Teen Depression - An Interview

by Teri Robert Patient Advocate

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Sarah is a bright, kind-hearted 19-year-old college student. She also has major depressive disorder. Fortunately for Sarah, her family (especially her mother) understand depression very well. At the age of 15, when Sarah told her mother she was having some problems, her mother knew to take her to the doctor and get her the help she needed.

It's now four years later, and Sarah is very open about her life with depression. She's doing well in college, handling life in her own unique style, and looking forward to the future. She was happy to do this interview in the hopes that it would help other teenagers.

Of course, everyone's situation is unique. But if you're a teenager with depression, we both hope that while reading about Sarah, you'll see things that apply to you. We both hope that her story will help you realize that you're not alone, and that life can be good, even with depression.

Q: How old were you when you started feeling different, depressed, whatever it was you felt? A: It wasn't so much depression that I felt at first. It started out as a lot of anger and frustration. Around 15 is when I can best remember starting to feel "less happy" or numb.

Q: What DID you feel? A: I remember thinking one day....shouldn't I be enjoying this more? I was hanging out with friends and everyone was laughing and having a great time, but I caught myself laughing because that's what everyone else was doing. But I wasn't finding anything funny. Now I know this happens to people, but then I started to recognize other symptoms. I was numb to everything. I found it hard to bring myself out of bed, I wasn't hungry I couldn't bring myself to enjoy things I normally did. At first I had no clue what was going on, I felt confused. I thought maybe it's just me going through a phase, but the feelings never left. It honestly felt like I was sinking in a pit of sand that was 1000 pounds heavy, but I couldn't get myself out, and I didn't want to. People say, "Well just change how you think about things, let the little things go," or my favorite, "It's not that bad. Think about how much pain other people are in." Well, when your that depressed you can't. You can't see other people's pain because yours is so great. People who don't suffer from depression need to understand that you have to measure your own pain with your own measuring stick. Everyone is different.

Q: At what age were you diagnosed? A: I went to see my primary doctor with my mother just after I turned 15. I explained to my doctor how I was feeling, or wasn't. I was very lucky to have a responsive doctor, and she referred me to a well known local psychologist. I went to see her, but didn't get positive results. Dr. X (as I'll call her) diagnosed me with ADD after spending no more that a session with me (not including testing). But after getting two other opinions from other doctors, it turned out that they disagreed with the preliminary diagnose (as did I that psychologist had no idea what she was talking about). Then I would say at 16 is when I was officially diagnosed with major depressive episodes.

Q: What treatment was suggested at that time? A: There was no treatment that was just suggested. In order to properly treat depression there are different combinations of treatment one must try. If you're lucky enough to find that your first treatment option works, that's great! But I had to go through a couple different options in order to find the best fit. Treatment is really like finding an awesome fitting shirt. You have to try a lot on to find the perfect one! I started out with CBT (cognitive behavioral therapy). I didn't want to have to take medication at first if I didn't have to. Then I made a choice, along with the suggestions of my mother and psychologist, that medication would be a smart move. You can talk about things that have you done, but if it is a chemical imbalance one needs extra help, that's where the medication came into play. Depression has a history in my family, so I knew then that I would need some extra help. I started taking Prozac, but didn't have a great reaction. Then my doctor switched me to Lexapro, which helped a lot.

Q: How did you feel about the diagnosis and suggested treatments? A: When I was first diagnosed, I felt a sense of relief because I knew there was a reason for the way I was thinking. I was very nervous though about the medical treatment. I was concerned about the side effects, and I was nervous about how it would affect the rest of my health. I felt at first as though my medicine was useless because I would go into the psychiatrist's office, and she would spend max 7 minutes with me (yes, seven minutes, I timed it), and I was questioning whether she was able to know me enough to treat me effectively. Talk therapy I was very comfortable with. It was nice to have someone to talk to who won't judge you for how you feel or bring you down because of how you feel. Also I wasn't surprised about my diagnosis because depression runs in my family. Yay, me! (laughing)

Q: How have things changed since your diagnosis? A: How? Since my diagnosis, things about my life haven't really changed. I still hang out with my same friends, like the same books, and listen to the same music. With that said, it helps to know there is a reason behind why you feel the way you feel. When you're having a low day, there is something helpful about knowing, OK, I have a chemical imbalance, and this is just one day. I'll get through it. How I look at life has changed though, I take one day at a time and really try to appreciate things like the grass on my bare feet. Although I don't think like this everyday, I really do try to appreciate the little things I do for myself.

