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Young & the lonely: a team of top experts answers your questions about loneliness and depression.

Do you often feel lonely? Irritable, angry, or with-drawn? "It's just a phase," a parent may counsel. "You'll get over it," advises a friend. After all, says conventional wisdom, you're an adolescent--and stormy emotional ups and downs come with teen territory. Or do they?

Until roughly the last two decades, medical researchers pinned adolescent angst on the natural course of human development. But slowly they've come to distinguish teenagers' normal feelings of sadness and anger from a genuine, often crippling mental-health disorder: depression. What's the difference between common loneliness and depression? "Feeling lonely occasionally is universal," says leading teen expert Dr. Harold Koplewicz. "Depression is a real disease." Increasingly, researchers have come to consider depression a biochemical disorder in the brain, where imbalances of neurotransmitters (chemical messengers between brain cells) like serotonin and dopamine adversely impact emotional control. But the causes of such biochemical imbalances--and whether they're fleeting or permanent--remain somewhat of a mystery.

Nevertheless, about 3 million 14 to 18-year-olds in the U.S. are clinically depressed, according to the National Institute of Mental Health. Depression knows no economic, social, or racial borders. From teeming cities to tiny towns, many Americans battle sporadic or frequent bouts of depression--sometimes suffering for years in silence, without diagnosis or treatment. So when SW wanted to tackle the issues of loneliness and depression, we turned to students in Maureen Van Ackooy's science class at LaGrange Middle School in Lagrangeville, New York, and asked them to submit the pressing questions they wanted answered. After all, their questions are yours.

Q: What starts depression?

Jamie Stenson, 12; Kurt Nicoliasen, 11; Kathryn Lee, 11

Depression occurs when a person's brain has trouble managing stress, says Dr. Harold Koplewicz, director of the New York University Child Study Center and author of More Than Moody: Recognizing and Treating Adolescent Depression (Putnam, 2002). When certain stressful crises occur--like a divorce, loss of a valued friendship, the death of a loved one, or economic hardship--people typically feel sad. Usually after a period of time, they're able to recover their normal feelings of well-being. "But for those people with a chemical imbalance in their brains, these stressful events can cause them to become depressed," Koplewicz says.

Q: Is depression inherited, or is it from your environment?

Stephanie Carrick, 11; Eric Rothdeutsch, 11 Researchers currently think an interplay of factors are responsible for depression. One factor is genetic, says Koplewicz: "Depression runs in families, which means you're more at risk if your mother, father, or sibling is depressed." However, he points out, most teens who battle depression don't have any relatives with the disease. That's because other determining factors include: one's family environment, such as the presence of physical or emotional abuse, or neglect; individual personality traits, such as low self-esteem or overdependence on others; and again, a person's unique brain chemistry.

Q: Does depression occur at a certain age? Paul Fielek, 11

Depression is more common during adolescence than at any other time of life, says Koplewicz: "Particularly being 13 or 14 years old is the most common age for depression to occur."

Q: What's the number one reason why teens get depression? Alyssa Minicucci, 11; Jaclyn Schauer, 11; Rachel Queenan, 10; Wylie Borum, 11; Dylan Britton, 11; Heather Peruffo, 11; Dana Capicotto, 11; Joe Murray, 11; Mark Kuczyra, 12; Peter Speak, 10; Cathleen Fitzpatrick, 11; Sean Reilly, 11; Anthony Rispoli, 11

While hormonal surges at puberty impact mood swings, new research shows the teen brain is literally in flux, Koplewicz explains: The frontal lobes, which help regulate emotional moods and self-control, alter

dramatically between puberty and adulthood. The lobes' gray matter (tissue connecting various cells and nerve branches) undergoes a growth spurt between age 11 or 12. But then, oddly, a pruning or reduction of brain-cell connections occurs that lets maturing teens focus more specifically on new information--from factual knowledge to abstract concepts--and emotionally absorb that information more deeply. Says Koplewicz: "For a small percentage of teens, this exciting but dramatic brain change--coupled with genetic or environmental factors--triggers depression."

Q: What does depression feel like? Sabrina Acompora, 11

"Some depressed people cry a lot and have trouble getting out of bed," says Alan Hilfer, pediatric psychologist at Maimonides Medical Center in Brooklyn, New York. Depression can also make you very tired--oversleep or cause sleeplessness, and make you overeat or lose your appetite. The person who turns depression inward as anger may seethe with constant rage. "It feels like an enormous weight, weighing you down," Hilfer says. "One thing we try to do in therapy is to get people to identify their anger, and learn to express and manage it properly."

Q: Do kids get depressed Because their parents are fighting? Matthew Mano, 11

"Yes, they do," says Patricia Saunders, director of the Manhattan Mental Health Center, Graham-Windham Services to Families. A family in which bitter fighting or abuse is the norm can spark depression. "Kids fear their parents might break up or are battling over them, for example," Saunders says. "It may be hard, but try to let your parents know how you feel." If it's too difficult to talk to them, Saunders suggests seeking outside help, such as a school counselor or mental health professional.

Q: Why de we sometimes feel sad or depressed when there's nothing to be sad about? Donielle Montague, 12

"Emotions are always reactions to something," Saunders says, "and you should take them seriously." You may be sad because of something that happened in the past--and current events, like the end of a friendship, revive old memories or feelings. The trigger may be a small thing, but enough to resurrect intense emotions, she explains. "Sometimes we have vague thoughts that we're not good enough," says Saunders, "that there's something wrong with us--and these thoughts are chronic." You may ignore them, but the price may be feelings of low self-worth, which causes people to feel sad or depressed for no apparent cause.

