Experts say that about one in nine youths attempt suicide by the time they graduate from high school. A new study finds that nearly 40 percent of young adults who said they had tried suicide said that they made their first attempt before entering high school.

The study is published in the Journal of Adolescent Health.

via Suicidal Behavior May Begin Before High School | Psych Central News.

via Informed Patient: Screening Teens for Mental-Health Problems – Health Blog – WSJ.

via Depressed teens mostly struggle alone – latimes.com.

Titania Welcoming Her Fairy Bretheren by Henry Maynell Rheam

Depression can occur during adolescence, a time of great personal change. You may be facing changes in where you go to school, your friends, your after-school activities, as well as in relationships with your family members. You may have different feelings about the type of person you want to be, your future plans, and may be making decisions for the first time in your life.

Many students don’t know where to go for mental health treatment or believe that treatment won’t help. Others don’t get help because they think depression symptoms are just part of the typical stresses of school or being a teen. Some students worry what other people will think if they seek mental health care.

This fact sheet addresses common questions about depression and how it can affect high school students.

Q. What is depression?

A. Depression is a common but serious mental illness typically marked by sad or anxious feelings. Most students occasionally feel sad or anxious, but these emotions usually pass quickly—within a couple of days. Untreated depression lasts for a long time and interferes with your day-to-day activities.

Q. What are the symptoms of depression?

A. Different people experience different symptoms of depression. If you are depressed, you may feel:

• Sad
• Anxious
• Empty
• Hopeless
• Guilty
• Worthless
• Helpless
• Irritable
• Restless.

You may also experience one or more of the following symptoms:

• Loss of interest in activities you used to enjoy
• Lack of energy
• Problems concentrating, remembering information, or making decisions
• Problems falling sleep, staying asleep, or sleeping too much
• Loss of appetite or eating too much
• Thoughts of suicide or suicide attempts
• Aches, pains, headaches, cramps, or digestive problems that do not go away.

Depression in adolescence frequently co–occurs with other disorders such as anxiety, disruptive behavior, eating disorders or substance abuse. It can also lead to increased risk for suicide.

Q. Are there different types of depression?

A. Yes. The most common depressive disorders are:

• Major depressive disorder, also called major depression. The symptoms of major depression are disabling and interfere with everyday activities such as studying, eating, and sleeping. People with this disorder may have only one episode of major depression in their lifetimes. But more often, depression comes back repeatedly.
• Dysthymic disorder, also called dysthymia. Dysthymia is mild, chronic depression. The symptoms of dysthymia last for a long time—two years or more. Dysthymia is less severe than major depression, but it can still interfere with everyday activities. People with dysthymia may also experience one or more episodes of major depression during their lifetimes.

Other types of depression include:

• Psychotic depression—severe depression accompanied by some form of psychosis, such as hallucinations and delusions
• Seasonal affective disorder—depression that begins during the winter months and lifts during spring and summer.

Q. What causes depression?

A. Depression does not have a single cause. Several factors can lead to depression. Some people carry genes that increase their risk of depression. But not all people with depression have these genes, and not all people with these genes have depression. Environment—your surroundings and life experiences—also affects your risk for depression. Any stressful situation may trigger depression. And high school students encounter a number of stressful situations!

Q. How can I find out if I have depression?

A. The first step is to talk with your parents or a trusted adult who can help you make an appointment to speak with a doctor or mental health care provider. Some school counselors may also be able to help you find appropriate care.

The doctor or mental health care provider can do an exam to help determine if you have depression or if you have another health or mental health problem. Some medical conditions or medications can produce symptoms similar to depression.

The doctor or mental health care provider will ask you about:

• Your symptoms
• Your history of depression
• Your family’s history of depression
• Your medical history
• Alcohol or drug use
• Any thoughts of death or suicide.

Q. How is depression treated?

A. A number of very effective treatments for depression are available. The most common treatments are antidepressants and psychotherapy. An NIMH–funded clinical trial of 439 teens with major depression found that a combination of medication and psychotherapy was the most effective treatment option.¹ A doctor or mental health care provider can help you find the treatment that’s right for you.

Q. What are antidepressants?

A. Antidepressants work on brain chemicals called neurotransmitters, especially serotonin and norepinephrine. Other antidepressants work on the neurotransmitter dopamine. Scientists have found that these particular chemicals are involved in regulating mood, but they are unsure of the exact ways that they work.

Q. If a doctor prescribes an antidepressant, how long will I have to take it?

A. You will need to take regular doses of antidepressants for four to six weeks before you feel the full effect of these medicines. Some people need to take antidepressants for a short time. If your depression is long lasting or comes back again and again, you may need to take antidepressants longer.

