Teen depression

Published in The Post-Star (A1)
1/2/06

Robin Diaz was 5 years old when she saw her older brother get hit by a truck. He died, and so did something inside Robin that has never truly returned: joy. She's struggled with major depressive disorder ever since.

"In the very beginning, all I can say is that I felt different. I knew something had changed, but I couldn't possibly explain to anyone what it was," said Diaz, now 59. "Only within the last five years have I opened my mind to the reality that I was mentally ill."

During Diaz's childhood in the 1950s, few people believed or understood that children could be depressed, she said. She visited school counselors in elementary and high school, but they didn't know how to help her.

"All I could do was sit in their office and cry, and when they asked me why, I would have no idea," she said.

These days, mental health professionals know that about 5 percent of adolescents suffer from clinical depression, said Dr. H. Wally Mahood, a child psychiatrist at the Glens Falls Hospital's Center for Children and Families.

"Depression is an illness, the same way diabetes is, but sometimes it's not recognized that way," he explained. "You hear things that these children have been told, like 'Why don't you just get happy?' That's like telling a diabetic, 'Why don't you just fix your blood sugars?' "

Girls are more than twice as likely to develop depression as boys, he said, for reasons that doctors don't yet understand.

"We're not sure why girls are more susceptible -- is it their roles in society? The way they're brought up? Hormones?" he said.

Diagnosing major depressive disorder in a child involves a combination of symptoms, usually displayed for two weeks or more. A sad or irritable mood, loss of interest in pleasurable activities, disruptions in normal sleep patterns or appetite and social withdrawal can all be signs a child is depressed.

"It's more than just a period of being sad. Depression is a physiological disturbance; it's the body reacting to some sort of stress," Mahood explained.

For adolescents, depression is especially challenging, because they don't necessarily have the self-awareness to know they are ill.

"It's a period where they're trying to develop their sense of self, and this can be very confusing when they become depressed," said Mahood. "They think, 'Is this who I am?' "

That's exactly what Diaz thought, as she remembers it now.

"I had a feeling that I wasn't good enough as I was -- although, frankly, there were times when I wasn't sure who I was," she said. "I didn't have any relationship in my own mind between what had happened in our family and what was going on with me. I just thought I was a bad person."

Diaz considers herself lucky because her mental illness never landed her in the hospital. Although she thought about killing herself "all the time" as a child and young adult, she never attempted suicide.

Suicide is the third leading cause of death among people ages 15-24 in the United States, according to the government's National Center for Injury Prevention and Control. Nearly 16,000 adolescents and young adults took their own lives between 1999 and 2002.

"It's an extremely high mortality rate," said Mahood. "Approximately 10 to 15 percent of people with untreated depression commit suicide."

Even with treatment, depression can lead to suicide attempts, as Rain Nallie of Queensbury knows all too well.

Nallie, 23, has tried to kill herself repeatedly since she was 12.

Her wrists bear witness to the times she cut herself with razor blades. Some of the wounds are fresh. When people ask her about the scars, she says she was in a car accident.

She has schizoaffective disorder, a debilitating mental illness with symptoms that include severe depression.

"That's really hard, especially when it's coupled with not sleeping," she said. "It gets very lonely, just wandering around the house all night. It's almost like a metaphor for what your life is like every day -- even though there's people around you all the time, you can't really talk to them. They don't really get it."

Her teenage years, Nallie said, were "a mess." She felt out of place and overlooked in the public school system, although things got a little better after she transferred to Spa Catholic in 10th grade.

"It's hard enough for anyone to be in school during the teenage years, and it's even harder when you have a mental illness," Nallie reflected. "The other kids don't make it easy. They use words like 'freak' and 'psycho' so loosely.

"The teachers would send me to the guidance counselor, but they would have no idea what to do with me besides call my parents. At the Catholic school, they sent me to talk to the priest. But what good does that do? I'm agnostic," she said.

"One thing that did help at Spa was the smaller class sizes," she said. "People get to know you, and they have more compassion."

Nallie graduated from high school in 2000 and eventually went on to complete beauty school.
She worked a few hours a week at a local salon until recently, when she married Stephen, 21, and moved with him to Pennsylvania so he could attend college for computer science.

They plan to move back to Queensbury next month because she wasn't able to afford her medications outside the New York Medicaid system.

"That's probably, like, $1,000 a month right there," she said, pointing at her prescription pill bottles. She takes six different medications a day.

When she returns, she plans to go back to work part-time at the salon as a "working disabled" Medicaid recipient, and she said she will start seeing her therapist again. But when she thinks about the future, Nallie said, it's hard to feel hopeful.

"People ask us, now that we're newlyweds, if we'll be having kids," she said. "But depression runs in families.

"We're not bringing a kid into the world with that. We know how hard it can be."
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