A Tale of Two Teenagers

Hard to believe, Amy loves the Army.  She’s in boot camp, enjoying lots of exercise, full days, new jargon to learn, and she even likes the lectures on Army protocol. It’s stressful to be sure; it’s supposed to be tough.  Some girls are fainting, some are washing out because they can’t hack it, some stay up too late and lose sleep. Amy has her eyes on the prize- graduating and moving up.  When she gets anxious, she swallows it and moves on. Uncharacteristic for her, she’s eating well and going to bed early.  Her parents are proud, not only for her accomplishment but for how far Amy has come.  Her life wasn’t always this way.

From an early age, Amy was having a rough go.  She had trouble paying attention in first grade, though she was highly intelligent.  She angered some teachers with her pointed, seemingly rude commentaries, though other teachers “got” her. She was tried on ADHD medications, which helped for a time, but then began causing side effects where Amy acted confused and panicky.  By high school, it was clear Amy was depressed.  She was sullen, didn’t get along with most of her classmates, and scraped out poor grades. Despite grasping the material, she just didn’t care enough to get papers in on time or study for tests.

Amy had no obvious reason for depression.  She had two loving, educated parents and two happy siblings.  At the first sign of trouble with attention or mood, she got the best doctors and therapists.  As Amy got older and was able to verbalize what was going on inside, it seemed her depression was “chemical:”  she was just born that way, with no external reasons like bullying or her looks.

Anti-depressant medication helped, as did continued counseling.  Her parents cheered her on through thick and thin, and as she got older Amy’s life began looking up.  College was much better than high school as far as academics and having friends. She had positive dreams for her future.  Joining the Army wasn’t her parents first choice; heck, even with a bachelor’s degree she enlisted rather than take on the responsibility of being an officer. But now they were singing a different tune.

Sharon has it much worse than Amy.  I saw Sharon in the Emergency Department last month.  She came by ambulance after being beaten by a gang of boys.  They ran up behind her, knocked her down, and kicked her repeatedly in the head and chest. There had apparently been some bad blood between Sharon’s friends and other factions in the neighborhood.

From our computer record I saw that Sharon had had a tough life already, though only 15 years-old. She had been seen by us twice for sexual assaults, another time for being beaten up, and once to be admitted to a psychiatric hospital for suicidal thoughts. She came from a rough house in a rough neighborhood.  Her mom obviously had mental illness of her own, from the pressured speech of hyperactivity or drug use, to her peculiar tattoos.  Mom yelled a lot, at Sharon and us, though this seemed to be not from anger but how she usually spoke.

Certainly Sharon’s depression has not gotten the attention that Amy’s did.  Though she had been in hospital for depression, Sharon isn’t on anti-depressants and isn’t in counseling.  Chaos rules her home life: her father’s gone, and she bounces between mom’s and the homes of several other families. Her school and neighborhood aren’t safe.

Despite all this, I have some hope for Sharon.  Kids can be resilient, and Sharon still had an occasional smile and some spunk, despite what just happened.  Mom also did seem to care about her, as did an aunt with her who seemed more emotionally stable.  They agreed that counseling was a good idea, and to see her doctor about a psychiatric referral.

Some kids like Amy are born with depression.  Some like Sharon, besides having inborn depression, also have life stresses that contribute.  Both kids need attention- counseling and maybe medicine to get them through bad patches. If your kid seems depressed, telling them to buck up and act happier isn’t enough.  You should ask about suicidal thoughts, why he is depressed, and see his doctor.  Depression is rough, so better that your kid gets the attention that Amy got, rather than Sharon’s. 

Your Kid May Not Be Lazy. Your Kid May Be Depressed!

We see a lot of depressed children and teenagers in the Emergency Department.  Often it is because the child is suicidal.  Either he or she has has attempted to kill himself, or has stated that he wants to.  Depression often comes to us under other guises too- headaches, stomach aches, fatigue, anxiety, chest pain and palpitations.  A suicidal child or teen is a terribly painful thing for parents as well as the patient.  How do things get this far?

Sometimes the child is stressed and feeling bad because of things going on outside the home, and outside themselves.  Kids can have trouble with friends, girlfriends or boyfriends, bullies, or teachers.  These things can get a kid depressed, but it often takes other stresses as well to get them so bad that they are suicidal.  More difficult for the kid are the troubles in the home, or the troubles in him or her self.

Change in the home can make a kid sad, such as divorce, moving, parents losing jobs, new parental boy or girlfriends moving in.  Some parents are abusive to their spouse or kid, yelling and hitting.  Sometimes the parents just don’t know how to handle their kid well.   When the kid seems lazy or stubborn, they punish the kid.  If the kid does not act better, they punish her some more.  Then they punish more, even when punishment has clearly not worked to change that particular kid’s behavior.  Meanwhile, all that punishment certainly is not helping the child feel better about themselves.

Finally, depression often happens because of something within the child.  They have ADHD, or bipolar disorder, or mood disorders.  Teenagers have hormones raging in them, and a skewed perspective on life.  Little problems to us are often huge in the life of a teenager.  When a kid gets suicidal, it is often because of a brew of factors outside the home, inside the home, and inside the kid.

How do parents prevent kids from getting so down they are suicidal?  It is not easy, because kids will hide their problems, especially if they and their parents are not getting along.  Sometimes, the clues are subtle- slipping school work, multiple vague complaints (headaches, stomachaches, etc), poor appetite.  Sometimes the clues don’t help us be sympathetic with our child, like when they fight with us, get defiant, or just shut down and do not talk at all.

If it seems your child or teen is getting depressed, act now.  First, start being open and friendly, instead of a drill sergeant.  Forgive your kid’s bad behavior, so you can begin to find out the whys.  Ask them straight out- are you depressed?  Are you suicidal?  Do you have a plan about how you would kill yourself?  It the answer is yes, time to seek help.

The best helpers to start with are either school counselors, or church counselors. Just about all schools and most religious denominations have staff trained to talk with kids about their troubles.  They can help parents decide if the child is going to be okay, or needs more intense and professional counseling and maybe medication.

So watch for depression if your kid is troublesome, or glum, or acting in those ways above.   Do not be embarrassed to get help if you are not sure, or if things are looking bad.  Getting help sooner is much better than seeing me later.