The boy stared at his homework.
He was reading “The Lord of the Flies,” but couldn't get through a single paragraph before feeling lost. His mind was in a completely different place, and he felt unable to concentrate. It was hard to believe his girlfriend had broken up with him nearly three weeks ago, but he still couldn't get her out of his head.
His eyes felt heavy from lack of sleep. Whenever he lay in bed, he seemed to live through the breakup again and again in his thoughts. It had been days since he had a decent night's sleep.
He was absolutely miserable, but angry at himself for feeling so sad. In frustration, he threw his book across the room in a fury, collapsing onto his bed and burying his face into his sheets. How much longer was he going to feel like this?
Teenage depression in boys is a complex, but often ignored issue today. Statistics from the National Alliance on Mental Illness show that 20% of adolescents experience depression during their teenage years. For more information see Adolescence Developmental Psychology.
Even though depression is more prevalent in girls than boys, dealing with depression in teenage boys still presents unique challenges that must be addressed to ensure a smooth transition to adulthood.
Depression is Hard to Identify in Teen Boys
Phrases such as “be a man” and “boys don't cry” teach boys to create masks to hide their emotions. Even when feeling sad or overwhelmed. cultural values pressure boys to harden their appearances, to act manly and handle their sadness on their own. For these reasons, teenage boys are less likely to seek help for depression. In fact, most teenage boys (and many girls) don’t realize they are depressed, further complicating the issue.
In the book, “Real Boys: Rescuing Our Sons From the Myths of Boyhood,” author William S. Pollock states parents and educators must not be fooled by a boy's mask.
Teenage boys tend to ignore their depression through distractions, such as playing games, getting together with friends, listening to music, or watching television. They are also less likely than girls to voice their concerns or emotions to friends and family. In fact, only 26% of boys in a study admitted to turning to friends for support, according to Pollock.
Pollock said that although society teaches boys to be stoic and toughened individuals, they aren't “lone rangers” and still need to be told they're good, that they make good friends, and that they're needed and loved. If a boy senses a lack of familial support or sympathy, or if events in his life feel beyond his control, the pain of depression might become unmanageable, leading to serious consequences for the teen’s mental – and physical – well being.
Who is at Risk for Depression?
Depression can affect any adolescent boy, but certain groups are at higher risk than others. According to the study “A Causal Model of Adolescent Depression,” published in the Journal of Psychology, depression is linked to lonely teens, teens with low self-esteem, and teens who lack strong family support.
The study, conducted by Diane Brage and William Meredith, examined 156 adolescents with a mean age of 14. The study found adolescents who do not acquire positive beliefs about themselves don't achieve a satisfying sense of self and become depressed.
Furthermore, adolescents with low self-esteem are more likely to feel lonely, have negative self-images, and feel inadequate in their abilities to make friends. The researchers found that family support was they key in building teenagers’ self-esteem, recommending open, trusting communications between all family members.
Unfortunately, lonely teens with low self-esteem are also likely to encounter bullying from their peers, feeding their depression. In “Bullying, Depression, and Suicidality in Adolescents,” published in The Journal of the American Academy of Child and Adolescent Psychology, frequent exposure to bullying was found to be significantly correlated to higher risks of depression and suicide in teenagers. The consequences of severe bullying have been thrust into the public eye recently for one particular group of adolescents – gay teenage boys.
Gay teenage boys face severe conflict from an early age as they grapple with confusion in the masculinization process. Society, schoolmates, and even parents inform them of what is “normal” behavior, which often conflicts with feelings they develop in adolescence.
This conflict between society's views and personal views puts gay teenage boys at high risk for suicide, according to “Risk Factors for Attempted Suicide in Gay and Bisexual Youth,” published in Pediatrics. The study found that 30% of the 137 gay or bisexual youth attempted suicide at least once, and half of that group attempted suicide multiple times.
Depressed teenage boys – whatever the issues - often attempt to overcome problems themselves, which, of course, doesn’t work. Counseling is always the best option for depressed teenagers. For parents, teachers, friends, or caregivers, noticing the signs of depression is imperative for helping today’s depressed teenage boys.
Signs of Depression in Boys
Several signs point toward young male depression. Many of these signs coincide with normal teenage emotional, social, and intellectual changes, such as mood swings. In fact, most parents expect their teens to experience mood swings as they deal with the pressures of school, socializing, and often, family issues such as divorce or a parent’s illness. Often, however, mood swings appear for a short time when problems surface, disappearing quickly when problems seem less extreme or even resolve.
On the other hand, clinical depression is most likely present in a teenager when these signs persist for longer than two weeks, according to Harvard Health Publications of the Harvard Medical School. Clinical depression also affects the teenager’s ability to function at normal activities on a daily basis.
In addition to the duration of depressive symptoms, Harvard Health recommends that those in close contact with the teenager should notice the severity of symptoms, and, the affect of the symptoms across all key areas of the teenager’s life: family, friends, and school.
For example, pulling away from family members is a normal part of adolescence as teenage boys attempt to differentiate themselves from their parents. But depressed teens who feel they do not connect with parents at all might begin to spend much more of their time with friends, especially if these friends experiment with alcohol, drugs, sex, and partying in an attempt to escape depression.
