Understanding Teen DepressionMarch 2, 2005
Today on the broadcast, author Sharon Hersh, a licensed professional counselor, helps parents understand teen depression.
Today on the broadcast, author Sharon Hersh, a licensed professional counselor, helps parents understand teen depression.
Understanding Teen Depression
Bob: There is a particular troubling behavior among some teenagers that is escalating according to author and counselor, Sharon Hersh.
Sharon: Probably, I get more panicked calls from mothers about cutting than any other behavior, and I think that's because it is unthinkable to us that our daughters, our baby girl, would take a razor or a piece of glass or a pocket knife and carve marks or words or symbols into her body. But that behavior is on the rise.
Bob: This is FamilyLife Today for Wednesday, March 2nd. Our host is the president of FamilyLife, Dennis Rainey, and I'm Bob Lepine. Why are adolescent girls beginning to cut themselves and what should parents do when they discover it's happening?
And welcome to FamilyLife Today, thanks for joining us. I remember an experience I had with my daughter her freshman year in college and, frankly, when this particular daughter, I won't say which one it was, but when she got to her freshman year in college, it was like there was a – the plates shifted a little bit. Things settled. There had been some earthquakes and now, all of a sudden, things were settling, do you know what I'm talking about?
Dennis: I do.
Bob: We had a conversation about the fact that she was watching one of her siblings exhibit immature behavior, and she said to me, "Remember when I used to act like that?" And I said, "As a matter of fact, I remember very well when you used to act like that." I didn't say this, but I thought, "It wasn't that long ago that you used to act like that." And I said to her, "Why did you act like that?" And she said, "Oh, I don't know, it was just kind of the thing to do." End of conversation, we moved on.
It was almost like the irrationality that comes with the teenage years had been cured, and she could look back on behavior that, at the time, seemed catastrophic and say, "Oh, it was just the thing to do at the time."
Dennis: And it's these kinds of things to do that drive parents bonkers.
Dennis: We wonder how do you raise a child – specifically, how do you raise a daughter – in the midst of the emotional seismic shifts that you're talking about, because there are a lot of earthquakes and aftershocks that occur.
Bob: And it's not that there aren't issues with teenage boys, but we're focused this week on mothers and daughters, right?
Dennis: And helping them have better relationships and withstand some of these plates that are moving. Here to help us is Sharon Hersh. Sharon, thanks for joining us on FamilyLife Today.
Sharon: It's great to be with you.
Dennis: I think the reason why Sharon is so good at this, Bob, is she is not only a mom of two teenagers, one of whom is a teenage daughter, but she is also a practicing, licensed counselor. She is an author of a number of books dealing with issues that teenagers face, and she's a speaker at conferences all around the country and has been our guest here on FamilyLife Today before. She lives on the Front Range of the Rockies near Denver, Colorado, and she's written a book called, "Mom, I Hate My Life."
Bob: I'm looking at your daughter's picture on the back of this book with you – she doesn't look like she hates her life.
Sharon: I love the fact that you guys are talking about earthquakes, because they say that on the surface the earth can look relatively untouched but underneath it are all of these fault lines and the after-effects from little earthquakes that have erupted.
Dennis: That's why in this picture she's hugging you.
Sharon: Yes, and she looks fairly normal and, really, she is. But even girls who have pretty even temperaments and don't necessarily fall into all of the awful traps of adolescence, experience this roller coaster of emotions that we are talking about, and the emotional turmoil that teenage girls experience is significant, and it can drive them and their parents crazy.
Dennis: Well, sometimes that emotional turmoil manifests itself in depression, and I know, from having helped Barbara in the process of raising our four daughters through adolescence, the depression is a very real possibility for a teenage girl today.
Sharon: And we really can talk about two types of depression – 20 percent of all adolescents experience significant biological depression that needs to be addressed and treated medically. But for the rest of the adolescents out there, their life sometimes is depressing, and it is normal and inevitable that they will experience times of feeling out of sorts, irritable, down, hopeless about life. Both types of depression require that we parents be aware of what's going on and offer them tools to deal with these realities.
Bob: And we're supposed to do that while we manage our own life.
