For those struggling with depression, life can feel bleak, dark or foggy. How do you live life through the darkness? And how do we help young people in dark places? Livability’s Katharine Welby shares her own mental health journey, and gives some Do’s and Don’ts for supporting young people with depression.
11.5% OF YOUNG PEOPLE AGED BETWEEN 11-16 YEARS HAVE A MENTAL DISORDER
4.4% OF 11-16 YEAR-OLDS HAVE AN ANXIETY DISORDER
62,000 OF 11-16 YEAR-OLDS ARE SERIOUSLY DEPRESSED
8,000 CHILDREN UNDER THE AGE OF 10 SUFFER FROM SEVERE DEPRESSION
x2 THE NUMBER OF YOUNG PEOPLE WITH DEPRESSION NEARLY DOUBLED BETWEEN THE 1980S AND THE 2000s
8.9% 16-24 YEAR-OLDS HAVE SELF-HARMED IN THEIR LIFETIME
194 IN 2011, 194 15-19 YEAR-OLDS COMMITTED SUICIDE
I am not a youth leader or a young person, so it would be entirely appropriate to question why in the world I am writing about either of these topics. But l like all adults was once a young person, and like more adults than acknowledge it, during my teenage years I was depressed.
Chances are high that in any gathering of ten or more 11-16 year-olds there will be at least one who has a mental health condition of some kind. Now being no sort of expert on this I might not actually be able to do much for you, but one thing I can do is let you know what it is like.
As mentioned above, I have depression. I was diagnosed aged 19, but the symptoms started around the age of 15, during my GCSE year. I feel like I have spoken a lot about my depression; after a while it begins to feel self-pitying. However, I am going to tell you a little bit about my experience of this disease.
The place to start for me is the feeling that I am a fraud. I am very lucky. I was born into a loving and encouraging family, I have great friends, a supportive church and a fiancé who encourages and builds me up daily. How can I possibly be depressed? Yes, there have been events in my life (many self inflicted) that have caused me great pain and hurt. But many of my friends have suffered more and do not have depression. This is the key, and it has taken me eight years to come to a point of acceptance: I am ill. It is a disease. It is deeply unpleasant, but not something that I have ‘earned’ through a desperately painful life. Therefore, the fraudulent feelings are suddenly less valid even if yet they persist.
I often wake up feeling hopeless. Like there is a blackness ahead that nothing can really shift. I don’t want to live in this state of mind forever, and I don’t believe I will. But the belief that there is an end often doesn’t really reach me as truth. I can sit and have an entirely logical conversation about how absurd the thoughts in my head are. I am useless, meaningless, forgettable, a burden to all who know me, a waste of space and someone people would generally prefer to live without. I know, now, that this is not true. I only know it because I have spent the last five or so years struggling and seeking something to hope in.
Partly through the Bible and what God says we are and partly through counselling, I can sit here and logically say that I know all of the above is not true. I know there is hope for the future. That truth, however, does not sink in. I don’t feel it; I know it but I have to fight to hold onto it. It is this battle that causes me the most pain. I am exhausted by the fight; waking up every day and going to war with myself, taking each thought in turn and checking the validity of it. Often I lose, or I give up trying to win.
This I think is why I care so much about young people with depression. I never really heard about it as a teenager. I recently spoke at an event, where a young lady came and told me she had been diagnosed with depression. She couldn’t tell her mother though, as her mother thought it was wrong, un-Christian. I don’t really know how to explain how angry this made me.
Why is it that we, as Christians, struggle so much with depression? Looking at the Bible we see every emotion going. It is full of real people, living difficult, challenging, often heartbreaking lives. Failures, who didn’t do what God wanted. Yet, we insist, that if we have the joy of the Lord we shouldn’t be depressed.
This is a lie that ensured I kept God at arms length. I am not good enough for a God who needs me to be happy all the time. It was last year that I learnt that happiness and joy are two very different things. To me, joy is the understanding that God is there in it all. We are never alone, we are loved, cherished, sung over with thanksgiving and delight. I am content. My illness is horrible, I hate it passionately! However, I know that God is with me, working in me and that brings me a deeper joy than any passing happiness can.
I think youth leaders are in a unique position to help both those with depression to feel accepted and loved, and to help everyone else understand what depression and other mental health conditions really are.
This is a story of a young woman in her late teens – we’ll call her Sarah – who was diagnosed with depression at 14 when it became unbearable, but the problems started when she was eight. I interviewed her for this article and for many reasons this young lady would like to remain anonymous. It is a brave and frightening thing to talk about.
Some of her family members had already noticed that something was wrong, so the news did not come as a huge shock to her mum, who took her to the GP. However, when I asked whether she told any friends, the answer was a straightforward no: ‘I wasn’t sure if I was depressed. I felt like a fraud. I thought all my friends would think I was a fraud too’.
