Depression



Depression Is Common



Lately Lindsay hasn't felt like herself. Her friends have noticed it,
too. Kia was surprised when Lindsay turned down her invitation to go to
the mall last Saturday. There was really no reason not to go, but
Lindsay just didn't feel like it. Instead, she spent most of Saturday
sleeping.

Staying in more than usual isn't the only change in Lindsay. She's
always been a really good student. But over the past couple of months
her grades have fallen and she has trouble concentrating. She forgot to
turn in a paper that was due and is having a hard time getting motivated
to study for her finals.



Lindsay feels tired all the time but has difficulty falling asleep.
She's gained weight too. When her mother asks her what's wrong, Lindsay
just feels like crying. But she doesn't know why. Nothing particularly
bad has happened. Yet Lindsay feels sad all the time and can't shake it.

Lindsay may not realize it yet, but she is depressed.

Depression is very common and affects as many as 1 in 8 people in
their teen years. Depression affects people of every color, race,
economic status, or age; however, it does seem to affect more girls than
guys.

Responses to Depression



Sometimes friends or family members recognize that someone is
depressed. They may respond with love, kindness, or support, hoping that
the sadness will soon pass. They may offer to listen if the person
wants to talk. If the depressed feeling doesn't pass with a little time,
friends or loved ones may encourage the person to get help from a
doctor, therapist, or counselor.

But not everyone recognizes depression when it happens to someone they know.

Some people don't really understand about depression. For example,
they may react to a depressed person's low energy with criticism,
yelling at the person for acting lazy or not trying harder. Some
mistakenly believe that depression is just an attitude or a mood that
someone can shake off. It's not that easy.

Sometimes even people who are depressed don't take their condition
seriously enough. Some feel that they are weak in some way because they
are depressed. This is wrong — and it can even be harmful if it causes
people to hide their depression and avoid getting help.

Occasionally, when depression causes physical symptoms (things like
headaches or other stress-related problems), a person may see a doctor.
Once in a while, even a well-meaning doctor may not realize somebody is
depressed, and just treat the physical symptoms.Why Do People Get Depressed?



There is no single cause for depression. Many factors play a role
including genetics, environment, life events, medical conditions, and
the way people react to things that happen in their lives.

Genetics



Research shows that depression runs in families and that some people
inherit genes that make it more likely for them to get depressed. Not
everyone who has the genetic makeup for depression gets depressed,
though. And many people who have no family history of depression have
the condition. So although genes are one factor, they aren't the single
cause of depression.

Life Events



The death of a family member, friend, or pet can go beyond normal
grief and sometimes lead to depression. Other difficult life events,
such as when parents divorce, separate, or remarry, can trigger
depression. Even events like moving or changing schools can be
emotionally challenging enough that a person becomes depressed.

Family and Social Environment



For some teens, a negative, stressful, or unhappy family atmosphere
can affect their self-esteem and lead to depression. This can also
include high-stress living situations such as poverty; homelessness; and
violence in the family, relationships, or community.

Substance use and abuse also can cause chemical changes in the brain
that affect mood — alcohol and some drugs are known to have depressant
effects. The negative social and personal consequences of substance
abuse also can lead to severe unhappiness and depression.

Medical Conditions



Certain medical conditions can affect hormone balance and therefore
have an effect on mood. Some conditions, such as hypothyroidism, are
known to cause a depressed mood in some people. When these medical
conditions are diagnosed and treated by a doctor, the depression usually
disappears.

For some teens, undiagnosed learning disabilities might block school
success, hormonal changes might affect mood, or physical illness might
present challenges or setbacks.What Happens in the Brain in Depression



Depression involves the brain's delicate chemistry — specifically, it involves chemicals called neurotransmitters.
These chemicals help send messages between nerve cells in the brain.
Certain neurotransmitters regulate mood, and if they run low, people can
become depressed, anxious, and stressed. Stress also can affect the
balance of neurotransmitters and lead to depression.

Sometimes, a person may experience depression without being able to
point to any particular sad or stressful event. People who have a
genetic predisposition to depression may be more prone to the imbalance
of neurotransmitter activity that is part of depression.

Medications that doctors use to treat depression work by helping to restore the proper balance of neurotransmitters.

Types of Depression



For some people, depression can be intense and occur in bouts that
last for weeks at a time. For others, depression can be less severe but
can linger at a low level for years.

Doctors who treat depression distinguish between these two types of depression. They call the more severe, short-lasting type major depression, and the longer-lasting but less severe form dysthymia (pronounced: diss-thy-me-uh).

A third form of depression that doctors may diagnose is called adjustment disorder with depressed mood.
This diagnosis refers to a depressive reaction to a specific life event
(such as a death, divorce, or other loss), when adjusting to the loss
takes longer than the normally expected timeframe or is more severe than
expected and interferes with the person's daily activities.

