There is a disturbing trend among teenagers: depression and suicide rates are on a steady rise. Recent studies indicate that as many as 11% of the teen population — that’s over 4 million students — may currently suffer from a major mental health disorder. Surveys completed by the Centers for Disease Control and Prevention (CDC) implicate suicide as the third leading cause of death amongst people ages 10 to 24, and as many as 15% of students within this age group have considered taking their own lives. Female students are at greater risk, with 21% reporting having suffered from a Major Depressive Episode (MDE) in a recent Department of Education survey, while their male peers reported MDEs at a far lower rate of 10%.
Teenaged depression can significantly impair a student’s ability to learn and connect with peers during a crucial period for academic achievement and social growth. Suicide is an especially concerning aspect of teenaged depression, as is suicide contagion — a phenomenon on full display in Silicon Valley last spring, when 4 teens committed suicide in similar manners over the course of a 6-month period. Even when teens do make it through their depression, they are more likely than their peers to suffer from psychosocial disorders as adults.
Together, these statistics underline the importance not only of treating teen depression, but also of doing so early. Teachers are on the front lines of the battle against teen depression and therefore have the potential to act as an essential part of a student’s support network. However, doing so is often easier said than done, and requires a deep understanding of the many faces of depression as well as the many intervention strategies available.
Depression can be exceedingly difficult even for trained mental health professionals to spot, because it can manifest in many different forms, and because many depressed people work hard to cover up their depression so as not to be a burden to others. This is all the more so for teens, whose depression is often confused with “teenagers being teenagers.” Parents and educators often dismiss depression as a student’s laziness, shyness, or insubordination.
There is an excellent article on the ACSD (formerly the Association for Supervision and Curriculum Development) website entitled, Responding to a Student’s Depression, that explores the difficulties for teachers in identifying depression through the case study of a 14-year-old student named Rita. In her first semester at Brentwood High, Rita, who was always a good student, has seen her grades plummet. She cries frequently, hasn’t made any friend, spends most of her time with a few teachers she trusts, is shy and irritable, and doesn’t engage with typical teenage interests. Her parents are busy at work, and so she feels lonely at home, and often thinks of death as a way out.
In Rita’s case, there are a number of telltale symptoms. Poor grades, for example, are often a clear indication of depression, as the disorder can inhibit memory, motor skills and planning abilities. Depressed students often exhibit labored speech and lethargy, and have trouble expressing themselves. What’s a little bit trickier about Rita’s case, at least from an adult perspective, is that her irritability is easy to downplay as teenaged moodiness. For other students, the same issues arise with depression-linked disruptive behavior, which is often attributed to other disorders, such as ADHD. The teenaged years are by definition a time of pushing away, but teens often feel disempowered and remain unaware of the resources available to them, so they are unlikely to reach out for help or to clarify these adult misperceptions.
Additionally, the ACSD article outlines a number of other telltale symptoms as they manifest specifically in teens, including:
Each of these symptoms relate to changes in the teen student’s mood, feelings of self-worth, and self-perception.
What does this mean for the busy educator, tasked with what may feel like mind reading? When symptoms like Rita’s crop up, it’s important to take your own feelings of frustration out of it, to reach out to the student with an empathetic tone, and to dig down deep in search of the right solutions.
As with all illnesses, it’s important to get to the source of the student’s depression in order to put together an effective treatment plan. However, there are numerous potential causes, and many may interact. For example, depression itself is often neurochemical in nature, but it can be difficult to untangle whether any given depression is caused by a neurochemical imbalance or a neurochemical imbalance is the result of externalities. It is best to embrace that complexity with a multi-pronged approach that considers any number of the following factors.
Adolescence is a time of rapid change in the brain and the body. Key hormones like estrogen, progesterone, and testosterone increase their flow, though they do so at varying rates, which can lead to significant mood swings.
Perhaps even more important are the changes that occur to the physical structure of the brain’s prefrontal cortex, as explored in two excellent TED talks from leading neuroscientists, Sarah Jayne Blakemore and Jill Bolte Taylor.