This statement is familiar, and this fear of being misunderstood is common. Most people in their teens (or who can remember their teens) will understand the feeling of fear that comes with being seen as different. Combine this feeling of common teenage terror of one’s peers, with an illness that confirms all your worst fears – you are useless, a fraud, a waste of space etc., and the terror becomes even greater.
Sarah told a couple of her closest friends, a couple of months after visiting her GP, that she had started therapy: ‘Depression isn’t often talked about among young people, and I knew that only a few of my friends actually understood what it was – as much as they could. Some of my other friends thought that you could just smile or cheer up and you would be fine. Of course I didn’t tell them, I didn’t want to be thought of as a cry baby or attention seeking.’
Sarah’s life didn’t get easier, but she had a supportive group of friends around her. This doesn’t always mean that life is simpler though. ‘Sometimes I feel that it’s harder for those who don’t have depression because it’s so difficult for them to understand exactly what happens in the brain. So while it’s difficult when friends let you down, I understand how hard it is for them to cope with a depressed friend. I think young people should be taught about mental illness from a young age, perhaps even in primary school, so that the young people who are depressed or have a mental illness and those who don’t, understand that it’s a disease not a choice. Then perhaps the stigma and fear can diminish. I don’t think it should be done in assemblies or something, but should be done in biology as it shows that it is a real disease that affects the body.’
A lot of illness generates curiosity, sympathy – occasionally pity. You won’t hear someone with asthma being told by their peers to just get over it. If you heard a member of a youth group saying ‘what do you have to be asthmatic about?’ you would (having overcome a fit of the giggles) most likely let the speaker know that asthma isn’t a choice. Depression isn’t the same as asthma, but it is still an illness.
Whilst very few people knew about Sarah going into hospital, teachers and her closest friends were made aware. Unsurprisingly, not all of those who knew understood which made going back to school a challenge.‘I knew that there had been rumours and talk in school while I had been in hospital and I was worried that people would think I was a nutcase – which was the common reaction on TV and in films. I spoke to those around me and we decided that as I didn’t want to tell people where I had been we would make a joke out of it. I joked that I had been pregnant, in prison, or on a secret mission for the Chinese government!’
Making light of someone’s depression is a dangerous thing to do – however, it is also, as Sarah mentions, something that can make life a little easier. I find that joking makes it easier for others around me, and often hides from them the severity of the problems I face. However, it can also communicate the pain and stress that comes with depression in a way that others understand. So knowing the individual is key – something youth leaders will know all about.
How do you deal with depression? You don’t treat it as depression. You understand that the disease is a disease and that although many of the symptoms will be the same but the working out of that disease will be different in every individual you encounter. Levels of depression will vary depending on the day, the circumstance and the environment. The key seems to be – education and the individual. Recognising the need for both of these factors will provide a platform from which it is possible to make a significant difference in the lives of teenagers with depression.
Below are some do’s and don’ts. These are things that I have experienced as valuable and are ideas only. A lot of it might feel obvious, but in my experience the obvious often needs repeating.
Ask what the individual wants or needs. Speak to the parents or carers and the individual concerned. Take the time to work out how the disease affects this individual.
When you say you will do something - do it. If they ask for something you cannot do, tell them. Make sure they know where they stand and that you are trustworthy and trying.
Try to do this before a youth group is affected, so that if someone gets a mental health condition they do not feel like a zoo animal. If it is too late for this, educate anyway. Pick out examples on TV or in the news and talk about the responses they get. Make it personal – how would you feel?
Withdrawal does not mean they don’t want to be involved. Many of those I know (including myself) feel we are a burden. Texts or emails are great, as are snippets of information, the odd invite. Show that you are still interested and keen to know how you can help, even if 90 per cent of the time you don’t get a response.
Not strict or unkind. However, as with anything, don’t just let people get away with unpleasant behaviour. Challenge is fine – done well and with understanding of where it comes from. This also gives a good structure. If it is done in the context of the above, it just gives further clarity and boundaries.
Make a fuss
This area is a great embarrassment to most. Tread carefully and recognise that often the individual really might not want others in the group to know. Love can be quiet.
If a member of your group has been depressed before, do not assume this will be the same or even similar. Knowing the symptoms and places to go for help is good. Otherwise, start from scratch.
Similar to the above. Don’t assume you know what someone will say or is thinking. You often may be right, but part of living with depression is knowing what you think. Let them work it out, help when asked or when it is clearly needed, but allow them space to come to what you might know already, themselves.
If you see other members of the group making fun, or getting angry, talk to them about why. This might require further teaching, or just a deeper understanding. This also applies to the individual – if they say leave me alone, maybe give space, but keep an eye at the same time where possible.
Get too serious
Joke – not too much, and make sure you know the individual well. But don’t make it all high pressure and serious and hard work. It makes the whole subject boring, painful or humiliating, depending on the role you have. Taking it seriously doesn’t always mean being serious.
Katharine Welby is the community mission coordinator for Livability.