If only we knew how much depression hurts
ONE NIGHT I got a text from one of my 16-year-old teens. She never usually texts at night, so I was concerned:
Meghan*: “Good night Dr J, I was going through my drawers and throwing out some stuff that doesn’t work anymore and I don’t want to worry you because it was before I started to seek treatment, but I found what I guess I would consider my suicide note.”
As a practitioner, it is not unusual to hear these words, especially if you have developed a relationship with your patient, they are likely to confide in you their struggles. For us, this information is a blessing, as struggles like these are often kept on the inside for fear of being judged, stigmatised or misunderstood. Thoughts of suicide are common among teens. Attempts may be even more common than reported and indicate where we have failed as a society, because timely professional intervention can prevent this.
Studies show that females are more likely to make suicide attempts than males; however, males are more likely to be successful than females. Thoughts of suicide are one of the components of depression, however, it is not the only symptom.
Later that night, I received another text from another patient’s parent:
Parent: “Hi Dr J, can I get an appointment for Sam* ASAP? She is very withdrawn, no longer engaging with us, she isn’t eating, she is not hanging out with her friends, I have never seen her like this.”
When I met with Sam, she reported not feeling like herself, she mentioned emptiness inside, she watches her friends at school being happy, chatting with each other, while she wants to be by herself. While she spoke, she held her head down and tears rolled down her cheeks. I could see how sad she was. I explored other symptoms and my hunch of depression was confirmed.
When a person experiences depression they are deprived of a range of emotions – some may not be able to experience pleasurable activities, and at its worst, some are unable to feel any emotions. The general population does not suffer from depression. So, unlike physical pain which we all experience, it might be difficult for us to understand emotional pain. Emotional pain is difficult to put into words, and in the case of depression, there is little or no motivation to talk about this pain, which can lead to further isolation and missed opportunity for support.
SOCIAL SUPPORT
Studies, including in Jamaica, have shown a strong relationship between
social support and lower reports of depressed symptoms. As social beings, it is not the norm for us to isolate ourselves and not engage with others. If you notice a sudden change in your child, friend or relative; of isolation, sadness, worthlessness, changes in appetite, thoughts of suicide, and changes in sleep patterns, get help for this individual. While they may be unable to tell you what they are feeling inside, your observation of the changes in their behaviour may very well save their lives.
For many who suffer from depression there is help, this can be through the form of psychotherapy and/or medication and, most importantly, social support. For both these cases, Sam and Meghan, I am happy to report that they recovered from their depressive symptoms. While we recognise that psychotherapy and medication assisted in their recovery, I would like to reiterate that the major influencing factor in their recovery was the social support they had from their parents, other family members and friends.
I will close by sharing the remainder of Meghan’s text:
Meghan: “It’s crazy because I had completely forgotten about it, at first it upset me [when I found it], but then I ripped it up and threw it away, and I felt better because I was reminded that I don’t feel that way anymore and that I’m in a better place”.
*Names changed to protect actual identity.
CONTRIBUTED BY CARYL JAMES PHD, Clinical Psychologist and Eating Disorder Specialist