SAD, ANGRY, LONELY AND SCARED:

241













SAD, ANGRY, LONELY
AND SCARED:
The Masks of Depression























ISBN
1-55548-409-3

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Credits
Executive Producer
Anson W. Schloat
Producers
Linda Atkinson
Nick Doob
Teacher’s Resource Book
Laurie Woods
Copyright 1997
Human Relations Media, Inc.

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Contents
Teaching Resources
Introduction
1
Learning Objectives
2
Program Summary
3
Reaching Out Charades
6
Stigma Discussion
7
Active Listening Instructions
8
Student Worksheets
Stigma
9
Research
13
Asking for Help
15
Reasonable Expectations
19
Active Listening Role Plays
23
Support
25
Helping Sam
29
Depression in Others
31
Fact Sheets
Active Listening
33
Defining “Mental Illness”
35
Symptoms of Depression and Mania
37
Warning Signs of Suicide
39
Children and Adolescents
41
Treatment Facts
43
Additional Resources
45
Bibliography
47

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Introduction
Winston Churchill called it his “black dog.” William Styron said it was like “being
engulfed by a toxic and unnamable tide that obliterated any enjoyable response to
the living world.” These two men suffered from depression: a serious illness that
can be debilitating and even fatal.
Until the 1970’s, it was thought that only adults suffered from depression. But over
the past two decades, research has shown that children and adolescents may be
affected by depression at rates equal to or higher than those of adults. Why were
psychologists so slow to determine this? The main reason is that in children and
adolescents, depression often occurs in tandem with learning disabilities, attention
deficit/hyperactivity disorder (ADHD), and other disorders so that the depression is
obscured. Depression in adolescents can be particularly difficult to spot because
teenage depression can manifest itself in a number of ways. While some depressed
teens show the dark, sad, blue mood that is typical of adult depression, others are
angry, irritable, or anxious. Often teenage depression is dismissed as a phase that
goes along with the tempestuous territory of adolescence.
Nevertheless, it is not impossible to identify teenagers who are depressed.
Teenagers who are depressed differ from their peers in that their dark or angry
moods last longer and are less likely to be tied to a specific environmental event.
Depressed teens are often loners, but popular students are not exempt from
depression. Some depressed teens cope with their depression by using drugs and
alcohol. Others cut or burn themselves. Female teens can sometimes deal with
depression by developing an eating disorder.
The causes of depression are unclear. It is thought that environmental factors interact
with a genetic disposition to bring on the disorder. Parental abuse or neglect can
contribute to depression, as can difficulties at school. Depression can be aggravated
if the sufferer is isolated by schoolmates. By contrast, an environment of acceptance,
tolerance, and support can help a depressed teen. It is crucial that we identify
teenagers who are depressed and that we help them find treatment. Adolescent
depression that goes untreated will almost inevitably recur in adulthood in a much
more severe form.
Friends, family, and teachers can help the depressed adolescent by pointing them
toward treatment and by offering emotional support: by actively listening, by
offering concerned sympathy and hope for the future. It is important that your
students learn to be careful with their depressed friends, that they know to listen
carefully and not to judge.
Finally, it is important to remove the stigma that is often attached to depression. Your
students should realize that people with depression are not crazy: they are ill.
Depression is a disease like cancer or diabetes. When correctly diagnosed, it can
be treated and cured.
Human Relations Media
Sad, Angry, Lonely, and Scared: The Masks of Depression1

