Please select from the topics below:


Take the next step. . . Contact Gerda.
Contact Gerda today to find out more about how you and your family can be on the road to  happiness.

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.

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.

Terms of Use  |  Privacy Statement

© 2007 All rights reserved.  Site Design and Maintenance by Southern WebWorks, Inc.