Teens joining a more wild group of friends are attempting to distract themselves from emotional turmoil by turning to drugs and alcohol. Parents of teens experimenting with drugs need to ask their teens about any problems in their lives. Unfortunately, because teenage boys are taught to mask their feelings, they often react to their parents' line of questioning in incendiary ways. Parents who question their child’s mood might face open hostility or anger as the teen attempts to find a way to express depressive emotions without showing sadness.
In addition to changes in a teen’s interactions with family members and a change in friends, academics is another area that will show changes resulting from depression. Grades often begin to suffer, but also anger at school also signals a problem. Many boys exhibit anger through teenage years, but when anger is persistent, expressed through violent acts such as fighting in school, or being aggressive toward family members, it is a clear sign that the teen is struggling, and depression might be an issue.
Withdrawal from Life
Not all depressed boys turn to their friends, anger, or drugs to escape depression, however.
Some depressed boys recede into solitude, unwilling to interact with anyone - friends or family members. Boys who act tired, bored, and stop showing interest in activities they previously took pleasure in most likely feel conflicted or depressed about something in their lives. They spend large amounts of time alone, often in their rooms, not bathing or getting dressed on weekends.
It might appear that they are simply introverted, or spend a large amount of time sleeping, but in reality, they lie awake at night, worrying about the situation causing their depression.
For example, consider a 17-year-old boy who experienced a breakup nearly a month ago. The boy has essentially barricaded himself in his room, away from friends and family. He spends most of his time alone, listening to loud music. To make himself feel better, he relieves stress and tension by yelling, playing videogames, eating, and watching TV. The boy's parents have tried talking to him about the situation, but he refuses to talk with them, participate in activities with friends, leave his room when at home, and dreads going to school each day.
Additionally, the boy lies awake each night, unable to sleep as the memory of his past relationship races through his mind. His lack of rest and fatigue have severely begun to affect his academic standing, and his parents are becoming worried.
In this situation, the boy's parents understand that the boy's feelings of distress stem from a breakup, but his grief has affected him too long, and is affecting his social and academic life. At this point, the teen's parents seek the services of a counselor who knows how to apply therapeutic interventions to help the teenager.
Risks of Untreated Depression
When depression remains untreated, it often leads to severe consequences, such as when teens end their own lives. According to statistics from the U.S. Centers for Disease Control and Prevention, suicide is the third leading cause of death for 15 to 25 year olds. Teenage girls are more likely to attempt suicide, but boys are almost four times as likely to die from suicide than girls.
Certain teenagers are more at risk for suicide, including:
- Teenagers facing relationship difficulties
- Teenagers with substance abuse problems
- Teenagers with clinical depression
- Teenagers with a past of sexual or physical abuse
- Teenagers with feelings of hopelessness
- Teenagers with poor peer relationships
- Teenagers who are gay
Parents, teachers, and counselors need to look for warning signs of suicide in teenage boys. Any mention of suicide from the teen must be taken seriously. If a teen exhibits an interest in death or suicide, parents should seek professional counseling help.
If a teen is at serious risk for suicide, help can be contacted at (800) SUICIDE or (800) 999-9999.
Teenage depression in boys is unfortunately overlooked by many in society. Luckily, counselors and psychologists that specialize in diagnosing and treating these unique concerns are available to help.
If you're interesting in counseling depressed teens, contact schools offering degree programs in Mental Health counseling.
Treating Depression in Adolescents
Given the tornado of emotions, hormones, and stressful events teenagers experience, it's no wonder most teens feel at a loss when tackling their depression. But luckily, professionals specializing in the emotional care of adolescents are available to guide teens through the depression recovery process.
When depression is pervasive and ongoing, professional help from psychotherapy is necessary. In addition, doctors might consider prescribing antidepressant medications.
The National Institute on Mental Health (NIMH) examined the effectiveness of cognitive behavioral therapy (CBT) and antidepressants on teenagers in the Treatment for Adolescents with Depression Study.
The study assigned adolescents to four groups: a group that received only Prozac; a group that received Prozac plus CBT; a group that only received CBT; and a group given placebo pills.
At the end of the 36-week trial, 86% of the teens receiving a combination of CBT and Prozac showed improvement, while the groups that received either Prozac only or CBT showed 81% improvement. The adolescents who took the placebo pills showed only a 35% improvement rate.
The results indicate that combined therapy and antidepressant treatment could lead to the best outcome for treating teens suffering from major depression.
But researchers and doctors also warn against antidepressant use for some teenagers. In 2004, the U.S. Food and Drug Administration (FDA) issued warnings about increased suicide risk for teenagers diagnosed with a major depressive disorder. The FDA reviewed 2,200 adolescents treated with antidepressants, and found that 4% of those taking medication experienced suicidal behavior, twice as many as adolescents who took placebo pills.
Other researchers maintain the effectiveness of antidepressants for adolescents outweighs the potential negatives. Doctors, parents, and teachers should closely monitor adolescents prescribed antidepressants, noting any behaviors or talk that suggest suicidal thoughts or tendencies.