The prefrontal cortex plays an essential role in decision making, planning, understanding other people’s emotions and perspective, inhibiting inappropriate behavior and being self-aware. During adolescence, there is a significant decline in the grey matter present in the prefrontal cortex, with the brain pruning a whopping 50% of synaptic connections. In layman’s terms, this means that the brain strengthens important connections while getting rid of anything it deems unnecessary — and it does so at a massive scale. According to Bolte Taylor, this is at the heart of why teens exhibit so many personality changes at this time, as well as shifting interests and friend groups.
However, while these major changes are a normal part of healthy brain development, it can often make teens feel unfamiliar with their own brains, lost, and confused. This in turn can put the amygdala on high alert — and because the amygdala is directly related to feeling fear, significant changes like these can increase anxiety.
Many researchers and educators believe these major shifts, as well as the hormonal surge and the feeling of having a “brain under construction” may be at the heart of why so many significant mental disorders develop at this age, including depression. However, the link still needs further research before it can be confirmed. At the very least, taking the time to understand what is happening to the teenaged brain and body will help educators better separate normal from pathological developments to a student’s personality and moods.
The academic pressures of teenagehood have long been known, but over the past decade there has been much analysis from leading educators measuring the cascading effects of these pressures.
The landmark 2001 book, Doing School: How We Are Creating a Generation of Stressed-Out, Materialistic, and Miseducated Students, written by leading Stanford educator, Denise Clark Pope, followed five high achieving students throughout the school year, noting their efforts to lie, cheat and manipulate their way to the top. The conclusions are damning: schools that place such high value in future outcomes and test-based successes foster anxiety, deception and hostility rather than intellectual curiosity, cooperation and engagement.
Since the publication of Pope’s book, testing has extended its reach across the age groups. Test anxiety has expanded along with it, leaving many students feeling anxious and exhausted for extended periods of time, if not the whole of their educational careers. This is a theme famously expanded upon in Ken Robinson’s viral TED Talk, entitled, How Schools Kill Creativity.
While no direct link has been made between a lack of creativity in school and depression, generalized anxiety and the pressure to be perfect certainly have, and for some students, the correlations here may indeed be causal.
There are many elements of a student’s lifestyle or home life that may lead to depression, including major life changes such as a death in the family or a divorce, inactivity, poor diet and lack of sleep. Studies have also found a link between sedentary lifestyles and depression, with the causation possibly running both ways. That is, a sedentary lifestyle can lead to depression, and depression can further decrease inactivity, which in turn can create a negative feedback cycle. This may indeed be a chicken or egg type of question, but there is no doubt they are linked. Making improvements to a student’s diet, adding exercise into their routine and providing access to psychological counseling can help put an end to this cycle.
Last but not least, bullying is a major contributing factor to teenaged depression — and not just for the bullied. According to a recent CDC report, even students who simply observe bullying report increased feelings of helplessness and lowered feelings of connectedness with peers.
The statistics are staggering. According to a recent UCLA study of nearly 2,000 students, 70.6% of students have witnessed bullying in their school, with 30% of students admitting to doing the bullying themselves. Bullying happens both online and offline, and 75% of school shootings have been linked to harassment.
While the causes of teen suicide (just like adult suicide) can rarely be pinned on a single factor, the CDC report indicates a significant relationship between the two. LGBTQ teens as well as teens with disabilities are at even more pronounced risk.
Just as the causes of teen depression are complex and diverse, so, too, are the possible interventions. Without a doubt, when an educator believes a student is currently exhibiting or at risk for developing the symptoms of depression, it is crucial to reach out to the student and to recruit a support network, which may include the student’s family and the school counselor as well as any outside help, to intervene in the following ways.
Checking in regularly with a student will help drive home the idea that someone does care about the student, and that they are not alone in their battle with depression. Check-ins can take place after school, during lunch or over email — really, in whatever medium the student is most responsive. The important thing is to develop a relationship, to express unconditional support, to avoid generalizations and singling out the student for criticism, to be specific in providing feedback, and to keep the tone positive.