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Learning Objectives
After watching the video Sad, Angry, Lonely, and Scared: The Masks of
Depression and participating in the class activities described in this Teacher’s
Resource Book, your students will:
understand that depression is a treatable mental illness
recognize that mental illnesses are no different from other
legitimate physical illnesses
be able to identify signs of depression in their friends and
themselves
realize how important it is for young people to help one
another through difficult times
learn that one should never give up hope, no matter how
futile a problem may appear
Sad, Angry, Lonely, and Scared: The Masks of Depression
Human Relations Media
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Program Summary
The video opens with haunting music and the image of a dusky landscape. We hear
a young woman’s voice. She describes her depression: it was a darkness, she tells
us, a black hole. She didn’t have anyone. She hated people. She felt utterly alone.
One by one, the words Sad, Angry, Lonely, and Scared come into view. They are
followed by The Masks of Depression.
The first on-camera speaker is David, who describes the onset of his depression.
He was eight years old and his family moved from Mississippi to Minnesota. The
transition was difficult because David, who is African American, was plagued by a
racism that he had not known before. In front of his own house, he was picked up
by the police because someone thought that he didn’t “belong.” He started to get
sad and ceased to care about anything.
Next we meet Matt. He tells us that he was depressed from the time he was six or
seven, but he didn’t realize that he had a problem. He was very internal, and he was
aware of being different, but he had no words for how he was feeling. He thought
that was simply the way life was. He didn’t hear the word “depression” until after he
was 9 or 10, even though he was seeing a therapist.
David describes his depressed mental state. Belittling, negative thoughts would flit
through his mind incessantly. Matt talks about yearning for relief from the pain, just
wanting it to end. “It’s not natural,” he says. “It’s not something a person should
have to go through.” David talks about a suicide attempt. He felt that he was hurting
so many people close to him that he shouldn’t live. He took forty or fifty of his
prescribed anti-depressant pills. Part of him was ready to die, but part of him still
wanted to live, he explains, because he told his mother what he had done.
At this point in the video, viewers are introduced to the mother of a young woman
named Carly. We see a photograph of a grinning, dark-haired teenager. Carly’s
mother talks about the journal that Carly kept. In the journal Carly wrote that she
knew that something was really wrong, but she didn’t know what it was. Shortly
after writing in her journal, Carly committed suicide.
Now we meet Michelle, who shows us a picture of herself. “I tried to smile in all
my pictures,” she says, “because when you are really upset, you don’t want
anyone to know.” She talks about how much she wanted to be alone. She would
repeatedly withdraw from her family so that she could be alone with her dark
thoughts. “I just wanted to be alone. I didn’t want to be with people, because I
didn’t like them.” Just as she didn’t like others, she felt that others had no use for
her. It all tied together for her: because she didn’t like people and she thought
that people didn’t like her, she became convinced that she should die. That
thought made her happy.
Human Relations Media
Sad, Angry, Lonely, and Scared: The Masks of Depression3

