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. 

How Do People Respond to Someone Who's Depressed? 

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 people mistakenly believe that  depression is just an attitude or  a mood that  a person can shake off. It's not  that easy. 

Sometimes even people who are depressed don't take their condition seriously enough. Some people 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  a person 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 When Someone Is Depressed? 

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. 

What Are the 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 Is Depression Different 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,  a person with depression can also feel tired, irritable,  and notice changes  in appetite. 

When someone 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, people with depression 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 conditions. 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 a person who has 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  the person feels  the medicine working. Because every person'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  a person'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.