Q. What is psychotherapy?

A. Psychotherapy involves talking with a mental health care professional to treat a mental illness. Types of psychotherapy often used to treat depression include:

• Cognitive-behavioral therapy (CBT), which helps people change negative styles of thinking and behavior that may contribute to depression
• Interpersonal therapy (IPT), which helps people understand and work through troubled personal relationships that may cause or worsen depression.

Depending on the type and severity of your depression, a mental health professional may recommend short-term therapy, lasting 10 to 20 weeks, or longer-term therapy.

Q. How can I help myself if I am depressed?

A. If you have depression, you may feel exhausted, helpless, and hopeless. But it is important to realize that these feelings are part of the depression and do not reflect your real circumstances. Treatment can help you feel better.

To help yourself feel better:

• Engage in mild physical activity or exercise
• Participate in activities that you used to enjoy
• Break up large projects into smaller tasks and do what you can
• Spend time with or call your friends and family
• Expect your mood to improve gradually with treatment
• Remember that positive thinking will replace negative thoughts as your depression responds to treatment.

Q. How can I help a friend who is depressed?

A. If you think a friend may have depression, you can help him or her get diagnosed and treated. Make sure he or she talks to an adult and gets evaluated by a doctor or mental health provider. If your friend seems unable or unwilling to seek help, offer to go with him or her and tell your friend that his or her health and safety is important to you.

Encourage your friend to stay in treatment or seek a different treatment if he or she does not begin to feel better after six to eight weeks.

You can also:

• Offer emotional support, understanding, patience, and encouragement
• Talk to your friend, not necessarily about depression, and listen carefully
• Never discount the feelings your friend expresses, but point out realities and offer hope
• Never ignore comments about suicide
• Report comments about suicide to your friend’s parents, therapist or doctor
• Invite your friend out for walks, outings, and other activities—keep trying if your friend declines, but don’t push him or her to take on too much too soon
• Remind your friend that with time and treatment, the depression will lift.

Q. What if I or someone I know is in crisis?

A. If you are thinking about harming yourself or having thoughts of suicide, or if you know someone who is, seek help right away.

• Call your doctor or mental health care provider.
• Call 911 or go to a hospital emergency room to get immediate help, or ask a friend or family member to help you do these things.
• Call your campus suicide or crisis hotline.
• Call the National Suicide Prevention Lifeline’s toll-free, 24-hour hotline at 1-800-273-TALK (1-800-273-8255) or TTY: 1-800-799-4TTY (1-800-799-4889) to talk to a trained counselor.
• If you are in crisis, make sure you are not left alone.
• If someone else is in crisis, make sure he or she is not left alone.

Q. What efforts are underway to help high school students who have depression?

A. Researchers are studying new ways to diagnose and treat depression in high school age students. Increasing the early detection and treatment of depression can help more students succeed academically and achieve their goals in school and after graduation.

The National Institute of Mental Health (NIMH) sponsors research on the causes, diagnosis, and treatment of depression, including studies focused on adolescents and young adults. Two large scale clinical trials focusing on depression in this population are:

• Treatment for Adolescents with Depression Study (TADS)
• Treatment of SSRI-resistant Depression in Adolescents (TORDIA) study

References

¹ March J, Silva S, Petrycki S, Curry J, Wells K, Fairbank J, Burns B, Domino M, McNulty S, Vitiello B, Severe J. Treatment for Adolescents with Depression Study (TADS) team. Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents with Depression Study (TADS) randomized controlled trial. Journal of the American Medical Association, 2004; 292(7): 807-820.

For more information on depression

Visit the National Library of Medicine’s MedlinePlus
En Español

For information on clinical trials

National Library of Medicine clinical trials database

Information from NIMH is available in multiple formats. You can browse online, download documents in PDF, and order materials through the mail. Check the NIMH website for the latest information on this topic and to order publications. If you do not have Internet access, please contact the NIMH Information Resource Center at the numbers listed below.

National Institute of Mental Health
Science Writing, Press & Dissemination Branch
6001 Executive Boulevard
Room 8184, MSC 9663
Bethesda, MD 20892-9663
Phone: 301-443-4513 or
1-866-615-NIMH (6464) toll-free
TTY: 301-443-8431
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FAX: 301-443-4279
E-mail: nimhinfo@nih.gov
Website: http://www.nimh.nih.gov

Reprints

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• NIMH does not endorse or recommend any commercial products, processes, or services, and our publications may not be used for advertising or endorsement purposes.
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The photos in this publication are of models and are used for illustrative purposes only.

U.S. Department of Health and Human Services
National Institutes of Health
National Institute of Mental Health
2011

Psyche Opening the Golden Box by John William Waterhouse

Note: If you’re a parent or educator interested in information about children and depression, my Depression and Children page might be more helpful.