Sharon: Yes, and sometimes our own depression. So that really does require that we, as parents, have some resources in place to help us while we are trying to help our teenage children.
Bob: Is there a way for a mom or a dad, for that matter, to identify, on the basis of the behavior, whether what our child is experiencing is somehow tied up in their biology or whether it's normal adolescent behavior.
Sharon: Yes, there is, and in the book, "Mom, I Hate My Life," I break it down into two sections. First of all, indicators that need watching, and this might be when she maybe is being a little more moody than usual, which that's sometimes hard to distinguish in the moody ups and downs of our daughters. It may mean that she experiences feelings of worthlessness or maybe her appetite changes a little, and we need to watch those things. And then there are indicators that require action.
Certainly, what I would say to moms who are listening – if you notice that your daughter is having a depressed mood, she's said, she's not engaging in activities that she has enjoyed before, and that has been experienced for two weeks or more and is accompanied by – maybe she's not sleeping, she's not eating, she's more irritable than usual, or maybe she's even talking about not just "I hate my life," but "I wish I wasn't even alive." Then you need to get medical attention and really consult with your family doctor who can do a little evaluation and refer you on to perhaps a psychologist who can give her some medication and further recommendations for treatment.
Dennis: Sharon, with your permission, what I'd like to do is put both of these lists, "Indicators That Need Watching," and "Indicators That Require Action," on our website, FamilyLife.com, because I think some of our listeners may need to look at that entire list.
Sharon: That would be good.
Dennis: But what I heard you describing just a moment ago could also be a description of a daughter who is also taking drugs or maybe experimenting with alcohol.
Sharon: Absolutely, and certainly the symptoms of drug and alcohol use and abuse can mimic those symptoms of depression, and sometimes it's hard to know which came first to sort those out. Because alcohol and drug use can fuel depression, but sometimes our teenagers seek those substances because they're trying to medicate depression. So I guess what I'm saying here is if alcohol and drugs are involved, the checklist will still be helpful and kind of point you in the right direction. If your daughter is using alcohol or drugs, an antidepressant or medical attention could help curb those choices as well.
Dennis: You also believe that depression can manifest itself in some other ways that are very self-destructive.
Sharon: They are. When boys are depressed and, as you said, Bob, boys get depressed, too, they tend to act out. They may get into fistfights, they drive too fast, they turn their music up loud – fortunately, sometimes, they play those aggressive feelings out on the sports field. When girls get depressed, they act "in." And two of the behaviors that I address in the book that girls are really experimenting with and dabbling with in increasing numbers are eating behaviors – eating disorders, and self-injury – cutting, self-mutilation.
Bob: I had a mom just a few weeks ago who said, "I wish you'd do a program on FamilyLife Today related to cutting," and I stopped and thought, "That seems so fringe to me." It seems like it's something that might be happening with some group of Goth kids in some school far away from where my children live.
Sharon: Unfortunately, that's not the case. Probably, I get more panicked calls from mothers about cutting than any other behavior, and I think that's because it is unthinkable to us that our daughters, our baby girl, would take a razor or a piece of glass or a pocket knife and carve marks or words or symbols into her body. But that behavior is on the rise. Two million Americans right now are involved in cutting, self-mutilating behaviors, and almost all of those started when they were adolescents, and almost all of them are girls.
Dennis: You said two million?
Dennis: You're talking about they are currently involved in that kind of behavior?
Sharon: Yes. And, like eating disorders, it's appropriate to talk about them together, because often girls who cut also have eating disorders and, like eating disorders, one of the reasons that they're on the rise in numbers who are doing this behavior is they are contagious behaviors. And so girls hear from other girls at school that they cut or they see the markings, and they think, "Oh, I’m going to try that."
Now, I know that you guys sitting here think, "But why would anyone want to do that? What are they thinking?" And it's really not what they're thinking, it's what they're feeling that we need to talk about.
Dennis: Take us into your counseling office, because you've undoubtedly talked to a young teenage girl who has been cutting.
Dennis: And where do they cut on their body – and take us into their mind as to what they're thinking and why it's occurring in the first place.
