By Katherine Kam
WebMD Health News
Reviewed by Hansa D. Bhargava, MD
Dec. 2, 2016 -- When Elizabeth began to feel depressed during her freshman year in high school, she ate little and slept poorly. But she threw herself into a busy schedule of school and sports, hoping that she could outpace her sadness and anxiety.
"I didn't feel right, and I didn't know what to do. I tried to keep myself as busy as possible," she says. "I'd call it a bad day and leave it at that. I'd try to wake up the next morning and put on as happy a face as I could."
She began pulling away from others and became "distant and nervous," she says. But she wouldn't confide in anyone -- not even her mother, who suspected that she was struggling. "I'd cry to my mom and tell her that I was just really tired. I needed to go to bed and start again the next day," she says.
"One day, I couldn't take it," says Elizabeth, now a 16-year-old junior in the Philadelphia area. She talked about her depression on the condition that for privacy, her last name not be used. When a friend noticed that she seemed panicked during lunchtime at school, he rushed her to the counselor's office. Later, Elizabeth was diagnosed with depression -- one of a growing number of teens who have the disorder.
A recent national survey by the federal Substance Abuse and Mental Health Services Administration (SAMHSA) found that 8.2% of young people ages 12-17 were depressed in 2011. By 2014, the rate had jumped to 11.4% -- almost a 40% increase in 3 years.
"Depression among youth is a serious problem that is becoming more widespread," the report says.
Another survey found that the number of teens reporting a major depressive episode in a 12-month period increased from 8.7% in 2005 to 11.3% in 2014. The rate was higher for teen girls -- increasing from 13.1% in 2004 to17.3% in 2014. Suicide rates are also up among teens, especially teen girls.
Many experts don't believe that the rise comes solely from better awareness and diagnosis of depression.
"Any developmental scientist will tell you that all the indicators are that teens' mental health is declining," says Diana Divecha, PhD, a developmental psychologist who conducts research for the Yale Center for Emotional Intelligence.
Many of today's prevalent problems -- stressed families, powerful academic pressures, unrealistic norms for good looks, and unhealthy use of social media -- can hamper rather than promote teens' healthy emotional development, Divecha says.
Carrie Spindel Bashoff, a psychologist in private practice in West Orange, NJ, also notes a growing problem. She cites risks such as crime, trauma, failure in school, obesity, peer problems, long-term bullying, alcohol abuse, and interpersonal difficulties such as "sudden shifts in a friendship or breakups."
For Elizabeth, academic pressures contributed to her depression. "I was nervous about college and high school. It's a big step," says Elizabeth, who also has anxiety. While depression and anxiety are separate disorders, they often occur together.
She also mentions a sense of foreboding that many teens share; they encounter a 24/7 cycle of frightening news on their phones and computers, including stories about global warming, terrorism, school shootings and other serious problems.
"It's pretty much, 'The world is a terrible place. Bad things happen to people, and something bad is going to happen to me,' Elizabeth says. "Why be happy when that's just going to happen? I think we scare ourselves into not being happy, on top of the family things and personal things that are going on. We don't know how to deal with it."
After Elizabeth got counseling, she felt much better, she says.
The Role of Social Media
More time on social media causes some teens to interact less with others, including their own families, the SAMHSA report says. It also noted that today's teens have grown up with fewer opportunities to play and explore freely, which can hinder their problem-solving skills.
Among depressed teens that Spindel Bashoff counsels, social media "comes up all the time, for better or worse," she says. High school principals who have spoken with Divecha "have been attributing a lot of teen anxiety to social media," she says.
And a recent study found a link between depression symptoms and "negative Facebook experiences" that included "bullying, meanness, unwanted contact, and misunderstandings."
Elizabeth says that teen girls are constantly confronted with unattainable images of perfection on social media.
"People who are depressed have this idea that their life is supposed to be a certain way and are really upset and depressed that it's not looking like those people that they idolize because of how skinny they look or how great their makeup is or how their eyebrows look," she says. "That's not reality."
Divecha agrees that media images, including those in social media, can be distressing for girls.
For boys, too much pornography and video games can increase risk of depression, Divecha says. They displace more productive activities and can distort boys' relationships with girls, she says. And social media makes it easier to bully kids, which can lead to depression.
However, "social media isn't inherently bad," Spindel Bashoff says. With isolated, depressed teens, "we're actually using social media as a stepping stone to help them increase their comfort in getting themselves back into life and reaching out to people," she says.
Elizabeth, who is on Instagram, says that social media can be uplifting, for example, "If people go someplace and the pictures turn out really nice."
What Parents Can Do
Parents need to help teens interpret social media, "giving them information that people present their best selves -- even a false self -- on social media, and that's not really how life works," Divecha says.
Positive factors can build teens' ability to cope. Spindel Bashoff says that a supportive home and school environment, good health, intelligence, being a good problem solver, and being involved in extracurricular activities can protect teens from depression.
Parents can also support their teens. Wendy Hahn, a pediatric psychologist at the Cleveland Clinic, offers these tips:
- Ask teens how to address problems, and work on solving them together
- Model healthy relationships and social media use
- Listen to your teen without judgement
It's important "for adults to be present, available, and interested in a teen's experience without dismissing it or quickly stating what the teen 'should' do," Hahn says. "Teens often express a desire to be validated for what they think and feel and why they act as they do in situations."
Elizabeth agrees. "If teenagers know that you're willing to listen and show that you're not going to get angry right away, it will make a world of difference in their heads. I can tell you right now that a lot of them don't say anything because they think they're going to get in trouble. To be willing to listen and to be as understanding as possible and to remember how you felt when you were their age is probably one of the best things."
Health Solutions From Our Sponsors
©2016 WebMD, LLC. All Rights Reserved.