By encouraging real-life but safe exposure to events that trigger anxiety for the bullied teens – which could include simply going to school – teens learn to engage with and process the traumatic event. It helps them understand their anxiety, but not become limited by it.
“Therapy validates their emotions, but it also helps move forward,” Dr. Adler Nevo explains. “They gain a stronger sense of self-efficacy, which means they have a stronger sense that they can do something about their situation. They can change it.”
The approach worked for David, the 14-year-old convinced his classmates were horrible. The worst-offending bullies were spoken to by teachers, but David also made personal progress by understanding little by little how his anxiety was affecting the way he was viewed by others.
“That sounds simple, but it’s really tremendously difficult. Imagine yourself a teenager, feeling fragile, thinking you need to be macho, strong and having to acknowledge your anxiety in order to move out of it. Many of the victims would rather deny,” she says. “Therapy was a combination of working internally on thoughts and feelings, seeing where they make sense and where they are unhelpful for him, where they’re not, and actually changing the way David approached his peers.”
And when David was asked about his classmates toward the end of treatment? “They’re actually ok,” he said.
Bullying and depression
A U.S. study published in Child Development in March found that the relationship between bullying and depression is not straightforward. While parents and teens may assume their depression is the result of bullying, the study showed it’s often the other way around – that depressed teens sometimes attract unwanted attention.
“Bullies have radar for kids who are going to be targetable – who are not going to fight back,” explains Dr. Elyse Dubo, a staff psychiatrist who treats depression in
youth. “Kids with depression can be targeted because they look like they have low self-esteem, and are somewhat withdrawn.”
To make matters worse, depression in teens can come with an unfortunate symptom, she says: rejection sensitivity. These teens view every social interaction as negative; they see two friends talking and are so self-conscious they assume it’s about them and think their friends don’t want to be around. Their relationships dwindle, setting them up as prime targets for bullies.
“The teens often start to isolate themselves and won’t sit with their friends at lunch because they think their friends don’t want to sit together, or they won’t return calls
because they think their friends don’t really want to talk to them,” Dr. Dubo says. “They find themselves completely isolated, making them easy targets for bullies. These
kids feel so socially fragile and they can so easily feel devastated because of their depression that it’s hard for them to gain perspective.”
Just treating the depression itself can have remarkable results. Dr. Dubo has seen extreme cases where the right medication helped get both the depression and the bullying under control within a few weeks.
“As we treat the anxiety and depression with medications and therapy or both, they improve in their symptoms,” explains Dr. Dubo. “As the depression improves, their self-esteem improves. Their perception changes, so they’re not seeing things so negatively and they can start to take risks socially. As they get out of their depression, they feel like they can start to reach out and start new social interactions.”
It’s not always that simple, of course. Long-term depression and anxiety can have detrimental and complicated effects on a teen’s development that need to be addressed. In those cases, it may take much lengthier therapy to help the teen undo his or her negative thinking patterns and behaviours that have developed as a result of their anxiety and depression. Dr. Dubo is also quick to emphasize the importance of grass-roots educational programs in the school system aimed at bullies, as well as those who may be unwilling participants in the dynamic. But she also points out that helping teens understand their role in the bullying is an important part of the overall picture.