Depression like the kind Evan experienced isn’t as simple as just feeling sad. “We all experience sadness—when we lose someone, are disappointed, or just don’t have things turn out the way we want and expect,” says Dr. Alan J. Gelenberg, professor emeritus of psychiatry at the University of Arizona. But for some, the downs keep coming.
When sadness isn’t tied to a specific disappointment or tragedy and you’re stuck in a cycle of negative thoughts (e.g., feeling like nobody likes you or like nothing will ever work out for you), depression might be the culprit.
“You feel like you’re in a mirror maze—all you can really see is yourself, but it doesn’t feel like you,” says Evan. You might be lethargic, have trouble sleeping, feel unmotivated or numb.
If this sounds like where you’re at, you’re not alone: According to a 2016 nationwide survey, nearly 13 percent of US teens aged 12 to 17 suffered at least one major depressive episode in the year before the survey.
“A stressor can trigger negative thoughts or distress, but depression is a sustained feeling of sadness along with a decreased interest in most activities, every day, regardless of the situation,” says Dr. Helen S. Mayberg, professor of psychiatry at Emory University School of Medicine in Atlanta, Georgia.
Here are some of the symptoms that people with depression experience. Keep in mind that, with depression, these will generally be present for two weeks or longer.
- Feelings of hopelessness and discouragement.
- Feeling “empty.”
- Feeling worthless or helpless.
- Withdrawal from friends, family, and activities that you used to enjoy.
- Aches and pains. (Depression can actually cause physical issues like headaches, digestive problems, loss of appetite, weight loss or gain, and muscle pain.)
- Difficulty falling asleep or staying asleep at night.
- Low energy and trouble concentrating.
- Self-harm (e.g., cutting, burning, pulling your hair out) or thoughts of suicide. If you’re experiencing this, talk to a parent or trusted adult as soon as possible. If you can’t bring yourself to tell someone in person, try calling 1-800-TLC-TEEN (852-8336) or text “TEEN” to 839863 for help.
If you are ever thinking about suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255
There’s no shame in depression. Celebrities like Beyoncé, Lady Gaga, Demi Lovato, Kid Cudi, and Michael Phelps have all opened up about their experiences with it in an effort to shed light on a topic many of us are afraid to talk about. Viral social media movements like #WhatYouDontSee have helped bring depression out of the dark even further, encouraging honesty and openness about experiences with depression.
“Depression is a brain disorder, not a weakness of character,” says Dr. Mayberg. “No one should be shy or embarrassed to ask for help.”
The science of depression
Researchers don’t fully understand why some people experience depression and some don’t. What they do know? It’s a physical disorder—not just something happening in your mind. A cause-and-effect relationship isn’t perfectly clear, according to the Mayo Clinic, but people with depression appear to have physical changes in their brains, including changes in neurotransmitters and hormones.
Psychiatrists will generally diagnose people experiencing depression symptoms into two categories: major depressive disorder or persistent depressive disorder, though that doesn’t necessarily mean all of a person’s symptoms fit into one or the other.
Major depressive disorder (MDD) is severe and disabling. MDD involves some combination of depression symptoms (everyone is different), but most people with MDD will lose interest in the activities they once enjoyed. This type of depression usually comes as an intense episode and lasts a few weeks or months at most. Once it’s over, you’ll generally feel like yourself again.
Persistent depressive disorder (dysthymic disorder) is similar to MDD, but symptoms are less severe (so you may be able to function at school or in social situations). It lasts longer, though, and can affect people for years.
- Depression can happen at any time.
- Women are more likely than men to experience depression, and teen girls are twice as likely to develop mood disorders (such as anxiety) as teen boys. There are a few theories as to why; studies show girls and women experience more intense hormonal fluctuations, higher genetic likelihood, and higher stress levels than boys and men do. Read more about the gender gap in depression here.
- Underlying medical conditions (e.g., hyperthyroidism, mononucleosis) can cause exhaustion and symptoms that feel like depression. If you’re having symptoms, be sure to get a full medical evaluation to check for these conditions and to rule out any other illnesses.
- Those with other disorders, such as attention deficit hyperactivity disorder (ADHD), anxiety, or eating disorders, are more likely to develop depression, as are teens with chronic medical conditions (asthma, cancer, diabetes, etc.).
How to help yourself
“Ideally, you should turn to a parent or guardian who can guide you to assessment and care,” says Dr. Gelenberg. “If ever a parent is unhelpful, seek help at school from a trusted teacher, coach, school counselor, or [religious leader].”
A lot changed for Evan when he reached out. “I speak to my counselors instead of hiding, I engage with my teachers instead of lying. I surround myself with the people who make me feel better and loved, and cut ties with the ones who don’t,” he says. “I hope for it to continue that way and that students who struggle with mental health [will] reach out to their peers and adults and be lucky [enough] to have guardians who care for their well-being.”
