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Posted: Apr 27, 2004 10:37


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By: Dr. J. Huffine, Clinical Director
Sage Walk: Wilderness Therapy Programs
Redmond, Oregon

Reprinted with permission of Sage Walk, from their April 15, 2004 Newsletter - The Desert Sage, Volume I, Issue I. This is an abridgement. - For the full paper, contact Sage Walk.

Wilderness therapy programs were developed for a number of reasons and are a powerful and unique intervention. They are especially effective with teenagers who are “stuck” in a negative behavior pattern and who are resistant to help. These negative behavior patterns can be fairly simple or very complex. They may be of a relatively short duration or chronic. One of the more common presenting problems seen in wilderness therapy is depression. Wilderness therapy is especially effective as a first step in the treatment of depression. Approximately 12% of all males will experience a Major Depressive episode in their lives and approximately 25% of all females.

The following are symptoms of depression: depressed mood, anhedonia (the loss of ability to experience pleasure in activities that were previously pleasurable), weight change (gain or loss), sleep disturbance, (insomnia or hypersomnia), psychomotor agitation or retardation (thinking or moving slowly), easily fatigued, feelings of guilt or worthlessness, concentration problems, and suicidal ideation. There is also impairment in an individual’s ability to function socially, academically, vocationally, etc. A major depressive episode can be mild, moderate, or severe. It can be a single episode or recurrent. About 40% of individuals with Major Depressive episode still meet the diagnostic criteria one year after the initial diagnosis. There can be several causes of depression.

Research has shown that there can be a strong genetic component. Some individuals are predisposed for depression, that is, they are more vulnerable to developing it. Environmental events can also contribute to depression such as the death of a loved one, the loss of a relationship, or other significant losses. Feeling depressed is a normal part of the grieving process. If people are able to go through the grieving process, a major depressive episode can be avoided. If this does not occur, however, unresolved grief can contribute to chronic depression or other symptoms.

Many teenagers develop depression because they have other problems that interfere with their success in school, socially, etc. Those who enter adolescence with less than adequate self-esteem and feelings of competence are a higher risk. Attention Deficit/Hyperactivity Disorder (ADHD) causes teenagers many adjustment problems, which then often leads to depression. Learning differences contribute to school problems that can lead to depression. Social adjustment problems (those teenagers that may be less mature or sophisticated socially, who may be targets of peer ridicule or rejection) also can lead to depression. In fact, factors that, in general, make it more difficult for an adolescent to control the important outcomes in their lives cause them to develop beliefs like “It doesn’t matter what I do, I’ll never be popular, successful in school, good at sports, etc.”

These beliefs create feelings of helplessness and hopelessness that can lead to a Major Depressive episode. Many teenagers do not recognize their problems as being related to depression. They may just say they “don’t care.”

Wilderness therapy is often very effective in creating some therapeutic movement in individuals who are depressed. It is very structured. It is very positive. The “rules” and expectations are fairly simple and straightforward. Teenagers with depression begin to experience success. They begin to gain control over outcomes in their lives, very simple ones at first. Gradually, with support, encouragement and guidance, they are able to “climb out of the deep hole” they were in.

Success increases. Improvements in self-efficacy, self-esteem, attitude and effort, lead to improvements in mood. Individuals become more hopeful, more competent and more positive in their perceptions. A person who has developed a Major Depressive episode must take the steps themselves necessary to get better. Wilderness therapy can be tremendously helpful in beginning this process.

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