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Depression: The invisible enemy

Updated: Nov 19, 2020

Looking back on the last 10 years, Kate* sees clearly that her adolescence was fraught with depression and anxiety. Now as a 25-year-old mother and graduate student, she has a lot to be thankful for every day. Having battled depression for 10 years, Kate stands as a survivor of her own mind.

The effects of depression are different for everyone, but we know the common behaviors

Kate is not alone.

The rise of depression and suicide among teenagers and young adults (ages 15-24) is not only a problem in the United States but a global problem that touches nearly every country.

Researchers have noticed this upward trend and have begun studying the several factors that may be contributing to this invisible illness. Depression is a difficult illness to analyze and track because of the varying types and levels of severity from patient to patient. For Kate, her difficulty began in middle school and manifested itself in what’s known as Anxious Depression, or mixed anxiety depressive disorder.

“Anxious depression is really common. I rarely see people with depression who don’t have anxiety. Most people say their anxiety is worse than their depression," says Claire Gatlin, a school counselor from Lucy Beckham High School in Mt. Pleasant, South Carolina. “This is characterized by a lot of negative, ruminating thoughts which are uncontrollable.”

These negative thoughts in young people often bring out dangerous behaviors. For Kate, middle school was a difficult time of trying to fit in and please the popular crowd.

When fitting in did not make her feel any better, she resorted to cutting, a behavior often found in young girls struggling to manage the negative intrusive thoughts. In their depressive state, young adults find increasing their physical pain a temporary solution to match and hopefully diminish their mental pain.

Depression can be hard to conceptualize for those who have not experienced it first-hand. Some psychiatrists like Dr. James Fox view depression as a phenomenon of layers with underlying causes.

“On the top layer are environmental causes. Take any human and put them in a difficult situation and many of them will exhibit signs of depression. The next layer is the psychological layer, which is made up of what we bring to the table. This involves how we view the world and how we interact with the world. The bottom layer is the biological layer,” Fox explains.

The rise in depression has more than one factor to blame

For young people in every country, this is a global and dangerous - and it is spreading quickly.

Depression affects more than 24 million people and through suicide kills approximately 800,000 people a year, making this the second-leading cause of death. Despite her troubles and difficulties, Kate is lucky. Her supportive family recognized her condition and actively sought therapeutic counseling services.

Why are so many young people suffering from anxious depression? For one thing, we have a greater awareness of mental illness. This increased introspection often leads people to seek help much sooner and more often. With a more open-minded approach to mental health issues, more young people, especially girls, seek treatment earlier.

Through these sessions, psychologists and psychiatrists can learn a great deal about the factors that contribute to anxious depression. High school and college students often feel increased pressure to perform.

“There’s a lot of pressure on our students now, more than there was ten or twenty years ago. College admissions is incredibly competitive, and students push the limits of what they have time for with difficult high level honor and AP classes, sports, volunteering, part-time jobs. They don’t always have time to be a kid which is incredibly important for their mental health,”says Gatlin.

The prevalence of social media is consuming teenagers

With all of the busyness of their high school years, many teens rarely take time to eat properly, to get enough sleep, and to spend quality time with family and friends.

Instead, many of their moments of leisure are often spent in a virtual world of social media.

That world is not always so friendly.

“Social media can have a horrible impact on young people because bullies are willing to say more things from a phone or computer than in person. Young people may process what they see on social media as a true representation of the world, when it is not,” states Wiley Flanagin, a psychology professor at Lucy Beckham.

Over the last 15 years, social media use in the United States has increased dramatically for all age groups. Social media use has increased in that 88% of young people aged eighteen to twenty-nine years use some form of social media daily. The consequences of social media use depend on the motivation for using social media, whether it is to seek connection with like-minded peers or to seek the instant gratification of a “like.”

“People tend to create a ‘fake’ world for others to view on social media and then they can’t live up to their own expectations and feel like imposters. Like a gambling addiction, people may live for the ‘high’ of the ‘likes’ and that’s often accompanied by severe lows,” Fox says.

This video explainer by Tufts University School of Medicine expands on the correlation between social media and depression, arguing that the interactive nature of social media can lead to feelings of inadequacy and low self esteem when teens see pictures of a party or event they were not invited to. They also comment on the age in which children receive cell phones, and recommend keeping children away social media until they are mature.

The instant gratification produced by social media is what keeps users coming back for more, which can easily turn into addictive behavior. With excessive use, the risk for developing a social media addiction increases, which may result in a lack of mindfulness or higher anxiety when without a mobile device.

The alternate reality that is curated on social media is unobtainable, despite the efforts of so many.

Anna Davis, a 24 year old graduate student at the University of Florida, has experienced something similar. She describes how her decision to delete her social media accounts impacted her mental health for the better.

“I’ve been in a very dark place mentally, and that puts things in perspective now because I still struggle with negative thoughts and anxiety," she said. "I left social media a few years ago, and now I’m able to look back at how bad things were a few years ago and be grateful for where I am today."

The biggest issue for Davis was comparing her life to those on social media.

"I felt like I had to compete with everybody in the world, and when I looked in the mirror, I never liked what I saw," she said. "Everyone else was prettier, smarter, and having so much more fun."

Researchers, however, have found some positives of social media.

A study done at Harvard T.H. Chan School of Public Health states that the harmful effects are not necessarily from the amount of time spent on social media, but rather the ways in which people interact with social media.

The problems arise when users develop an emotional connection to their social media accounts. Excessively checking for notifications, feeling upset when friends are not online, and pairing self-worth with the success of a post are all signs that point to an unhealthy relationship with social media.

Always a battle

Kate battled for 10 years with issues related to depression that included cutting, anorexia nervosa, drug and alcohol abuse, and impulsive and rebellious behaviors.

At many points in those 10 years, Kate didn't see a way through.

“In those moments I felt as if I would be this way forever, and that terrified me," she said. "But looking back, those internal struggles made me who I am today, and I’m pretty happy with myself."

But there are still battles, each a fight against feelings of inadequacy, unhappiness, and hopelessness. Like many others, Kate carries with her the scars of war and the medals of courage. Her enemy may return at any time, but knowing how to fight depression with lifestyle changes, with therapy, and sometimes medication has prepared her for its return.

"Of course I still have hard days, but I now know how to better manage strong emotions and be more aware of myself," she says. "For me, depression was something I had to fight with before I learned how to live with it."

* Name has been changed to protect the privacy of the individual.

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