What treatment looks like
Evan sought treatment for his depression. Treatment for depression usually involves talking to a trained therapist and/or taking medications (e.g., antidepressants). While the approach might vary depending on the type of therapist, “typically there’s an assessment of symptoms,” says Dr. Lauren Weitzman, director of the University of Utah Counseling Center, where the therapist will ask you questions to get a pulse on exactly how you’re feeling. “Counselors are going to be listening for whether they think a medication evaluation might be warranted,” Dr. Weitzman explains.
Treatment for depression usually involves cognitive behavioral therapy (CBT), which helps you deal with depression by examining your thought patterns and helping you come up with a new way of thinking, Dr. Weitzman says. In treatment for depression, your therapist may:
- Help you recognize negative thinking patterns and how to change them.
- Lead you to understand your emotions and what’s triggering them.
- Help you come up with solutions for problems that are weighing you down.
- Suggest changes to your lifestyle that could improve your mood (physical activity has been shown to help alleviate symptoms of depression).
- Help you feel more confident and hopeful by reassuring you that you can get better.
- Encourage you to keep a journal so you can keep track of your feelings and reactions.
What to do if you think a friend may be depressed
If you think a friend might be struggling with depression, it’s OK to share your concern. “Usually I recommend saying something that acknowledges what you’ve been observing,” says Dr. Weitzman, such as, “Hey, you haven’t really seemed like yourself the last few weeks and haven’t been up for hanging out. I’m a little concerned—is everything OK?”
“What we call ‘normalizing’ depression is really important,” Dr. Weitzman says.
In addition to making your friend feel heard, the best thing you can do is be present and nonjudgmental, Dr. Gelenberg says. Even when it’s hard to know what to say, you can help by:
- Being present and spending time with them, whether that’s a quiet night in or a fun activity that could take their mind off the depression (if they’re up for it).
- Accepting them and their depression. Recognize that they can’t just “cheer up” or “get over it.”
- Encouraging physical activity. Take a run together after school, join a yoga or dance class, or organize a basketball game.
It’s important to be careful in how you talk to your friend about depression. Try to avoid the types of statements below, even if they’re well-intentioned.
1. “You’re being really irrational/acting crazy.”
“We have such stigma around mental health and the word ‘crazy,’” Dr. Weitzman says. “Depression is an illness—it’s not being irrational or acting crazy.”
2. “Everyone gets depressed sometimes.”
While a lot of people do experience depression, brushing it off like this minimizes your friend’s experience.
3. “Just cheer up. Snap out of it. Forget about it.”
This suggests that you can make depression go away just by having a positive attitude, Dr. Weitzman says, but it’s not that easy. It’s like telling someone to just snap out of having the flu.
4. “You’ve got it way better than some people.”
Again, statements like this minimize what your friend is going through. For people dealing with depression, it’s a big deal.
5. “When are you going to act like your old self again?”
It’s OK to acknowledge that it’s hard to interact with someone who is depressed, Dr. Weitzman says, “but try to do that in a non-blaming, non-shaming, supportive way.” Instead, try something like, “Wow, I miss the person that you were a few weeks ago, but I want to make sure that you get help.”
Most importantly, you need to recognize when your help isn’t enough—especially if you’re worried a friend or classmate might harm themselves or others. “Let them know you really want to help them find some help,” Dr. Weitzman says. You might even offer to walk with them to the counseling center.
If someone seems at risk of harming themselves or others and seems resistant to help, don’t drop it. Talk to a teacher you trust, or tell your school counselor. All schools have protocols for handling these situations, and some schools even have ways for you to share concerns anonymously—check in with your counseling center for your school’s specific protocol.
Need help? Talk to teen line
1-800-TLC-TEEN (852-8336) or text “TEEN” to 839863
Talk to someone now: National Suicide Prevention Lifeline
Lauren Weitzman, PhD, director of the University of Utah Counseling Center.
Alan J. Gelenberg, MD, professor emeritus, Department of Psychiatry at the University of Arizona and editor-in-chief of the Journal of Clinical Psychiatry.
Helen S. Mayberg, MD, professor, Department of Psychiatry at Emory University School of Medicine in Atlanta, Georgia.
Ahrnsbrak, R., Bose, J., Hedden, S. L., Lippari, R. N., et al. (September 2017). Key substance use and mental health indicators in the United States: Results from the 2016 national survey on drug use and health. Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm#mde1
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Moghaddam, B., & Sturman, D. (2012). Processes reward differently in adolescents versus adults. Proceedings of the National Academy of Sciences, 109(5), 1719–1724. Retrieved from http://www.pnas.org/content/109/5/1719.abstract
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Student Health 101 survey, September 2016.
University of Michigan Depression Center. (2016). Depression in children and adolescents. Retrieved from http://www.depressiontoolkit.org/lifespan/children.asp