Is it Sadness or Depression? - How to Tell the Difference.

Submitted by Roni Gillenson, LMFT Program Director ACS On Campus Counseling Program

How do we tell the difference between “within the range of normal” sadness and depression? First we need to start with the developmentally appropriate range of feeling for a teenager. To quote the medical encyclopedia, for normal teenagers we can expect “sensitivity and concern over body issues, excruciating comparisons between oneself and peers, acts of rebellion, conflict with parents, risk-taking behavior, increased risk for depression due to pressures and conflicts that may arise within families or in friendships. If adolescents appear to be isolated from peers, disinterested in school, or deteriorating in performance in school, work, or sports, psychological evaluation may be necessary.”

That was quite a mouthful, but, as you can see, there is quite a broad range of normal for teenagers. The issues come about in the gray areas. Someone who is exhibiting extreme behaviors is easy to identify. It is when we are unsure that it becomes more difficult. The major signs of depression are fatigue, heaviness, listlessness; loss of appetite; difficulty concentrating and completing tasks; feelings of shame, worthlessness, inadequacy and incompetence; lack of sleep; loss of interest in life; withdrawal from friends and family; engaging in self-destructive behavior; expressing desire to harm oneself.

Another factor is separating out sadness and depression. Sadness (or grief) is a natural response to loss and the symptoms may seem the same as depression. The major difference with depression is that the person feels that there is something wrong with themselves, “no one likes me, there is something wrong with me.” That usually doesn’t happen with simple grief.

Let me tell you about a teenager I am seeing in my private practice. She came in with most of the above symptoms – not eating, not sleeping, feeling as though no one liked her. In fact, she scored high on a depression scale I gave her. What became important for me over time is that she kept coming back each time to the fact that she was lonely. That was her predominant symptom. She said she was not suicidal. She made good use of therapy. At first she was quiet and said very little. However, as we continued to meet, she opened up more about her loneliness. I learned, though, that she overemphasized some things. Her perception is that she had no friends, but in conversation, she would name several people that she spoke to. But she said they were not really friends. Her perception of being lonely was important to listen to, because that is how she was operating, based on her perception. Therapy has helped her see things more realistically – that she actually has friends, but that she may have been misperceiving. She did not need to take anti-depressants as therapy was helping her to improve. Sometimes medication is necessary, but I always try to see if therapy will help alleviate the pain they feel first.

Sadness is a part of life, just as is grief over a loss. But when it becomes depression, it is time to take action.

If you find that your teen is having difficulty with sadness or depression, do not hesitate to have them contact an ACS counselor. Adolescent Counseling Services has therapists on your teen’s campus who are available to help. We also have access to outside resources to help parents to get through this difficult time.

Adolescent Counseling Services is a community non-profit, which provides vital counseling services on seven secondary campuses at no charge to students and their families. To learn more about our services please visit the ACS website at www.acs-teens.org or call Robyn Alagona, Site Director at Gunn (650) 849-7919. ACS relies on the generosity of community members to continue offering individual, family, and group counseling to over 1,500 individuals annually. ACS provides critical interventions and mental health services, building a better future for tomorrow. If you are interested in helping to support our efforts, do not hesitate to call to make a donation. It goes a long way in helping teenagers find their way!

Breakfast with ACS!
Join us for breakfast and learn more about ACS programs, trends in child and teen mental and emotional health, and hear from our licensed clinical staff about how you can better communicate and interact with any teen in your life. These events are free, but space is limited. Please RSVP to gulrukh@acs-teens.org with your name, address, phone number and the date you would like to attend.

Wednesday, October 5, 2011 | 8:00-9:30am | ACS Corporate Office, 1717 Embarcadero Road, Suite 4000, Palo Alto, CA 94303

Wednesday, December 7, 2011 | 8:00-9:30am | ACS Corporate Office, 1717 Embarcadero Road, Suite 4000, Palo Alto, CA 94303

Wednesday, May 2, 2012 | 8:00-9:30am | ACS Corporate Office, 1717 Embarcadero Road, Suite 4000, Palo Alto, CA 94303