Sharon: Most girls begin to cut because they've heard of someone at school who does it, and cutting always happens in isolation. It always happens when they are alone in their room. This is not a behavior that they do in groups. And, as I said before, a girl will take a piece of glass – sometimes it has significance – or they will take a pocket knife, they will take a kitchen knife, they will take scissors, and they will cut into their arms or sometimes their thighs, their upper legs. Usually they do it someplace where they can cover it up later. Although I think, as is true with girls with eating disorders, most girls who cut want to get caught, but they're not going to overtly display what they've done, but they are hoping that someone will pay enough attention to them to ask what's going on and to stop them.
So when girls come into my office because they've been caught cutting, one of the first things I do is I ask them to show me – show me what they've done. And I have seen girls who have carved words like "ugly," or "bad" into their arm or their legs. I have seen girls who have just made many, many slashes or taken a razor blade and done fine, intricate designs on their upper arm or their leg. And I have come to call these markings the "hieroglyphics of hurt," because what I know is that there are several things going on in the heart and mind of this girl; that she is feeling like she doesn't belong. She is probably feeling or experiencing some loss, and that she is feeling there is not someone who it is safe for her to express her emotions with.
So I know when moms see this behavior, they really are scared, and they don't know what to say or how to respond. The first thing that I tell them is this is a form of emotional expression, and when girls cut themselves they are really trying to make sense of the emotional pain inside by carving or cutting themselves and experiencing some pain. But then they also experience relief – kind of a numbing. And that's why this behavior is so dangerous, because it literally becomes addictive. It is the way to manage, express, deal with pain, and then feel comfort and feel some solace.
Girls who cut might think that this is an attempt at suicide – we're talking about depression today – but it's not. It really is a way to sustain life; not end life. It's a way to live with their emotional pain in an unhealthy way, a self-destructive way, but I tell moms, "Relax. We can deal with this." One of the first things that moms who are aware that their daughters have been cutting need to commit to do and to tell their daughters, "I'm going to ask you every day to see your arms and legs."
Daughters often think, "What's the big deal with this behavior? It doesn't hurt anyone but me." And this is where moms really need to, once again, get a grip on their own emotional state; first of all, to deal with their shame. I think it's so important for parents to hear that you can have good families, you can be doing all the right things for your daughters, and they will still come face-to-face with some of these struggles. Even if you have failed her horribly, to get lost in those feelings of guilt and shame will not be best for your daughter.
And so to go to your daughter and say, "I know there's a lot going on inside of you – a lot that needs to come out, and maybe I don't know the best ways to ask or talk to you, but I'm going to hang in there with you, and I just need you to know that I am heartbroken that you have been hurting so much." When daughters begin to see that what they do impacts their parents, it can begin to stop with this behavior.
Dennis: You mentioned two million people who are still in the process …
Sharon: … of self-injury …
Dennis: … of self-injury. What percentage of that two million are female and what percentage is male?
Sharon: Ninety-percent are female, and so this is primarily, like eating disorders, a female behavior, which does not mean that there are not boys out there who are burning themselves, marking themselves in some ways, but this is primarily a female behavior.
Bob: And is it tied to depression? We started off talking about depression. This and eating disorders – is there a root of depression with both of them?
Sharon: There is, and I think it gets all twisted up and woven with other strands of meaning. It can be – 50 percent of all girls who cut have been sexually abused, and so that's a strand in many girls' lives. Many of these girls come from very rigid families, and this is important when we're talking to Christian families, because we do have sure values. We have certain ideas about what is right and wrong, but that does not mean that we, ourselves, have to be rigid – and being open to our children and inviting curiosity and expression of ideas and questions about why – so we can have rules and standards without creating a climate of rigidity.
Sometimes another strand, as I mentioned before, is loss. It seems like girls, in particular, are vulnerable to the impact of loss, and that loss could be the loss of being a little girl. A lot of girls resist that growing up and developing a female body and the responsibilities, and that's where eating disorders can come into play. It can be the loss of family, in a broken family. It can be the loss of your middle school life, going into high school. And for their many losses that sometimes go inward, and girls don't know how to deal with the pain, and that's where cutting or eating disorders come into play. Both of these behaviors give girls an idea – "Okay, I can control something."