Introduction

Been there, done that, bought the t-shirt. Of course, it was over thirty years ago, but I still remember with painful clarity what it was like to be a teenager with depression. The sadness, the feeling of helplessness, the belief that it was part of my personality and the conviction that something was wrong. I just didn’t know what it was. At that time, in the late ’70s, no one really did. The medical community didn’t believe children, including teenagers, could suffer from depression. Fortunately, now things are different, to some extent. There still is a lot of misunderstanding about what clinical depression is, so many teens don’t get help, either because they don’t realize they have depression, or because it’s hard for them to get help.

How Does It Feel?

• You’re sad all the time, and/or you feel anxious or numb.
• You feel hopeless about everything.
• You feel guilty.
• You feel worthless.
• You have a lot of physical problems (stomachaches, headaches, chest pain) that don’t seem to have any cause.
• You feel irritable (everything and everyone annoys you).
• You have very little energy and you’re tired all the time.
• You feel restless and fidgety.
• You have difficulty concentrating on anything.
• You’re thinking about suicide or death a lot.

How It May Be Affecting Your Life

• Your grades have dropped.
• You’re sleeping a lot or having trouble sleeping.
• You’ve gained or lost weight.
• You don’t want to spend time with your friends anymore.
• You have no interest in things you used to like doing.
• You cry a lot for no particular reason.

How Do I Tell My Parents?

This is a tough one, and a question I get fairly often. First of all, let’s assume that your parents are loving, stable and have your best interests at heart. They may still unknowingly make it difficult for you to get help. They may say, “What do you have to be depressed about?” or tell you that your feelings will pass and are a normal part of being a teenager. There are two factors at work in this case. One is denial. No parent wants to think something is wrong with their child, especially something like mental illness which has so much stigma attached to it. They may feel guilty or deny what is happening because they feel helpless to take care of you, the way they used to be able to put a bandaid over a scraped knee. The second factor is lack of knowledge on their part. They are not alone in this – over 70% of adults surveyed believed that a depressed person just needed to pull himself/herself together. In this case, it’s not their fault that they don’t know enough about depression, and probably just need to be educated. Once you present them with some information, they will probably be eager to get help for you.

I know that you may not have parents like that. Let’s assume that your parents are self-involved or have their own problems like addiction or are abusive. In this case you’ll have to be strong and get help on your own. It’s hard that your parents can’t be there for you when you need them, but chances are that you’re used to taking care of yourself. If you have depression it’s very difficult to do anything positive, but you have to get help. You can’t let it ruin your life.

How Do I Get Help?

Detail from The Sleeping Beauty by Henry Maynell Rheam

If your parents are in the first category, probably all you have to do is tell them that you have the signs of clinical depression, and you would like to get a complete physical by your family doctor and get the name of a psychiatrist. If you present them with information about depression and educate them, you can probably overcome their denial and objections fairly easily. They do want what’s best for you, and they probably have noticed a change in you.

If your parents are in the second category, you have two choices. One is to find a sympathetic adult who can convince your parents that you need help. This could be a school counselor, a favorite teacher, your priest or minister, or a friend’s parent. You can educate this person about depression if need be and ask them to talk to your parents.

If you can’t think of an adult who can help you, go directly to your family doctor and ask for a referral to a psychiatrist. If your family doctor is no help or there is a problem with insurance, find a local mental health clinic, suicide prevention center or crisis hot line. The most important thing is getting treatment; don’t let anything stand in your way.

Should I Tell My Friends?

This is also a tough question. You should realize that this might be something that separates your real, true friends from your not-so-true friends. Some people will be supportive and other people won’t, and will probably start avoiding you. But you might want to take negative reactions with a grain of salt. A friend may have a relative who has depression or another mental illness, and that could make it tough for them to be there for you. Or, they may have a sneaking suspicion that they’re having problems with their own emotional wellness, and having you confront yours makes them freak out. Don’t entirely shut the door on anyone; they may come around in time.

Resources

Web Pages

• Teen Advice – About.com
• Teen Moods
• Teens for Teens: Help Stop Teenage Depression
• Trapped Minds
• Youth Suicide Prevention

Articles Online

• Adolescent Depression often Continues to Adulthood
• Curbing the Violence – WebMD
• Cutting
• Love Doesn’t Have to Hurt Teens
• My Friend is Talking About Suicide – What Should I Do?
• Teen Helps Peers with Depression
• What to Do If a Friend Has Depression
• Why Am I So Sad?

Booklets Online

• Depression: What it is and what to do About It
• What to Do When a Friend is Depressed: A Guide for Teenagers

Read on