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A Relentless Hope -- Surviving the Storm of Teenage Depression by Gary E. Nelson  © 2007 (Cascade Books, a Division of Wipf & Stock Publishers: Eugene, OR)
All rights reserved [137 pages].

[Answer 14 of 20 questions correctly to receive
8 hours of continuing education credit.]

Chapter 1: Three Fastballs Down the Middle (of the Hallway) -- Looking at Teen Depression from the “Outside” (p. 1-22)
1. Why is depression so difficult to identify in teenagers, even for professionals?
a. Some teens, like Tom, live a fairly normal public life and don’t appear to be depressed.
b. Some parents cannot identify depression in their teen because of their own untreated afflictions.
c. Not all depressed teens exhibit the same symptoms. Some struggle with depression, some with anxiety, and some with a combination of both depression and anxiety.
d. All of the above.

SOME TYPICAL SYMPTOMS OF TEENAGE DEPRESSION & ANXIETY

                     Irritability                           Decline in academic grades
                     Moodiness                         Lack of interest in normal pleasurable activities
                     Irregular sleep patterns       Experimentation with drugs or alcohol
                     Difficulty concentrating       Interest in high-risk activities.
                     Outbursts of crying            Getting stuck on certain thoughts 
                     Sadness                           Isolation from family & friends
                     Lack of energy                  Acts of self-mutilation
                     Change in appetite             A sense of just feeling “stuck” or “numb”
                    
Weight loss or weight gain
 

2. What is NOT true about clinical depression?
a. Clinical depression doesn’t generally respond to simple encouragement, such as, “Why don’t you think positive thoughts?”
b. Sometimes clinical depression is a result of not trying hard enough or just not wanting help from others.
c. Clinical depression is usually passed on genetically through families, so other extended family members have suffered from it.
d. Often clinical depression is hidden behind alcoholism or some other addiction. The person uses their addiction to self-medicate from the pain of their depression.

3. When Tom was a young boy, the author and his wife finally identified an “altered state” in which Tom would become emotionally out of control. His parents discovered that the most effective way to respond to Tom in an altered state was to
a. send him to his room and let him cry it out.
b. interpret his cries as manipulation and ignore him.
c. give in to his demands so he would stop crying.
d. sit with him and help him calm down.

THE IDENTITY QUESTIONS YOUNG TEENS ARE ASKING THEMSELVES

Who am I like?
What makes me feel good about myself?
Who do I want to hang out with?
What am I good at?
What is the “uniform” for the group I like to be with?
Who understands me?
What is fun and who is doing it?
Where do I belong?
 

Chapter 2: “All My Bones Are Out of Joint” (Psalm 22:14) --
Looking at Teen Depression from the “Inside” (p. 23-41)

4. The author has asked people suffering from depression to read which Bible passage, that highlights the depressed teen’s isolation, lack of self-esteem and confidence, hurt, lethargy, numbness, and being “beaten from the inside”?
a. Psalm 22
b. Psalm 32
c. Psalm 38
d. Psalm 102

5. A teenager’s depression alters their experience of time. It makes him think that the past, present, and future have all melded into one. He feels awful now, he cannot remember when it hasn’t felt this bad, and that means he will always feel this bad. This experience is called
a. a constant state of melancholy.
b. perpetual pessimism.
c. the cognitive triad of depression.
d. the “glass is half-empty” syndrome.

6. Often, depressed teens listen to music that parents feel might be depressing because the teens
a. are trying very hard to hurt their parents.
b. are rebellious and they identify with rebellious music.
c. identify with many of the ideas and feelings expressed in the lyrics and feel that someone else understands them.
d. are just trying to form their own identity apart from their parents, so they listen to music their parents don’t like.

7. Which BEST characterizes how a depressed teen feels about his parents?
a. Leave me alone, you’ve failed me.
b. Leave me alone, I don’t need you.
c. Leave me alone, but don’t go too far.
d. Leave me alone, I want to hurt you.

Chapter 3: Wrestling Holds to Use (on Parents) --
Equipping Ourselves for the Journey (p. 43-72)

8. In the author’s attempts to get his son, Tom, out of bed in the morning for school, the author learned to control his anger by
a. announcing to Tom it was time to get up, then immediately leaving Tom’s room.
b. successfully persuading Tom to get out of bed.
c. letting Tom get himself out of bed without going into his room.
d. rewarding Tom for getting out of bed.

9. The author said that God gave him the courage to stop doing the same thing over and over, since it wasn’t working, and even though he didn’t know what else to do. He discovered that what was driving him to do it was
a. anger toward Tom.
b. fear of helplessness over Tom’s depression.
c. guilt for not being a better father.
d. his great sense of duty to teach Tom responsibility.

10. The turning point (“awakening”) for the author and his wife in dealing with Tom’s depression was when
a. Tom got on medication for depression and showed significant improvement.
b. Tom started to take small steps to rebuild his physical stamina through adequate sleep and regular exercise.
c. they realized they were not fighting with Tom, they were fighting a terrible medical illness that had the capacity to steal life.
d. they distanced themselves from Tom in order to give him space.