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Program Summary continued
Carly’s mother returns to describe a discussion that she had with Carly a few months
after Carly had attempted suicide. She asked Carly if she thought about her and the
rest of the family when she tried to kill herself. Stone-faced, Carly had answered,
“Mom, when I get that way, you aren’t in the reality of where I am.”
Michelle recalls a fight that she had with her mother. The argument escalated to the
point that they were screaming at each other. Overwrought, Michelle took a knife
from a drawer and declared that she would kill her mother and herself if her mother
moved or yelled at her. She is visibly shaken by the memory. She describes the
conviction with which she held the knife, and her determination to go forward with
her plan. Her father arrived, at which point she let go of the knife, and he called a
crisis team. The team of two men stayed with her until three o’clock in the morning.
Carly’s mother talks about the days before Carly’s death. “I didn’t even hardly
know her at the end.” After Carly died, Carly’s mother found her journal and a will.
She realized that Carly had planned the suicide months in advance. She reads a
line from Carly’s journal about “life equating to torture and death equating to
freedom... I have a ring of pain. I cannot cope with this. I welcome death with open
arms.”
The video now switches its focus to Aaron, an eleven-year old Sioux Indian boy. His
therapist, Chris, talks about how Aaron grows saddest and angriest in the winter.
Chris describes how Aaron, in a behavior typical of depressed children, would
avoid eye contact, keeping his gaze trained on the ground. We can see this as we
watch Aaron and Chris interact. Chris tells us that Aaron’s depression manifests
itself as anger. Aaron doesn’t know the difference between sadness and anger. In
one poignant sequence, Aaron struggles to talk about his dreams—in particular one
recurring dream in which walls close in on him. Each time he breaks one wall,
others follow. When asked what he would like to see on the other side of the walls,
Aaron answers: “Light.”
We meet Dr. Gabrielle Carlson, a professor of psychiatry and pediatrics. She tells
us that there is good news and bad news about depression. The bad news is that it is
becoming apparent that depression is more common in children than once believed.
The good news is that depression is a treatable disease. There are many different
paths to recovery, she says. “It may be necessary to be in therapy, it may be
necessary to take medicine. It may be necessary to do both.”
Michelle talks about her therapy. She has worked with a psychiatrist for about two
years. This treatment was effective. “Things drastically changed,” she says. “It’s
much better now.” She was reluctant to speak at first, but as she began to trust that
her therapist would not violate her confidence, she opened up. By listening to
herself, she began to realize that she was not the only person with problems, she
was not so alone, and that it wasn’t so bad.
Sad, Angry, Lonely, and Scared: The Masks of Depression
Human Relations Media
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Program Summary continued
Dr. Carlson talks about the difference between a sadness and depression. Someone
with a mild depression who needs to organize his life can be treated with therapy to
help mobilize a change. Very often a depressed person cannot see that things will
get better. Depressed people tend to feel guilty, responsible for their misery. They
might have sleeping problems and they might think about suicide. A person with
this kind of serious depression might benefit from psychoactive drugs.
David talks about his anti-depressant medication. “It kind of just balances me out. If
I’m low it will bring me up, or if I’m too high, it will bring me down.” He also talks to
his doctor regularly. He is happy with this combination of treatments. “It seems to
be working well,” he says.
Dr. Carlson talks about the effectiveness of psychoactive drugs. They are not
immediately effective, she advises. It takes a couple of weeks for the drugs to kick
into action. She also tells us that when they do take effect, they don’t produce a
drastic, sudden change. They might work more subtly, first helping the sleep
pattern, then modulating the moods, so that the patient starts to feel better one step
at a time. She emphasizes that because these medications work so gradually, they
are not addictive. Matt describes his therapy. He says that psychoactive drugs are
an important part of his therapy, but the drugs themselves are not a cure-all.
Exercise and talking are also essential parts of the process.
Chris, Aaron’s therapist, says that he believes that Aaron is lucky to have some
intervention at his early age. Had Aaron not had any sort of treatment, Chris
believes that he might have developed other problems like chemical dependencies.
Because of his therapy, Aaron will have the resources and the support to make
choices to avoid those problems. If he chooses to stick with athletics, for instance,
he would be provided with a support network of coaches and teammates. Aaron’s
age prevents him from really understanding how his thinking is different from that of
other kids, but Chris feels that it is only a matter of time before Aaron recognizes that
he doesn’t have to feel so bad and think such gloomy thoughts. With the help of talk
therapy, he will realize that there are alternatives.
Carly’s mother regrets that in her daughter’s school no one talked about depression.
She thinks that if Carly had known that there were others like her, she might not have
given up. David emphasizes that because he has read about depression, it is easier
for him to deal with his own illness; it is easier to come out of a depressive state.
Matt says, “It is only my knowledge of who and what I am that has saved me...It’s the
dumbest thing in the world not to know about yourself.” David says that now he
knows how to think positively. “It was all bad.” Before he started treatment, he
couldn’t find anything good to talk about. Now he has hope.
Human Relations Media
Sad, Angry, Lonely, and Scared: The Masks of Depression5

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Reaching Out Charades
This class activity will help students to recognize that people need one
another in order to feel a sense of connection and community. In times
of crisis or despair, it is crucial for young people to know that they are
not alone. When students are having fun together, they are learning to
reach out to their peers.
1 Break the class into small groups, with no more than five students in
each group.
2 Select one student from each group to be the group’s official artist
and ask the artists to come u