Q: How does depression impact living with yourself? A: Living with myself during depression is the hardest thing for me to do. I can accept everyone's mistakes but mine. Everyone is beautiful but me. Everyone has something going for them but me. Everyone is in a great relationship but me. These are all thought processes that I still, to this day struggle with. I'm still not sure why (I am working on it in therapy), but I am my biggest critic. When I make a mistake, I'm very hard on myself. When it comes to daily living, it is just that. I have days where I look at myself in the mirror and I think "Wow you're pretty;" and there are the days where I can't look at myself in the mirror. These feelings of selflessness are much less common now that I have found a medication combo that works, but they still happen every so often.

Q: What about the relationship with your mother? A: I have always been very fortunate to have an amazing relationship with my mother! My mother has been one of my biggest support systems in my life. My depression has affected our relationship in that I just was withdrawn, she was the one person that I tired not to let my depression effect.

Q: ...with your father? A: I only had a good relationship with my father when I was very young. My depression/anger is what made me stop talking to him for at least 6 months. I was angry at how he treated my mother and I was angry he was so selfish. I was sadden by how he only seemed to car about himself and only sought out to fulfill his own needs.

Q: ...with your brother? A: I was lucky enough to not let my depression affect my relationship with my brother like it affected everyone else. All he knew is that I was going to a "happy place" (my psychologist's office) one a week, and that I was not around as often. I spent a lot of time alone in my room.

Q: ...with friends? A: I believe that my friends only had a small glimpse of how I was feeling. Throughout my depression, I was very good at hiding it. I have always had a knack for stuffing my emotions down and not talking about them or letting anyone else know how I felt. So from my friends' point of view, they knew something wasn't right, but they didn't know what. I never wanted to hang out with them. I never wanted to go out and see movies or go hangout at someone's house. I had no desire to see anyone, or go out and do anything. To this day, I still have to push myself to go out and hang out with those who love me.

Q: How has living with depression impacted your school life? A: My depression impacted my school work. As for my school life, it didn't affect that as far as I can recall. It's not that I didn't care or try to do my school work, it was that I was always so tired. Depression takes a lot out of me physically and I would come home from school and sleep, then wake up to eat, then fall asleep again. Sleep was my way of dealing with any stress in my life.

Q: What about your social life? A: I would say that staying involved in Yearbook (I was editor of the Yearbook club) is what gave me a lot of purpose. I was never big into the school spirit -- our football team was awful, so I saw no reason to have school spirit. But I was involved with the Yearbook for four years. That yearbook office was the place I felt safe at school and was my territory. There I felt confident and secure. Without that place I don't know if I would have done as well in high school as I did.

Q: Who did you turn to for support in high school? A: The advisor for the yearbook was a teacher I was close with for four years. He introduced me into photography, and was always there for support. It was nice to have someone I could confide in and trust and who could give me feedback. He truly helped me through everything.

Q: A tough one for you, Sarah --- have you ever thought about suicide? A: Yes I have thought about suicide...I am not proud to admit this, but I have no problem talking about it as I hope it will help someone else. Suicide is clearly a very serious topic as I know people who have lost best friends to this act.

Q: Just random thoughts or what? A: For me personally they were 75 percent of the time random fleeting thoughts. But the other 25 percent of the time they where a little more serious. These thoughts would be strongest when I felt powerless to do anything. They also seemed to be the most serve at night when I was alone and not keeping myself busy. In retrospect, they are very scary thoughts. But something I think is so important to share is that when you are in this deep state of depression not everyone thinks of suicide to be selfish!!! I can not stand it when someone who hasn't dealt with depression says "oh it so selfish to commit suicide." I felt like I was burdening everyone with my problems, so why not just end my pain AND stop burdening the ones around you. Some may end their life just to end there pain but not every suicidal person is thinking this way so do not make the mistake of labeling us all as selfish.

Q: What do you think teens need to know about depression? A: One point that I can't stress enough is do not give up because one doctor didn't connect with you or help you enough. I hear all to often from friends that they just give up because one medication doesn't work for them, or one doctor doesn't help. You HAVE to continue to try different doctors or different medications. If your first try doesn't work, keep going, and keep trying! I can't stress this enough.


Interview with Sarah. Teri Robert. August 31, 2009.

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Teri Robert
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Teri Robert

Teri Robert is a leading patient educator and advocate and the author of Living Well with Migraine Disease and Headaches. A co-founder of the Alliance for Headache Disorders Advocacy and the American Headache and Migraine Association, she received the National Headache Foundation's Patient Partners Award and a Distinguished Service Award from the American Headache Society.