Does my teen daughter have depression or is she just lazy?
This is such a common question for parents and frankly I believe a lot of girls question the same thing. I can't count how many times a client has told me she is "just so lazy" and we have to check out that belief to see if it's true or if it's really the depression she might be struggling with that makes her feel that way.
What is so difficult about the question of laziness vs. depression is that she can actually at times be dealing with both. However, there are a lot of misunderstandings when it comes to depression in teen girls so let's clear some of them up. Let's start with an understanding of laziness...
Laziness involves an ability to carry out an activity or task that we choose not to because of the effort involved. In my office we call it the "E" word as if it's a horrible word that no one should use! LOL. She may complete it but very slowly, on her own time, not at all or choose to do something more pleasurable instead. These behaviors are more consistent with laziness.
Laziness can become a habitual response to life tasks that she is capable of but won't do, like putting her dishes in the sink, completing her chore list, walking the dog (which she begged you for), turning in part of the assignment because she knows she can get a C and not have to do the harder part that could get her an A, etc...
Laziness is a lot more about attitude and the heart. It's a mindset of willfully choosing to cut corners or not do things simply because she doesn't feel like it in the moment. Depression is different. Often she really wants to do it but something is blocking her. It comes across as willful but in reality it truly isn't.
Girls who are depressed will often tell me how much it hurts them that they disappoint others (friends & family) when they don't follow-through or show-up. Girls who are lazy don't care. With laziness it's a selective not caring, with depression it is a generalized apathy... it's in every aspect of their life, not just chores or tasks.
We are beginning to understand depression in teen girls better and there are 2 key components that symptoms stem from biology and a negative life-view. She may be genetically predisposed to depression. Understanding family history is critical. It's time to get honest about the great aunt who would lock herself in an apartment for 3 weeks and not come out. Even if the aunt was never diagnosed with depression, there is enough information out there to make reasonable assumptions about family history at this point.
Depression can be very physical, with sleep disturbances being a hallmark sign. Insomnia or excessive sleeping are common in teen girls with depression. When you notice extremes for a few weeks, there is most likely a problem.
Complaints about aches and pains are also common. Lots of un-diagnosed physical problems often go with depression. Stomach aches, head aches, muscle tension, flu-like symptoms can all be signs.
Changes in her eating patterns are also associated with depression. Weight gain or weight loss are common. Notice if you see any pattern shifts. Has she lost weight or gained weight in a short amount of time? Know that if she has an eating disorder then she most likely has depression. They go together. You can have depression and not have an eating disorder but it is highly unlikely to have an eating disorder and not have depression.
The negative life-view is a major red flag. People who struggle with depression have a natural inclination to the negative. They selectively tune into negatives of any given scenario. It's like they have an internal negativity magnet. They have a much more difficult time finding positives. This is genuine and part of their make-up. Your daughter will not just know how to find positives. She has to learn through specific training how to adjust her thinking. It is not just going to happen. In fact, without treatment it will most likely get worse.
Girls who have experienced early life trauma, especially death or loss are more at risk for depression. These experiences impact life-view and she can begin to develop a bias towards negativity. She will be drawn to it in the world and others. Note that the loss of a relationship such as a friendship or boyfriend can trigger clinical levels of depression. Divorce is also a significant loss and can shift her life-view.
A negative self view is also a huge piece of the problem. Every teen girl runs a script in her head about herself. Girls who are depressed will typically have a script that includes one or ALL of the following beliefs...
These are specific core beliefs that she starts to believe during the teen years and often will result in depression.
Unfortunately technology and the comparison factor doesn't help with these beliefs. Girls are more likely to struggle with a negative self-view when they use social media and other platforms that generate images about their peers. They can reinforce an already distorted way of thinking... "I am a failure because I haven't won anything", "I must be worthless because I have 2 friends and she has 20". "I will never be pretty because my hair is curly and hers is so wavy and smooth".
Girls struggling with depression will begin to isolate themselves and push people away. Break-ups with friends, anger outbursts with family are all common. Her negativity can be so intense that she would rather be alone with it then subject others to it even though it's impossible not to impact others. In extreme cases the negativity can be so intense it leads to suicidal thoughts. This can be terrifying to her.
Depression will cause her to stop doing things she used to love to do. Sometimes teens will naturally make a change but in general if she loved writing poetry but now can't seem to muster the energy, it could be a sign. I often here girls say "what is the point?" The apathy can take over and she can see no value in previous activities. The negative self-view scripts can cause her to give up.
In a report published in the journal of Translational Psychiatry from the recent National Survey of Drug Use and Health, researchers discovered a significant increase in depression rates among teen girls. Approximately 36% of teen girls will struggle with clinical levels of depression and the findings show these signs begin early in the teen years.
Girls will not always recognize or tell you they are depressed. Look for the signs and start to notice patterns. If you see a significant change in any area it should cause you to pause and assess. Even changing of clothing style, music choices, etc... can be signs. Parents typically report these kind of changes in 7th or 8th grade but a change can happen at any time. Girls will often tell me they noticed a shift in mood during these years. The emotional change is so significant that she can develop depression as a result of her chemistry and life experiences.
Depression is a complex subject with too much to discuss in a single post. Next week we will talk about some practical ways to help her if you are starting to notice any of these changes. You can talk to your pediatrician if you are concerned. It's a great place to start.