groups and publications can be helpful to both families and congregations. At church, pastors and receptionists can keep a list by their phone-and make copies to hand out-that would also include local sources for information and counseling, from Lutheran Social Services to emergency rooms (and how they work). Print or order the materials listed below to keep in the church resource center, or to give to members, friends or schools. And use them all to organize events during Mental Health Month, every May.

Organizations

American Academy of Child & Adolescent Psychology
Download (for free) "Facts for Families," a publication with nearly 100 fact sheets about topics such as "Children and Divorce," "Comprehensive Psychiatric Evaluation" and "Self-Injury in Adolescents."

Child & Adolescent Bipolar Foundation
Find a variety of resources, from support groups to doctors to research.

Depression and Bipolar Support Alliance
Download a free copy of The Storm in my Brain: Kids and Mood Disorders (published in conjunction with CABF). Includes tips for parents, kids and teachers.

ELCA
See official messages on Suicide Prevention and Community Violence. To read a faith-based reflection with ways parents and schools can help children, go to "Perspectives on Violence: Loss, Suffering, Healing, Growing.

Lutheran Services in America
Search among more than 300 health and human service organizations.

Mental Health America
Get materials and other tools, especially pertaining to Mental Health Month, or search the site's "Affiliate network" for an MHA group near you.

National Alliance on Mental Illness
Search among more than 1,000 affiliates, and get news and information. Go to the site's "Child and Adolescent Action Center" to find discussion groups and learn about school programs, among other things.

National Association of School Psychologists
Get information for families (on topics from bullying to tips for supporting children's mental health) or discover what a school psychologist can do.

The National Child Traumatic Stress Network
Learn about traumatic stress and how it affects children.

National Institute of Mental Health
Go straight to the pages about children and adolescents to find information about medication, treatment options and more.

Suicide Prevention Action Network
Become an advocate for suicide prevention and find resources including local connections and prevention hotlines.

Or do an Internet search:
mental health child (or adolescent) depression

Books

• A Relentless Hope: Surviving the Storm of Teen Depression by Gary E. Nelson (Cascade Books, 2007).

• Defeating Depression: Real Help for You and Those Who Love You by Howard W. Stone (Augsburg Books, 2007).

• Losers, Loners, and Rebels: The Spiritual Struggles of Boys by Robert C. Dykstra, Allan Hugh Cole Jr. and Donald Capps (Westminster John Knox Press , 2007).

How to find

... an art therapist:
Go to the Art Therapy Credentials Board or send an e-mail.

...a pastoral counselor:
Go to The American Association of Pastoral Counselors and search by state or get a referral from a physician, pastor or friend.

... a psychotherapist:
Go to the American Psychotherapy Association and search by state and specialty.