Bipolar disorder (also sometimes called manic
depressive illness) is another depressive condition that involves
periods of major depression mixed with periods of mania. Mania is the
term for abnormally high mood and extreme bursts of unusual activity or
energy.Symptoms of Depression



Symptoms that people have when they're depressed can include:

• depressed mood or sadness most of the time (for what may seem like no reason)
  
• lack of energy and feeling tired all the time
  
• inability to enjoy things that used to bring pleasure
  
• withdrawal from friends and family
  
• irritability, anger, or anxiety
  
• inability to concentrate
  
• significant weight loss or gain
  
• significant change in sleep patterns (inability to fall asleep, stay asleep, or get up in the morning)
  
• feelings of guilt or worthlessness
  
• aches and pains (with no known medical cause)
  
• pessimism and indifference (not caring about anything in the present or future)
  
• thoughts of death or suicide
  

When someone has five or more of these symptoms most of the time for 2 weeks or longer, that person is probably depressed.

Teens who are depressed may show other warning signs or symptoms,
such as lack of interest or motivation, poor concentration, and low
mental energy caused by depression. They also might have increased
problems at school because of skipped classes.

Some teens with depression have other problems, too, and these can
intensify feelings of worthlessness or inner pain. For example, people
who cut themselves or who have eating disorders may have unrecognized
depression that needs attention.How Depression Differs From Regular Sadness



Everyone has some ups and downs, and sadness is a natural emotion.
The normal stresses of life can lead anyone to feel sad every once in a
while. Things like an argument with a friend, a breakup, doing poorly on
a test, not being chosen for a team, or a best friend moving out of
town can lead to feelings of sadness, hurt, disappointment, or grief.
These reactions are usually brief and go away with a little time and
care.

Depression is more than occasionally feeling blue, sad, or down in
the dumps, though. Depression is a strong mood involving sadness,
discouragement, despair, or hopelessness that lasts for weeks, months,
or even longer. It interferes with a person's ability to participate in
normal activities.

Depression affects a person's thoughts, outlook, and behavior as well
as mood. In addition to a depressed mood, someone with depression also
can feel tired, irritable, and notice changes in appetite.

When somebody has depression, it can cloud everything. The world
looks bleak and the person's thoughts reflect that hopelessness and
helplessness. People with depression tend to have negative and
self-critical thoughts. Sometimes, despite their true value, they can
feel worthless and unlovable.

Because of feelings of sadness and low energy, people with depression
may pull away from those around them or from activities they once
enjoyed. This usually makes them feel more lonely and isolated, making
the depression and negative thinking worse.

Depression can be mild or severe. At its worst, depression can create
such feelings of despair that a person thinks about suicide.

Depression can cause physical symptoms, too. Some people have an
upset stomach, loss of appetite, weight gain or loss, headaches, and
sleeping problems when they're depressed.Getting Help



Depression is one of the most common emotional problems in the United
States and around the world. The good news is that it's also one of the
most treatable. Therapists and other professionals can help. In fact,
about 80% of people who get help for their depression have a better
quality of life — they feel better and enjoy themselves in a way that
they weren't able to before.

Treatment for depression can include talk therapy, medication, or a combination of both.

Talk therapy with a mental health professional is very effective in
treating depression. Therapy sessions can help people understand more
about why they feel depressed, and ways to combat it.

Sometimes, doctors prescribe medicine for depression. When
prescribing medicine, a doctor will carefully monitor patients to make
sure they get the right dose. The doctor will adjust the dose as
necessary. It can take a few weeks before a person feels the medicine
working. Because everyone's brain is different, what works well for one
person might not be good for another.

Everyone can benefit from mood-boosting activities like exercise,
yoga, dance, journaling, or art. It can also help to keep busy no matter
how tired you feel.

People who are depressed shouldn't wait and hope it will go away on
its own because depression can be effectively treated. Friends or others
need to step in if someone seems severely depressed and isn't getting
help.

Many people find that it helps to open up to parents or other adults
they trust. Simply saying, "I've been feeling really down lately and I
think I'm depressed," can be a good way to begin the discussion. Ask
your parent to arrange an appointment with a therapist. If a parent or
family member can't help, turn to your school counselor, best friend, or
a helpline to get help.When Depression Is Severe



People who are extremely depressed and who may be thinking about
hurting themselves or about suicide need help as soon as possible. When
depression is this severe, it is a very real medical emergency, and an
adult must be notified. Most communities have suicide hotlines where
people can get guidance and support in an emergency.

Although it's important to be supportive, trying to cheer up a friend
or reasoning with him or her probably won't work to help depression or
suicidal feelings go away. Depression can be so strong that it outweighs
someone's ability to respond to reason.

Even if your friend has asked you to promise not to tell, severe
depression is a situation where telling can save a life. The most
important thing a depressed person can do is to get help. If you or a
friend feels unsafe or out of control, get help now. Tell a trusted
adult, call 911, or go to the emergency room.

Depression doesn't mean a person is "crazy." Depression (and the
suffering that goes with it) is a real and recognized medical problem.
Just as things can go wrong in all other organs of the body, things can
go wrong in the most important organ of all: the brain.

Luckily, most teens who get help for their depression go on to enjoy life and feel better about themselves.