11. When fear begins to rear its ugly presence in the author’s life, what does he do?
a. He relies upon Scripture, reason, tradition, and experience.
b. He relies upon God’s grace to free him from the agony of having to make perfect decisions. God just requires him to be faithful, not perfect.
c. He acknowledges his helplessness, which helps him to feel the presence of God.
d. All of the above.

‘Nothing ever ‘cured’ Tom. We never found anything that made the illness go away while Tom was a teen. We found lots of things that were helpful for awhile, but nothing that became the ‘magical fix’ we so desperately wanted for him…We also discovered lots of things that were hurtful, and tried not to do or repeat them. The journey was one of experimentation. Little by little, Tom found ways to recover.” (p. 59)
 

12. At one point during Tom’s depression, the author and his wife decided to ask Tom what his plan was for getting on with his life, instead of telling him what to do (p. 58). The author also believed that God was guiding him by a voice inside him that said, “Just keep loving him” (p.64,65,66,69,71,72). This helped the author to find ways to help Tom, even if they were not popular or conventional solutions. The author used all of the following strategies to help Tom EXCEPT
a. sending Tom away to a military school to get him away from troublesome teens in the school system and also to provide the author and his family relief from the daily grind of living with depression.
b. allowing Tom to get his G.E.D. instead of fighting the daily battle of attending conventional high school classes.
c. buying Tom a used car to keep him moving. Once a depressed person sits down it’s hard for them to get up and go again.
d. allowing Tom to go unpunished for many cross words or disrespectful comments, things the author would have been punished for when he was growing up, because they realized it was the depression talking, not the real Tom.

Chapter 4: How Do We Sing a Song to the Lord (in a Foreign Land?) -- Exploring the Spiritual Dimensions of Depression (p. 73-88)
13. If parents have raised their children with a strong faith in God, self-respect, and respect for others, and a depressed teen stops going to church, it is most likely for any of the following reasons EXCEPT
a. the teen is going through a normal developmental process of separating from his parents and becoming his own person.
b. the teen is abandoning their faith in God.
c. the teen has trouble connecting with caring people who inadvertently pressure him to feel better.
d. the teen feels like a spiritual failure because he has so much difficulty feeling God’s presence.

14. Which is NOT helpful spiritual advice to give to a depressed teen?
a. God has compassion for you in your suffering.
b. God has a purpose for your suffering.
c. God comforts those who suffer.
d. God has healed other people suffering from depression.

15. Why is sometimes the best thing to do for a depressed teen is to
not talk and simply be with him?
a. Because talking may send a subtle message to the depressed person that you’re uncomfortable with their pain and you just want him to “get over it”.
b. Because suffering is not easily explained. Words can be inadequate in trying to explain why we suffer.
c. Our quiet presence can reassure them of God’s presence.
d. All of the above.

16. Using Psalm 22 as a model for prayer, what does the author encourage depressed teens to say to God?
a. To recall the great attributes of God.
b. To confess their personal sins.
c. To express thankfulness for all of God’s blessings.
d. To share their feelings of pain, anguish, doubt, anger, and fear.

Chapter 5: The Hurler, Anaconda, and Grizzly (and Other Things
that Help) -- Exploring the Many Other Dimensions of Depression
(p. 89-115)

17. Which is NOT true about antidepressant medications?
a. In order for them to be effective, you must take them every day for several weeks.
b. It is not uncommon for the physician to have to alter the dosage or try a different medication in order to obtain the desired result.
c. They can reduce or eliminate a temper problem.
d. They are addictive.

18. Which is NOT true about managing depression?
a. Parents should require less from a depressed teen when he is having a “down” day.
b. Depression robs the individual of the ability to break a large task into smaller, more manageable pieces. The depressed person is overwhelmed, not lazy. Because he is anxious to succeed, he often overestimates his ability to accomplish something.
c. Weight-lifting is better for managing depression than aerobic exercise.
d. Getting adequate sleep is essential for managing depression. Some things that are helpful in regaining a healthy sleep pattern are medication, morning exercise, “white noise”, productive daytime activities, counting, and avoiding the adrenalin dumps that occur when watching television, reading an exciting book, or staying awake in bed for more than 20-30 minutes.

19. At the time of his son’s depression, what did the author tell parents who came to him for counseling about their teen’s depression that made them say he was exactly the one they wanted as a counselor?
a. He told them how his son, Tom, had overcome his depression.
b. He told them how he was not able to stop Tom’s depression. This made the parents feel like the author really understood what they were going through.
c. He told them about the many years of counseling experience he had in successfully helping parents with their teen’s depression.
d. He told them about the remarkable success of current antidepressants with managing teen depression.

Chapter 6: Alligators (Swim with Caution) --
Encouraging Families to Care for Themselves (p. 117-130)

20. When a married couple comes to the author for counseling and they are verbally fighting, perhaps blaming each other for their teen’s depression, what homework assignment does the author give the couple?
a. He has them write down the 5 things they admire the most about the other.
b. They are to go home and make “not hurting each other” their top priority. If they can’t talk about a topic without hurting each other, they wait and discuss it in counseling.
c. Apologize every time they attack each other.
d. Reschedule separate sessions so they won’t be together fighting in the same counseling session.