Dennis: Sharon, what I've heard you say here, I just want to review a couple of things. First of all, you're talking about a form of an addiction. It's difficult for some people to think about an action, such as cutting yourself, as being addictive, but it is.
Sharon: And let me compare it to a substance-abuse addiction. The reason that substance abuse becomes so powerful in a person's life is because it kidnaps the brain and tells the brain, "If you are feeling stressed or unhappy or angry, then smoke a cigarette or have a drink, and you can relax, and you cannot feel the pain so much." For a girl who cuts, it's a very similar experience, it's an addictive experience rather than a substance that kidnaps the brain, and it says the way to deal with emotional angst is to cut yourself, to bleed, to feel the relief that comes after the pain goes away, and the brain begins to be held hostage to this behavior as the only way to manage emotion.
Dennis: And so what can happen in those situations is a young person can move from one form of addictive behavior such as cutting to an eating disorder.
Dennis: Or to even a more self-destructive form, which would be suicide. A second thing I've heard you emphasize is for parents to emphasize the relationship – to love your child, to pursue your child, to believe in your child, to make sure you remain the parent; you assume responsibility for that child's life and not get pushed out of her life; and then, finally, third, to maintain some form of accountability where you ask hard questions. You insert yourself into that child's life at key points where they can't hide, where they can't deceive you.
Now, that's easy to say here in the studio. I'll never forget what John Votters' [sp] daughter told us, Bob. You remember the statement – she said "My ability to deceive," in her case around drugs, "was much greater than my parents' ability to discern the truth."
Sharon: That's a powerful statement.
Dennis: And as a kid, I remember playing that card. I held more cards in my hand than the parents did. All we can do, as parents, is our very best, seeking God, asking for His help but, to the best of our ability, with the strength God supplies, depending upon Him, we need to ask God for wisdom about how to keep our children accountable.
I just want to thank you for not only your work as a licensed counselor but also for books like you've written for eating disorders, now this book about, "Mom, I Hate My Life." You have come alongside moms at a dangerous time for young people, and I'm just grateful for your friendship, Sharon, and I hope you'll come back and join us again sometime.
Sharon: I would love to. Maybe I can conclude with a passage of Scripture that I conclude with in the book, "Mom, I Hate My Life." It comes from a young king in Israel's time who was also feeling very overwhelmed, and as he cried out to God, he said, "O God, we have no strength against this vast army that is surrounding us." Ever felt like that as a parent? He said, "But our eyes are on You," and I love God's answer to him, because it gives weary moms and dads hope in the middle of some dark nights. God said, "Jehosophat, do not be afraid or discouraged, because the battle is not yours, it is mine." And that's a good place for us to rest.
Bob: I think you give a lot of moms hope and help in the book that you've written, "Mom, I Hate My Life," that, again, we have in our FamilyLife Resource Center. Anyone who would like to get a copy can order online. If you go to our website at FamilyLife.com and on the home page there will be a button down at the bottom of the screen that you can click on that says, "Today's Resources," and it says "Go" right in the middle of it. You just click that button, it will take you right to the page where you'll find information about Sharon's book and about other resources we're recommending for parents of adolescents, including the book you and Barbara wrote, Dennis, called "Parenting Today's Adolescent."
Any of our listeners who this week order both of those books together, we'll send at no additional cost the CD or the cassette of our conversation this week with Sharon Hersh. Again, you can order from our website, FamilyLife.com or you can call for more information, 1-800-FLTODAY is our toll-free number, 1-800-F-as-in-family, L-as-in-life, and then the word TODAY, and our hope is that these books will provide the kind of encouragement and help that parents need as we raise our teenage daughters and our teenage sons.
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Well, tomorrow we want to look at another challenging issue parents face, and that is the issue of children who wander from the faith. Why is it that children can be brought up in a Christian home and arrive at their teenage years or their college years and abandon those things that they appeared, at one point, to embrace. Tim Kimmel is going to be with us tomorrow to help us with answers to those questions, and I hope you can be back with us tomorrow as well.
I want to thank our engineer today, Keith Lynch, and our entire broadcast production team. On behalf of our host, Dennis Rainey, I'm Bob Lepine. We'll see you next time for another edition of FamilyLife Today.
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