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Depression Disrupting Daily Life
Dear Gerda:
 I have been feeling odd lately, but my
doctor can’t find anything physical wrong
with me. He says I might be depressed. I
feel weak, sleep a lot, get angry easily,
and don’t really feel like eating. I can’t
remember things I usually remember. Noises
bother me too. Do you think my doctor is
right, could I have depression?
The symptoms that you described are
indicative of depression and if the symptoms
are present for more than two weeks you
should consider seeking treatment. You
stated that your doctor has eliminated any
possible physical cause which would suggest
the possibility of depression. Your
physician should refer you to a psychiatric
professional for a complete evaluation.
Diagnosis of depression can be made by a
physician, psychologist, or psychiatric
nurse practitioner. The specialist will ask
a battery of questions to determine factors
that may be influencing your change in mood.
Environmental factors such as stress from
work, family, finances, relationships,
medical illness, alcohol, chronic pain, and
grief or loss issues can each play a role in
depression. Note that people who have a
family member with depression may themselves
experience depression.
Depression is an illness and should be
treated like any other illness. If left
untreated it carries other serious health
risks. Treatment options will depend on the
severity of the symptoms and how they are
affecting your ability to function.
Medication with antidepressants and
anti-anxiety medications can help to
alleviate the symptoms. Cognitive therapy
can help improve your coping and
understanding of the illness. Proper
nutrition, diet and exercise also have a
role in treatment. Avoiding the use of
alcohol is important, as it is a depressant.
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Youth and Depression
Youthful years are supposed to be a time of
carefree living. Yet, to the contrary, many
youths find themselves feeling depressed,
detached, and lonely. Many lack self-esteem,
use drugs and/or alcohol in attempts to
cope, and even contemplate or attempt
suicide.
Although there are many mental health issues
relative to the teen years, depression alone
is a major issue, and is more common than
previously believed among adolescents. It is
well known that teens with depressive
illnesses who do not receive help often turn
to suicide as the only way out. Suicide is
now the second leading cause of death among
youths 15-24 years old. Ever day in the U.S.
nearly two thousand adolescents attempt
suicide. Approximately six actually do.
Females attempt suicide three times more
than males; however, males actually commit
suicide three times more than females.
There is no accurate estimate of the
countless number of young people who
struggle to exist from one day to the next
in emotional pain and despair. This group of
silent sufferers are the victims of the
public’s misperception and unhealthy
attitudes toward mental health in general,
and an almost complete failure to recognize
mental health issues in children.
Most adults tend to minimize sadness in
youth in the belief that depression does not
affect the teenage sector, and that teens
have nothing to be saddened or worried
about. It is important to recognize that
depression is an illness, not a personal
weakness or imperfection. It must be
diagnosed and treated.
Adolescents with depressive illness feel sad
and sullen and often view their situation as
hopeless. This sadness is not usually
relieved by interaction with family members
or friends, extra privileges, or receiving
money. Too often, well-meaning families can
be seen in an effortful yet futile waltz,
trying to make their depressed loved one
happy. This is not to say that there is not
normal sadness among adolescents which can
be relieved by family interaction and
socialization; however, there is a clear
difference. The difference between “normal”
adolescent sadness and depression is based
on the severity, duration, and magnitude of
change from the youth’s usual behavior and
personality. There is a strong familial link
in depressive disorder, and as a result of
this, teenagers who have depressed parents,
grandparents, or other family members will
sometimes become depressed when under
stress. Again, caution should be taken here
to not simply associate the teenager’s
depression with other family members (i.e.
“it runs in the family”), thereby minimizing
his/her symptoms, delaying treatment, and
inadvertently reinforcing the teenagers’
feelings that nobody cares.
There are certain events that increase the
adolescent’s risk for depression and
suicide. These include:
• Loss of a parenting figure by death,
divorce, or separation.
• Loss of important peer relationships (ie:
breakup with a boyfriend or girlfriend)
• Family violence/discord/abuse
• Physical or sexual abuse
• Academic decline and failure at school
• Alcohol and/or drug abuse (usually a
symptom of a more enduring problem)
Depression in adolescents presents the same
symptoms that are characteristic of adults;
however, due to their age their symptoms may
be viewed or expressed differently, and may
include any of the following:
• Marked sadness may be expressed by wearing
dark clothes, writing morbid poetry or
school composition, or displaying a
heightened interest in music with death
themes.
• Sleep patterns may be reversed. Depressed
teenagers usually “don’t do mornings” on a
CONSISTENT basis. They may watch TV or
listen to music all night, and sleep during
the day, therefore having difficulty getting
up for school.
• Lowered energy levels may be present,
creating a lack of motivation, poor class
attendance, and the “bored syndrome,” in
which they show total disinterest in almost
everything.
• Poor concentration and slow thought
patterns may manifest themselves in poor
academic performance, irritability, fatigue,
and low tolerance for the slightest
provocation.
• Adolescent depression may also present
itself in the form of behavior problems or
substance abuse. There may be noticeable
peer conflicts, frequent fights and
arguments, and defiance toward adults and
authority.
• Increased risk-taking behaviors and/or
social withdrawal may be present.
• Loss of appetite can occur and may be
expressed in the form of an eating disorder
such as anorexia or bulimia.
• Numerous complains of unfounded physical
problems are common.
Response to teenage depression must be swift
and should begin with adult interest and
awareness. Adults who have daily contact
with adolescents must LISTEN to them.
Special effort should be made to show
genuine concern and to validate the
teenager’s feelings and problems with
patronizing. Adults should convey caring and
understanding to teenagers without
minimizing or trivializing their problems.
In communication with a teen, adults must
stay focused on the problem at hand, and
should not rush to take away their pain with
promises of future success in school, work,
or interpersonal relationships.
Remember that adults don’t need to have all
the answers. It is beneficial to help a
depressed adolescent form a supportive
circle consisting of other family members,
friends, school, and church. Encourage a
youth to take to other people as well as to
you. Help to create opportunities for
socialization and enjoyment; however, don’t
attempt to force them to be happy and have
fun.
Parents should review their parenting
practices. Use positive discipline. Creating
shame and punishing may increase feelings or
worthlessness and inadequacy, and promote
detachment from others. The adults involved
in the depressed teenager’s life should not
expect immediate improvement. Rather, they
should remain objective and maintain an
understanding and learn to recognize an
improvement in symptoms.
It is important to recognize when
professional help is needed. Attempts to
seek help should first be discussed with the
teenager. Too often parents and family
members take an adolescent to seek mental
health care without first discussing the
issue. This usually results in an angry,
deceived teenager who feels forced and
refuses to participate in the process.
When looking for a practitioner, your family
physician may be a good place to start. A
pastor may also be a good resource for
locating a mental health professional in
your area. It is important to call each
provider to get a feel for his or her mode
of practice before making an appointment.
Don’t be afraid to make inquiries regarding
culture, language, and other issues. It is
vital for a teen to be as comfortable as
possible with a mental health provider in
order to achieve the best progress.
Gerda Williams, MSN, ARNP is a Psychiatric
Nurse Practitioner in private practice in
Florida. She has years of experience working
with at-risk youths, both in the hospital
and community setting, and is a frequent
speaker on various mental health issues. For
more information, please visit our contact
page.
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