WHAT TO DO WHEN
A FRIEND IS DEPRESSED
A Guide for Teenagers
from the U.S. Department of Health and Human Services 
CORBIS PHOTO,
ALL RIGHTS RESERVED
As a teenager, you know that these school years can be complicated
and demanding. Deep down, you are not quite sure of who you are,
what you want to be, or whether the choices you make from day
to day are the best decisions.
Sometimes the many changes and pressures you are facing threaten
to overwhelm you. So it isn't surprising that from time to time
you or one of your friends feels "down" or discouraged.
But what about those times when a friend's activity and outlook
on life stay "down" for weeks and begin to affect your
relationship? If you know someone like this, your friend might
be suffering from depression. As a friend, you can help.
1. FIND OUT MORE ABOUT DEPRESSION.
Q. What is depression?
A. Depression is more than the blues or the blahs; it is more
than the normal, everyday ups and downs. When that "down"
mood, along with other symptoms, lasts for more than a couple
of weeks, the condition may be clinical depression.
Clinical depression is a serious health problem that affects
the total person. In addition to feelings, it can change behavior,
physical health and appearance, academic performance, and the
ability to handle everyday decisions and pressures.
Q. What causes clinical depression?
A. We do not yet know all the causes of depression, but there
seems to be biological and emotional factors that may increase
the likelihood that an individual will develop a depressive disorder.
Research over the past decade strongly suggests a genetic
link to depressive disorders; depression can run in families.
Bad life experiences and certain personality patterns such
as difficulty handling stress, low self-esteem, or extreme pessimism
about the future can increase the chances of becoming depressed.
Q. How common is it?
A. Clinical depression is a lot more common than most people
think. It affects 10 million Americans every year. One-fourth
of all women and one-eighth of all men will suffer at least one
episode or occurrence of depression during their lifetimes.
Depression affects people of all ages but is less common for
teenagers than for adults. Approximately 3 to 5 percent of the
teen population experiences clinical depression every year. That
means among 100 friends, 4 could be clinically depressed.
Q. Is it serious?
A. Depression can be very serious. It has been linked to poor
school performance, truancy, alcohol and drug abuse, running
away, and feelings of worthlessness and hopelessness.
In the last 25 years, the rate of suicide among teenagers
and young adults has increased dramatically. Suicide often is
linked to depression.
Q. Are all depressive disorders alike?
A. There are various forms or types of depression. Some people
experience only one episode of depression in their whole life,
but many have several recurrences.
Some depressive episodes begin suddenly for no apparent reason,
while others can be associated with a life situation or stress.
Sometimes people who are depressed cannot perform even the
simplest daily activities - like getting out of bed or getting
dressed; others go through the motions, but it is clear they
are not acting or thinking as usual.
Some people suffer from bipolar depression in which their
moods cycle between two extremes - from the depths of despair
to frenzied heights of activity or grandiose ideas about their
own competence.
Q. Can it be treated?
A. Yes, depression is treatable. Between 80 and 90 percent
of people with depression - even the most serious forms - can
be helped. Symptoms can be relieved quickly with psychological
therapies, medications, or a combination of both.
The most important step toward treating depression - and sometimes
the most difficult - is asking for help.
Q. Why don't people get the help they
need?
A. Often people don't know they are depressed, so they don't
ask for - or get - the right help. Teenagers and adults share
a problem - they often fail to recognize the symptoms of depression
in themselves or in people they care about.
2. BE ABLE TO TELL FACT FROM FICTION.
Myths about depression separate people from the effective
treatments now available. Friends need to know the facts. Some
of the most common myths are these:
Myth: Teenagers don't suffer from
"real" depression.
Fact: Depression can affect people at
any age or of any race, ethnic, or economic group.
Myth: Teens who claim to be depressed
are weak and just need to pull themselves together. There's nothing
anyone else can do to help.
Fact: Depression is not a weakness,
but a serious health disorder. Both young people and adults who
are depressed need professional treatment.
A trained therapist or counselor can
help them learn more positive ways to think about themselves,
change behavior, cope with problems, or handle relationships.
A physician can prescribe medications
to help relieve the symptoms of depression.
For many people, a combination of psychological
therapy and medication is beneficial.
Myth: Talking about depression only
makes it worse.
Fact: Talking through feelings may help
a friend recognize the need for professional help. By showing
friendship and concern and giving uncritical support, you can
encourage your friend to talk to his or her parents or another
trusted adult, like a teacher or coach, about getting treatment.
If your friend is reluctant to ask for
help, you can talk to an adult - that's what a real friend will
do.
Myth: People who talk about suicide
don't commit suicide.
Fact: Many people who commit suicide
have given warnings to friends and family.
A signal or warning may be a statement
such as "I wish I were dead," "I can't take it
anymore; I want out," or "My parents would be better
off without me." Some people even tell a friend about a
plan to kill themselves before they actually do.
If a friend talks like this, take it
seriously! Immediately make a responsible adult aware of what
your friend has said.
Myth: Telling an adult that a friend
might be depressed is betraying a trust. If someone wants help,
he or she will get it.
Fact: Depression, which saps energy
and self-esteem, interferes with a person's ability or wish to
get help. And many parents may not understand the seriousness
of depression or of thoughts of death or suicide.
It is an act of true friendship to share
your concerns with a school guidance counselor, a favorite teacher,
your own parents, or another trusted adult.
3. KNOW THE SYMPTOMS.
The first step toward defeating depression is to define it.
But people who are depressed often have a hard time thinking
clearly or recognizing their own symptoms. They may need your
help.
Check the following boxes if you notice a friend or friends
with any of these symptoms persisting longer than two weeks.
Do they express feelings of:
Sadness
or "emptiness"?
Hopelessness,
pessimism, or guilt?
Helplessness
or worthlessness?
Do they seem:
Unable
to make decisions?
Unable
to concentrate and remember?
To have
lost interest or pleasure in ordinary activities - like sports
or band or talking on the phone?
To have
more problems with school and family?
Do they complain of:
Loss
of energy and drive - so they seem "slowed down"?
Trouble
falling asleep, staying asleep, or getting up?
Appetite
problems, or are they losing or gaining weight?
Headaches,
stomach aches, or backaches?
Chronic
aches and pains in joints and muscles?
Has their behavior changed suddenly
so that:
They
are restless or more irritable?
They
want to be alone most of the time?
They've
started cutting classes or dropped hobbies and activities?
You think
they may be drinking heavily or taking drugs?
Have they talked about:
Death
Suicide
- or have they attempted suicide?
4. FIND SOMEONE WHO CAN HELP.
If you checked several of the boxes, a friend may need help.
Don't assume that someone else is taking care of the problem.
Negative thinking, inappropriate behavior, or physical changes
need to be reversed as quickly as possible. Not only does treatment
lessen the severity of depression, treatment also may reduce
the length of time (duration) your friend is depressed and may
prevent additional bouts of depression.
If a friend shows many symptoms of depression, you can listen
and encourage him or her to ask a parent or teacher about treatment.
If your friend doesn't seek help quickly, talk to an adult you
trust and respect - especially if your friend mentions death
or suicide.
There are many places in the community where people with depressive
disorders can be diagnosed and treated. Help is available from
a family doctor, mental health specialists in community mental
health centers or private clinics, and from other health professionals.
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