Coming Out of the Teen Depression Closet

This is definitely one of my most challenging columns. Trying to bring some humor to a sadly serious subject. I'll have to fall back on a favorite "Stress Doc" motto: "I don't know where I'm going. I just think (or hope) I know how to get there."

Ever since my Humor From The Edge column expanded into an "Online Psychohumorist" website on Online Psych, America On Line's major mental health resource network, I've received a steady stream, if not a rush, of email. Readers are asking a variety of heartfelt and research-related questions regarding work, family and marital stress, the effects of medication, looking for a second opinion, etc. (I feel I'm becoming "The Virtual 'Dear Abby' of AOL.")

Even had a reader write for some encouragement after she made a major life-identity change. She recently quit her corporate job and radically altered a conservative image by shaving her head. What can I say, except, Bol d and Bald Is Bad and Beautiful!

There are students who want to know more about about psychology and the mental health field or who want me to provide ideas for a homework assignment, class project or future career exploration. And some of these are truly urgent seekers, like the student who, for his high school science fair project, asked me to supply information about stress and heart disease. He was desperate: "The project is due the next day!" I already know this student's grade...Type A.

Perhaps the largest group of emailers, I'm sad to say, (though I'm glad they are writing) is adolescent girls (junior high to high schoolers) and mothers of teens. The common thread is that both groups are worried about stress and depression. Both seem to recognize that a need to be perfect, always trying to be "good," not wanting to be a burden is somehow a contributing culprit to this emotional malaise and misery. The difference: the young female emailers believe they have no adult - parent, teacher, counselor, spiritual leader - they can share their plight with (or the youngsters feel too ashamed to seek help); the parents who email are not sure what to do with a a child in the throes of a mind-body-social upheaval. The concerns include serious eating problems, disordered sleep, severe headaches, obsessive worry about school performance, isolation or anxiously competitive relations with peers and friends, as well as Chronic Fatigue Syndrome. Only a couple of the girls have acknowledged alcohol and drug use. (No one's mentioned sexual promiscuity.)

To distinguish further these two sets of young females, I'd like to focus on the secretive rather than sexual implications of a contemporary metaphor. Seems like the adolescents who write are still in the closet regarding their agitated depression, at times accompanied by suicidal thoughts. One youngster even paired suicidal thoughts with a smiley sign, :-) . Now that shook me up. I mean what's the message: "I'm feeling suicidal, but you have a nice day!" Perhaps the seemingly contradictory pairing depicts a girl who must be relentlessly (and oppressively) cheerful. Maybe we need to rethink the casual meaning of a "killer smile."

Regarding the mothers, my tentative hypothesis is that their daughters finally got sick of or, more likely, sick from being cloistered in an oppressive closet; their secret stress condition has not just come out, but has erupted into a medical syndrome. Sometimes full blown symptoms are valuable. First, it's harder to overlook, cover up or deny that there is a tangible, if not serious, problem. And once acknowledged, hopefully, we can do something about the nature, context, course and outcome of the problem without too much residual damage or adverse long-term effects. Obviously, the potential for a) suicide, b) dehydration, starvation and death from anorexia or other eating disorders, or c) vulnerability to addictive behaviors makes this a rather critical intervention issue, as well as a topic for prevention.

The key and final point is that depression alone is not the primary danger. With advances in biochemistry and psychotherapy most people receiving proper treatment can be helped in a timely manner. A perilous state often arises when we refuse to face and embrace depression; when we close our mind and turn our back on the silent rage and feelings of abandonment; when we run from the shame and lurking anxiety; when we are consumed by a misguided and self-defeating survival strategy

So the challenge is often two-fold: a) to help the person shadowed, burdened and constricted by depression come out of the closet and b) to understand ways of inviting a depressed family member or friend to at least open their closet door.

In the next two columns, I'll share some thoughts on the whys and ways of female teen depression and how a family can dismantle this dysfunctional closet and, perhaps, prevent its return.

And, of course, when out of the closet, just remember...Practice Safe Stress !

Feedback Segment: How about sharing your thoughts on how you, friends or colleagues use humor in dealing with stress, conflict or moods, yours or others, in your personal life, at home or at work? HFTE will run the best stories and, of course, credit you. (And the real lagniappe, you become a member of the Stress Doc's Stress Busters Club.) Also, email me to learn more about "The Stress Doc's" upcoming serious and humorous on-line support/chat group -- "The Frequent Sighers Club.

Mark Gorkin, "The Stress Doc," Licensed Clinical Social Worker, is a nationally recognized speaker, workshop leader and author on stress, reorganizational change, anger, team building, creativity and humor. The Stress Doc is a columnist for the popular cyber-newsletter, Humor From The Edge. Mark is also the "Online Psychohumorist" for the major AOL mental health resource network, Online Psych . His motto: Have Stress? Will Travel! Reach "The Doc" at (202) 232-8662, email: Stress Doc@aol.com