Q: Sometime when I wake up, I don't want to go to school. Am I depressed? Michael Dix, 12

"Not necessarily," says Dr. Kenneth Skodnek, chairman of the Nassau University Medical Center in East Meadow, New York. There can be many reasons why teens don't want to go to school: crises with peers, difficulties with homework or school procedures, or conflicts at home. Again, if the dread of going to school becomes a common emotional pattern, Skodnek recommends turning to a guidance counselor: "It's a good idea to see if you can find the help you need."

Q: Why do people start to hate themselves just because their friends don't likes them anymore? Afnan Ahmad, 11

"Being 11 is a sensitive time in a young person's life," Skodnek replies. Teens are beginning to form their own personal identities, forge close bonds with friends, and lessen their emotional dependence on parents. So their self-esteem to a significant extent depends on how their peers respond to and value them. "Whenever an 11-year-old isn't liked by peers, it's a painful disappointment," Skodnek says. "It's easy to blame yourself when you don't get the positive responses you'd like from a friend."

Q: When you're depressed, does it cause you to do drugs? Thomas Musa, 11; Robert McGoorty, 11

"Some people turn to drugs--or `self-medicate'--to try to block emotional pain," says Patricia Saunders. But being depressed doesn't automatically lead anyone to do drugs. It's that depression often results in poor judgment and impulsive decisions.

Q: Will your depression affect your relationships with others? Kelsey Malara, 12

"Whether or not your depression affects your relationships with others is dependent on two things: how you feel about them and how they feel about you," says New York City clinical social worker Lauren Howard. When you're depressed it's often hard to see the actions of others clearly. You may overreact to things people do or say. And if you've turned feelings of anger inward, you may act explosively toward others. "The lens through which you see the world is clouded by your own feelings," Howard says.

How others respond to you when you're depressed depends on the terms of your friendship. "Relationships have layers, like an onion," she says. "In a limited friendship, some people may be intolerant of your change. The people in your life with whom you have deeper bonds will respond to you with understanding and acceptance. One of the great challenges of life is figuring out where people fit in on that continuum."

Q: How can I help someone who is lonely and depressed? Michael Nuzback, 11

"Probably the most proactive thing you can do to help is to spend time with the person," says Howard. She explains: Realize that a person who is depressed may turn away from overtures to do things together. Make it safe for them to be with you, even if it's just hanging around and doing nothing. Just your physical presence can feel comforting. Don't press them to talk about their feelings--but if they do, be a good listener. Don't try to persuade them their feelings aren't valid. You want to show that you accept and enjoy being with them, even when they're not fun and engaging.

Q: What can teens do to help solve whatever is making them depressed? Danielle McLean, 11

"Teens should try to talk about their feelings open]y," says psychiatrist Dr. Eileen Sweeney at Staten Island University Hospital. Start at home by talking to parents or siblings. If this isn't possible, seek out trusted teachers, guidance counselors, or clergymen. However, "if your depression persists more than a couple of weeks, consider seeking psychiatric evaluation," says Dr. Swarna Mani at Staten Island University Hospital. A mental health professional can help determine the causes of depression, prescribe a form of treatment such as talk therapy, and, in some cases, medication.

Today a battery of antidepressants exists: "For most cases of depression in young people, we usually prescribe Zoloft, Prozac, or Paxil," Mani says. These drugs are known as SRRIs--or selective serotonin reuptake inhibitors: they regulate the brain's levels of serotonin, one neurotransmitter linked to emotional well-being. When antidepressants are effective--and researchers are still trying to decipher why they succeed or fail--the medication tends to restore emotional stability, level out extreme mood swings, and increase users' focus on daily tasks.

Q: Can you be depressed your whole life? Chris, 11

"Sometimes depression can affect a person in varying degrees throughout his or her life," says Lauren Howard. For most people, the most frightening aspect of depression is the feeling it will never go away. That's rarely the case, Howard says. The problem is, when people are depressed they often lack the motivation to reach out for professional help. That's where education and self-awareness become critical: "As more people become aware of how depression creates a roadblock to getting help, they can push through their state of mind in an effort to master their own personality. Learning how to adapt to one's personality and manage one's moods provides a roadmap for living a full and rewarding life, even when a person suffers from depression."

For more information ...

The National Institute of Mental Health has several resources available on teen depression. For free brochures "Let's talk about depression," and "What to do when a friend is depressed," visit their Web site: www.nimh.nih.gov/publlcat/depchildmanu.cfm

Or obtain information on depression by calling the NIMH hotline: 1-800-421-4211

Depression signals often persist every day for at least two weeks, and include:

* EMOTIONAL SYNPTOMS, such as prolonged sadness, emptiness, low self-esteem, guilt, or thoughts of suicide and death.

* PHYSICAL SYMPTOMS, such as sleep and appetite disorders, headaches, or stomachache.

* BEHAVIORAL SYMPTOMS, such as isolation; acting out anger; conflicts with friends, parents, or at school; turning to alcohol or drug abuse.

5% OF BOYS AGES 14-18 ARE DEPRESSED DURING ANY ONE YEAR *

10 % OF GIRLS AGES 14-18 ARE DEPRESSED DURING ANY ONE YEAR

19% OF BOYS AGES 14-18 HAVE HAD AN EPISODE OF MAJOR DEPRESSION BY AGE 19

35% OF GIRLS AGES 14-18 HAVE HAD AN EPISODE OF MAJOR DEPRESSION BY AGE 19

* SOURCE: CLINICAL PSYCHOLOGICAL REVIEW
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Publication:Science World
Geographic Code:1USA
Date:Feb 7, 2003
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