In
a Depressed State
Is your child down in the dumps?
by Norm Berlinger
PARENTGUIDE News June 2005
Depression is one of the greatest medical impostors
I know for tweens and teens. At least half the time,
depression in young people doesn’t look at all
like it does in an adult. Unfortunately, many parents
still expect to see the adult picture— a person
who is sad, despondent or severely withdrawn. The typical
depressed adult mopes, cries and holds his head in his
hands.
That is the case less than half the time for our depressed
children. Their mood is much different, and they don’t
look sad at all. Instead, they are extremely cranky
and irritable. The irritability is manifested as anger,
rebelliousness, sullenness, aggressive behavior or even
by a barrage of disrespectful and cruel comments hurled
at you— the parent. That is why I conducted over
one hundred interviews of parents with depressed children
for my new book, Rescuing Your Teenager From Depression.
I wanted to know what kind of detective work these parents
did in order to figure out the dark mystery that had
seemed to kidnap their once happy and loving child.
Sadly, many of them admitted they missed the diagnosis
entirely.
Another major symptom our young people manifest is anhedonia.
This is medically defined as the inability to show interest
in or derive pleasure from things that are ordinarily
interesting or pleasurable. The anhedonia may be masked,
too. Instead, the parent may hear comments such as,
“My friends are dumb,” or “School
is boring.” The child may withdraw from activities
with flimsy excuses such as, “I don’t have
time.”
Now, you might be saying to yourself, “I felt
cranky or bored yesterday, and I wasn’t depressed.”
You’re right, and the American Psychiatric Association
is quick to point out a crucial difference. A clinically
depressed mood is sadness, irritability or anhedonia
that occurs pretty much every consecutive day for at
least two weeks. Furthermore, the mood aberration must
significantly interfere with the child’s “jobs”—
going to school, getting along with friends and family,
and participating in sports or extracurricular activities.
Why don’t depressed young people usually look
sad? The answer is that they are still children, and
that defines them as emotionally immature. The average
child is a concrete thinker until about age 12 and cannot
handle abstract notions. Below age 12, they usually
cannot manage abstract algebra problems or interpret
proverbs such as “A stitch in time saves nine.”
How, then, can we expect them to figure out a dark emotional
mystery inside them, display their emotions correctly,
or even put a name on it all?
Moreover, depression is not only sadness, although sadness
is a great part of it. Depression is more accurately
defined as the combined feelings of worthlessness and
hopelessness. These also may be difficult notions for
the young child to understand, and so instead he acts
out his discomfort with hostility or aggression.
The parent may see other more subtle signs. For one
thing, the depressed child may have found an “antidote”
for the depression. One mother whom I interviewed said
about her daughter: “She felt so bad about herself
on the inside, she wanted to look good on the outside.
She subscribed to three or four fashion magazines. She
became obsessed with clothes and make-up and planned
out all her outfits on a grid for a week.” Other
parents said that their child became “obsessed”
with sports or entertainment as distractions from the
pain. Early in the course of his depression, my own
son consumed large quantities of caffeine, to the point
of becoming jittery and hyperactive, in order to make
himself look and feel “alive.”
The parent may also see attempts at “self-medication.”
Tweens and teens use recreational drugs and consume
alcoholic beverages for many reasons. One of them, though,
may be that the child is trying to put himself out of
touch with his emotions. And if these emotions happen
to be worthlessness and hopelessness, he is trying to
numb the pain of depression. Also, the most recent scientific
studies clearly show that excessive food consumption
may similarly be a form of self-medication. (There is
a reason “comfort food” is called such.)
We used to think that the overweight child became secondarily
depressed, because children are very concerned with
body image. In fact, the converse is often the case.
A depressed child may eventually become overweight,
even obese, by trying to eat herself out of the problem.
A parent must be the prime detective. Seldom will anyone
else alert you to the fact your child seems depressed.
Teachers usually don’t. It’s not that school
resources usually are insufficient to address this need.
Rather, the child considers school his main stage and
will often make heroic efforts to avoid looking “weird”
or “psycho” at this most important place.
When he gets home, the chameleon child changes colors
and becomes irritable or sad. Your child’s friends
probably won’t alert you either. Even if they
could suspect the nature of your child’s problem,
children are usually uncomfortable talking to adults
about dark emotional issues. Finally, other parents
will not be likely to discuss your child’s worrisome
behavior, especially when they suspect it could be depression.
The reason is that even in this enlightened time depression
is a stigmatized disease. Parents do not want to stigmatize
your family in the process. And they don’t want
to admit that they are eagle-eyed because, perhaps,
they had to deal with it in their own family.
It’s better to cry wolf when you suspect depression
and take your child to a family physician for a formal
depression inventory. Don’t wait until it’s
obvious. One mother I interviewed said, “I didn’t
want to admit that my daughter was depressed until I
heard she jumped off a second story deck at a friend’s
house. It took two weeks for her friend’s mother
to tell me it was not an accident.”
Norm Berlinger is the author of Rescuing Your Teenager
From Depression (HarperCollins). He lives in Minneapolis,
Minnesota, with his wife, Pat. Their son, a survivor
of teenage depression, is now in college.
