The Paly e-Reporter December 2007/January 2008 Page 10   first page    previous page      next page

Is it Sadness or Depression ?

How to Tell the Difference

Teenage depression is much in the news lately. The FDA has been requested to change its warning label regarding suicide on all of the anti-depressants. The percentage of those who actually commit suicide is a very small fraction of those who are depressed, nevertheless, it is a frightening thought for parents.

So, how do we tell the difference between within-the-range-of-normal sadness and depression? First we need to start with the developmentally appropriate range of feeling  for a teenager. To quote the medical encyclopedia, for normal teenagers we can expect “sensitivity and concern over body issues, excruciating comparisons between oneself and peers, acts of rebellion, conflict with parents, risk-taking behavior, increased risk for depression due to pressures and conflicts that may arise within families or in friendships. If adolescents appear to be isolated from peers, disinterested in school, or deteriorating in performance in school, work, or sports, psychological evaluation may be necessary.”

That was quite a mouthful, but, as you can see, there is quite a broad range of normal for teenagers. The issues come about in the gray areas. Someone who is exhibiting extreme behaviors is easy to identify. It is when we are unsure that it becomes more difficult.  The major signs of depression are fatigue, heaviness, or listlessness; loss of appetite; difficulty concentrating and completing tasks; feelings of shame, worthlessness, inadequacy and incompetence; lack of sleep; loss of interest in life; withdrawal from friends and family; engaging in self-destructive behavior; and expressing desire to harm oneself.

Another factor is separating out sadness and depression. Sadness (or grief) is a natural response to loss and the symptoms may seem the same as depression. The major difference with depression is that the person feels that there is something wrong with themselves, “no one likes me, there is something wrong with me.” That usually doesn’t happen with simple grief.

Let me tell you about a teenager I am seeing in my private practice. She came in with most of the above symptoms – not eating, not sleeping, and feeling no one liked her. In fact, she scored high on a depression scale I gave her. What became important for me over time is that she kept coming back each time to the fact that she was lonely. That was her predominant symptom. She said she was not suicidal. She made good use of therapy. At first, she was quiet and said very little. However, as we continued to meet, she opened up more about her loneliness. I learned, though, that she overemphasized some things. Her perception is that she had no friends, but in conversation, she would name several people she spoke to. But she said they were not really friends. Her perception of being lonely was important to listen to, because that is how she was operating, based on her perception. Therapy has helped h er see things more realistically – that she actually has friends, but that she may have been misperceiving. She did not need to take anti-depressants as therapy was helping her to improve. Sometimes medication is necessary, but I always try to see if therapy will help alleviate the pain they feel first.

Sadness is a part of life, just as is grief over a loss. But when it becomes depression, it is time to take action.

If you find that your teen is having difficulty with sadness or depression, do not hesitate to have them contact an ACS counselor. Adolescent Counseling Services has therapists on your teen’s campus who are available to help. We also have access to outside resources  to help parents to get through this difficult time.

Adolescent Counseling Services is a community non-profit, which provides vital counseling services on six secondary campuses at no charge to students and their families. To learn more about our services please visit the ACS website at www.acs-teens.org or call Margaret Murchan at ACS at (650) 424-0852, ext. 102.  ACS relies on the generosity of community members to continue offering individual, family, and group counseling to over 1,500 individuals annually, helping teens find their way! ACS provides critical interventions and mental health services, building a better future for tomorrow.