Depression and high school students FAQ-NIMH

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Answers to students’ frequently asked questions about depression.

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Depression can occur during adolescence, a time of great personal change. You may be facing changes in where you go to school, your friends, your after-school activities, as well as in relationships with your family members. You may have different feelings about the type of person you want to be, your future plans, and may be making decisions for the first time in your life.

Many students don’t know where to go for mental health treatment or believe that treatment won’t help. Others don’t get help because they think depression symptoms are just part of the typical stresses of school or being a teen. Some students worry what other people will think if they seek mental health care.

This fact sheet addresses common questions about depression and how it can affect high school students.

A. Depression is a common but serious mental illness typically marked by sad or anxious feelings. Most students occasionally feel sad or anxious, but these emotions usually pass quickly—within a couple of days. Untreated depression lasts for a long time and interferes with your day-to-day activities.

A. Different people experience different symptoms of depression. If you are depressed, you may feel:

SadAnxiousEmptyHopelessGuiltyWorthlessHelplessIrritableRestless.

You may also experience one or more of the following symptoms:

Loss of interest in activities you used to enjoyLack of energyProblems concentrating, remembering information, or making decisionsProblems falling sleep, staying asleep, or sleeping too muchLoss of appetite or eating too muchThoughts of suicide or suicide attemptsAches, pains, headaches, cramps, or digestive problems that do not go away.

Depression in adolescence frequently co–occurs with other disorders such as anxiety, disruptive behavior, eating disorders or substance abuse. It can also lead to increased risk for suicide.

A. Yes. The most common depressive disorders are:

Major depressive disorder, also called major depression. The symptoms of major depression are disabling and interfere with everyday activities such as studying, eating, and sleeping. People with this disorder may have only one episode of major depression in their lifetimes. But more often, depression comes back repeatedly.Dysthymic disorder, also called dysthymia. Dysthymia is mild, chronic depression. The symptoms of dysthymia last for a long time—two years or more. Dysthymia is less severe than major depression, but it can still interfere with everyday activities. People with dysthymia may also experience one or more episodes of major depression during their lifetimes.

Other types of depression include:

Psychotic depression—severe depression accompanied by some form of psychosis, such as hallucinations and delusionsSeasonal affective disorder—depression that begins during the winter months and lifts during spring and summer.

A. Depression does not have a single cause. Several factors can lead to depression. Some people carry genes that increase their risk of depression. But not all people with depression have these genes, and not all people with these genes have depression. Environment—your surroundings and life experiences—also affects your risk for depression. Any stressful situation may trigger depression. And high school students encounter a number of stressful situations!

A. The first step is to talk with your parents or a trusted adult who can help you make an appointment to speak with a doctor or mental health care provider. Some school counselors may also be able to help you find appropriate care.

The doctor or mental health care provider can do an exam to help determine if you have depression or if you have another health or mental health problem. Some medical conditions or medications can produce symptoms similar to depression.

The doctor or mental health care provider will ask you about:

Your symptomsYour history of depressionYour family’s history of depressionYour medical historyAlcohol or drug useAny thoughts of death or suicide.

A. A number of very effective treatments for depression are available. The most common treatments are antidepressants and psychotherapy. An NIMH–funded clinical trial of 439 teens with major depression found that a combination of medication and psychotherapy was the most effective treatment option.1 A doctor or mental health care provider can help you find the treatment that’s right for you.

A. Antidepressants work on brain chemicals called neurotransmitters, especially serotonin and norepinephrine. Other antidepressants work on the neurotransmitter dopamine. Scientists have found that these particular chemicals are involved in regulating mood, but they are unsure of the exact ways that they work.

A. You will need to take regular doses of antidepressants for four to six weeks before you feel the full effect of these medicines. Some people need to take antidepressants for a short time. If your depression is long lasting or comes back again and again, you may need to take antidepressants longer.

A. Psychotherapy involves talking with a mental health care professional to treat a mental illness. Types of psychotherapy often used to treat depression include:

Cognitive-behavioral therapy (CBT), which helps people change negative styles of thinking and behavior that may contribute to depressionInterpersonal therapy (IPT), which helps people understand and work through troubled personal relationships that may cause or worsen depression.

Depending on the type and severity of your depression, a mental health professional may recommend short-term therapy, lasting 10 to 20 weeks, or longer-term therapy.

A. If you have depression, you may feel exhausted, helpless, and hopeless. But it is important to realize that these feelings are part of the depression and do not reflect your real circumstances. Treatment can help you feel better.

To help yourself feel better:

Engage in mild physical activity or exerciseParticipate in activities that you used to enjoyBreak up large projects into smaller tasks and do what you canSpend time with or call your friends and familyExpect your mood to improve gradually with treatmentRemember that positive thinking will replace negative thoughts as your depression responds to treatment.

A. If you think a friend may have depression, you can help him or her get diagnosed and treated. Make sure he or she talks to an adult and gets evaluated by a doctor or mental health provider. If your friend seems unable or unwilling to seek help, offer to go with him or her and tell your friend that his or her health and safety is important to you.

Encourage your friend to stay in treatment or seek a different treatment if he or she does not begin to feel better after six to eight weeks.

You can also:

Offer emotional support, understanding, patience, and encouragementTalk to your friend, not necessarily about depression, and listen carefullyNever discount the feelings your friend expresses, but point out realities and offer hopeNever ignore comments about suicideReport comments about suicide to your friend’s parents, therapist or doctorInvite your friend out for walks, outings, and other activities—keep trying if your friend declines, but don’t push him or her to take on too much too soonRemind your friend that with time and treatment, the depression will lift.

A. If you are thinking about harming yourself or having thoughts of suicide, or if you know someone who is, seek help right away.

Call your doctor or mental health care provider.Call 911 or go to a hospital emergency room to get immediate help, or ask a friend or family member to help you do these things.Call your campus suicide or crisis hotline.Call the National Suicide Prevention Lifeline’s toll-free, 24-hour hotline at 1-800-273-TALK (1-800-273-8255) or TTY: 1-800-799-4TTY (1-800-799-4889) to talk to a trained counselor.If you are in crisis, make sure you are not left alone.If someone else is in crisis, make sure he or she is not left alone.

A. Researchers are studying new ways to diagnose and treat depression in high school age students. Increasing the early detection and treatment of depression can help more students succeed academically and achieve their goals in school and after graduation.

The National Institute of Mental Health (NIMH) sponsors research on the causes, diagnosis, and treatment of depression, including studies focused on adolescents and young adults. Two large scale clinical trials focusing on depression in this population are:

1 March J, Silva S, Petrycki S, Curry J, Wells K, Fairbank J, Burns B, Domino M, McNulty S, Vitiello B, Severe J. Treatment for Adolescents with Depression Study (TADS) team. Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents with Depression Study (TADS) randomized controlled trial. Journal of the American Medical Association, 2004; 292(7): 807-820.

Visit the National Library of Medicine’s MedlinePlus
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For information on clinical trials

National Library of Medicine clinical trials database

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U.S. Department of Health and Human Services
National Institutes of Health
National Institute of Mental Health
2011

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