One in five children and adolescents is affected by mental health problems and disorders. Those aged 18-24 have the highest prevalence of mental disorders of any age group. Depression in this age group should be taken seriously. Youth suicide is the third most common cause of death in this age group. Both biological and developmental factors contribute to depression in adolescence. If Bipolar disorder or psychosis is suspected, biological causes would need to be examined.
It is often hard to distinguish adolescent turmoil from depressive illness, especially as the young person is forging new roles within the family and struggling with independence, and academic and career decisions. An adolescent who is depressed may not show obvious signs of depression. Instead, he or she may start to behave uncharacteristically, for example by becoming socially withdrawn, engaging in drug and alcohol abuse, engaging in risk-taking behaviours (e.g. inappropriate sexual involvements, reckless driving), falling in their performance at school and sometimes a minor physical problem is used as a disguised appeal for help.
Sometimes the adolescent may not want to seek help. In this case it’s best to explain that you are concerned and perhaps also provide them with some information to read about depression.
It’s important for young people to know that depression is a common problem and that there are people who can help. If there is any talk of suicide this should be taken seriously and immediate help sought from a mental health professional.
I would have to say the most important thing I have learned through my suffering with a mood disorder is this: there are some things you cannot do alone, and getting over; depression is on of them.*
Like the pool of quicksand, it is hard for me to say with precision when Jack’s depression started . It is not like breaking an arm or a leg. I can’t point to a day or a month or a year when he became depressed. Somewhere along the way it took hold of him. It was somewhere after the days when he was a baby and people in the street would stop and comment on his winning smile. And it was somewhere before his late teens when he consulted our general practitioner and was prescribed antidepressants.
He was, and is, a child with a variety of interests. He enjoys academic pursuits. He enjoys physical pursuits. He enjoys artistic pursuits. He has performed well in all three. He is physically healthy, and at the age of twenty-three he has his winning smile. My friends often comment on his good looks. They say he has sexy eyes. I don’t paint this picture to boast about him, but more to set the background against which he struggled with his depression and I struggled to understand it and how to cope with it.
I used to look at him and wonder how a child with so much talent and so much opportunity could fail to find contentment. But depression, like quicksand, is not selective with its victims. It wraps its dark and smothering cloak around people regardless of their intelligence, beauty, talents, social standing, physical prowess or financial position… Jack and I talked about his unhappiness. We did not refer to it as depression. Yes, he was depressed but I thought it was transitory. I thought that, in the main, it was because he was a child who found school limiting and socialising with his age group difficult. I gave it other labels. I desperately wanted him to be happier. I know it is a motherhood statement, but I lived his pain with him. It hurt to hear him sobbing in his bedroom. I would try to comfort him. Talk him through his lowest moments. Rationalise. Give advice. Stroke his forehead. Whilst the quicksand pulled him in a downward spiral, I tried to throw him the rope from the armchair.
Then, and now, I ask: am I somehow responsible for his suffering? Is it something I did or didn’t do? Why has this happened to him? I can read about depression and family histories and genetic links. I can intellectualise about causation, but, as his mother, could I have made a difference?
Rather than Jack being able to chase it away, the black dog moved in and dominated his life after he left school. The debilitating periods became more frequent and intense. They would drain away his energy. He talked of giving up. He could not see that his future would be any different. He had been a prisoner held in the quicksand of depression for as long as he could remember and he was tired. He craved just one day when he could switch off the tormenting tape in his head. I felt powerless and at times fatigued by his suffering…
Early on, Jack had asked me not to tell people about his constant struggle. He did not want to be the topic of conversation because of it. He feared he would be diminished in other people’s eyes, even in the family. To be honest, I was comfortable about this request. I found it so hard to talk about it to others anyway. Partly because I wondered what their reaction would be. Partly because I am my mother’s daughter and we hide our pain. And partly because I saw it as Jack’s privacy about which only he could make decisions. I rationalised our secrecy.
In retrospect, I was wrong to do this. Secrecy about depression simply fuels the fire of despair for everyone involved. Pretending everything is all right closes the door on support, whereas disclosure has healing qualities and spreads a safety net beneath the sufferer . But it is easier to know these truths than to act on them. I am learning to act.
It was fortunate that through his dark haze, Jack was always able to ask for help. Even today, as I write, a friend of mine five hundred kilometres away is burying her son; a wonderful and much-loved young man who took his own life. At times when Jack was at his lowest, I worried that he might do the same. If he was late home or late up, my mind would be tormented by such thoughts, relieved only by the sound of him closing the front door opening his bedroom door. Help and death can be seconds apart.
What an all-powerful thing is this depression that it can torture a person so much that the human instinct for self-preservation is overridden. The taunt by some to ‘pull up your socks’ fails to appreciate the enormity of the blackness, the despair and the exhaustion that engulfs the sufferer. Everyday tasks can be too hard. It took me time to understand. It took me time to see that Jack’s hours of sleeping or video watching were respite for him from the struggle of each day. It looks mindless to the outsider but it is restorative in a sense. If you stay still in the quicksand, you might not sink so fast.
Through…. psychiatric treatment, anger, fear resolution, impatience, self-doubt, tears, humour, strength, openness, willpower, courage, understanding and gradual acceptance, Jack has chased the black dog towards its kennel But it is still there in the backyard. The dark periods have become far less frequent and far less intense. Will he ever be totally free of it? I don’t know. Will the dark days return? What is important is that he knows his life is now different. He knosw that he can be free of the torment.
For the moment, most of his body is out of the quicksand. Whilst I will always be there to stand on the chair and throw him the rope, for now I can put it away.**