With all students it’s important to teach through his or her strengths, but it is all the more so with a depressed student whose self-esteem might be fragile. The student might benefit from a little more quiet study time or time to focus on a passion project if all other work is completed early. Alternatively, a teacher might encourage the student to draw, write, or practice music in their downtime as an outlet for their emotions. Lowering their homework load can help, as can giving them more breaks throughout the day, breaking up larger assignments, and providing extra time whenever the educator feels doing so will aid — not hinder — their educational and emotional development.
In 2009, a government-appointed task force estimated that as many as 2 million teenagers may be suffering from depression, with the majority undiagnosed and untreated. According to the task force and many mental health experts, schools and primary care should regularly screen for depression using simple questionnaires to help diagnose students who lie outside of the typical high-risk populations. The American Psychological Association also recommends that teachers complete programs like the Stop a Suicide Today! program or the Penn Resiliency Program to better acquaint themselves with the signs of depression and suicide and for training on how to best interact with and suggest treatments to their depressed students
Schools that don’t already have anti-bullying programs in place should consider implementing one a top priority. The StopBullying.gov website provides a wealth of resources on the topic, collected from a number of top government agencies. The quick facts included on this infographic are helpful for becoming acquainted with the many forms bullying can take. This Edutopia article lists a number of excellent resources for curriculum and lesson plans on bullying, gathered from the Not In Our School Program, KQED, Teaching Tolerance, Common Sense Media, and the Gay, Lesbian, and Straight Education Network.
The Edutopia article also provides resources for encouraging student leadership on these issues, as it is the students who suffer from and cause bullying, and it is the students who can do the most to stop bullying from within. Schools and educators can and should provide students with the tools and the framework they need to do so.
Successfully managing student emotions in the classroom, including those that extend far beyond the diagnosis of depression, is contingent on students learning coping mechanisms for self-regulation. For example, developing rituals for students, like always writing their homework down before the bell rings rather than waiting to do so until the very end, can help them have an anchoring reference point during times of stress, which are more difficult for a depressed student to handle. Encouraging students to reach out for help when they’re feeling at their worst is also an excellent way of coping, and it can even be helpful to provide them with the language for doing so, as well as a go-to anchor resource, like a good friend, yourself, or the guidance counselor.
However, teaching mindfulness goes even deeper than this. As Jill Bolte Taylor articulated so cogently in her TEDxIndianopolis speech above (around the 3 minute mark), only students themselves have the power to break their own negative circular thinking, and to free their brains from the grip of their amygdalas (see 6:45). Educators can help students break these cycles by helping them to understand depression as well as how their brains work, and by encouraging them to pay attention to and examine their feelings. Some studies also indicate that teaching students about how maleable their personalities and life situations can be as they develop can help prevent a rise in depression rates (thus why projects like It Gets Better may prove so effective).
Teachers can get started in teaching mindfulness simply by modeling it themselves, and by making time for quiet and meditation before exams to combat anxiety. PBS has produced an extensive teacher’s guide to teaching mindfulness that provides an excellent definition of mindfulness, explores the links between a lack of mindfulness and stress in the classroom, and suggests a number of techniques and activities for implementing mindfulness in the classroom.
Likewise, this excellent article from Teaching Development offers a number of strategies for helping students manage stress and emotions (including the usefulness of exercising more), while this Edutopia article includes excellent tips on helping students develop a greater sense of purpose.
Shifting the instructional focus away from test-based learning is a bigger job than a single teacher can tackle on his or her own. However, to whatever extent possible, it is important to allow more time for curious, creative and engaged learning, whether that’s through independent projects, self-chosen paper topics, or encouraging students to pick up extracurriculars purely for reasons of interest and passion. Teaching general problem solving strategies can also be effective, as it will provide students with a framework they can apply to their own brains.
Of course, none of these strategies can or should replace clinical and medicinal interventions with the help of a trained mental health specialist, as well as the support of the family, and it is ever important to keep the complexity of teen depression in mind. However, a customized, multi-pronged intervention at school can be highly effective — and with the stakes so high, it is crucial to implement such an intervention the moment signs of depression are spotted.