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Dr. Grauer's Column - HappySadMadGlad

Parent-Teacher Guide to Depression

For Dr. Grauer's readers who are fans of podcasts, you can click on this link to listen to this column read by Dr. Grauer: "HappySadMadGlad" Podcast

It is one of the coldest and rainiest years in memory here in San Diego. At home at The Grauer School, fireplace going full-logged, we are deep into another year, the pre-spring time we sometimes, behind the scenes, call the doldrums, rife with the changes and challenges teens and their families and teachers face.

Through them all, I believe that the adolescent years can and should be a fundamentally joyful and empowered time to look back upon. An abiding belief in our basic goodness causes me to be on the lookout for anything that might prevent this joy and empowerment. The preventers are many: academic pressures, unrealistic parent and social expectations, anxiety (increasingly from social media pressure), legitimate failures, and many more, including serious depression. Today, depression rates are high, far higher than we could ever get outside of this advanced civilization we have created or in some state of nature.

Teaching is the study of the student. On campus, there are a variety of emotions and behaviors I look for as an educator engaged in the study of my students. As the title of this post suggests, there often exist unique combinations of these emotions and behaviors. Both on campus and off, professionally and personally, depression is among the most important conditions I have consistently studied through life. While in the company of teens and their teachers and parents, I have learned to notice and rely upon certain indicators of depression.

Grauer junior Zoé-Daphnée L. '20 led a fundraising campaign to sell Candy Grams for Valentine's Day, raising $500 for the National Suicide Prevention Lifeline - February 13, 2019 

None of these things I notice mean that any child—your child or a child you know and observe—has depression, and this is a critical point. They are merely indicators that depression could be an important condition to have a professional rule out. Nor do I blame any young person, or any person, for suffering from time to time despite our best efforts to create a compassionate environment here at our school, a school outside of the bounds of many of today’s afflictions, some of which seem institutionalized and even celebrated in our prevailing culture of excess and ego. 

If you’d like to learn about the three indicators I have found to be the most helpful of all, read on:

1. Incongruent self-concept: When a young person clearly has grown to perceive him/herself differently than his/her peers and teachers, that person is normally unhappy. I think persistent unhappiness warrants looking into, regardless of any causes we can attribute to it or blame we can assign to it. At The Grauer School, because teachers evaluate students on their exhibition of our core values and students also self-evaluate, we have been able to track discrepancies in teacher- and self-concept of the student every year since founding. I have seen an enormous amount of data comparing teacher and student perceptions, and I don’t think I can ever recall a time when following up on a discrepancy between the two wasn’t useful. I believe we have saved lives in this way. 

2. Victimhood: Healthy people take any reasonable responsibility for their failures, inabilities, set-backs, moods, self-concept and functionality. When I see a child, as a pattern, blaming others for a variety of issues that I know teens often go through, I might “refer.” Happy, high-functioning people have a fundamentally internal locus of control, i.e., they feel reasonably in charge of their own happiness (and life direction). They have a voice. Our emeritus teacher Dr. Edith Eger kept dancing as long as she had the strength even while in a Nazi concentration camp: she never succumbed to depression and always focused on prevailing. Happy and functioning people have a growth mindset. They don’t give others too much power over their peace of mind or functionality, and so they do not habitually blame others. When I see parents and friends participating in this blaming, and establishing a substantial pattern of blame, I really worry—they are feeding the victimhood. Parents who participate in the blaming often see their participation as a form of empathy or sympathy, but in reality it is bad news. They are saying to their teen: You don’t have what it takes to solve your own problems. Since a fundamental job of teens is coming of age and establishing independence, this can be a harmful message that feeds depression.

3. Functionality (maybe the simplest, and maybe the most important): Functionality is an indicator of depression I have discussed many times with mental health professionals, and it is probably the simplest of them all. If a person is “not functioning” (and they are able-bodied), they can be defined as depressed. Functioning people “make it happen.” Think you “need” to miss school? Lou Gehrig of the New York Yankees played in 2,130 consecutive games, a record that stood for 56 years. Maybe that’s not a perfect example, but I loved citing Gehrig as an example to my daughter years ago when she suggested she might skip school! He kept his spirits up even when he got Lou Gehrig’s disease. If—over a substantial enough amount of time to establish a pattern—a teen is blameful, erratic, moping, needy, over-sleeping, missing or late to school, dropping plans or responsibilities, withdrawing, or failing to do things you had routinely relied upon them to do, they are not functioning as well as I’d like to see. I’d refer. (This reminds me of why exercise can be a great antidote to depression—it seems axiomatic that active people are less likely to be depressed than inactive people—check out the research on the body’s production of endorphins to learn more on this and how exercise changes the brain [1]; and check out the impact wilderness and nature have on teens, and on all of us, as well.)

For me, those are my three most important indicators that could trigger a referral to rule out depression: incongruent self-concept, victimhood, and functionality. I hope they will help make even one more person have a better chance at happiness. They could be associated with drug use, talk of or attempts at suicide, persistent family issues, or serious aggression. Maybe your child is behaving erratically and in new ways and it is showing up in any of the above big three ways. The indicators are not depression, they just could be symptoms. These indicators have helped me enormously over the years.

Students reaching the high school age and consciousness can experience a swirl of ideas, conflicts, and self-doubts that can trigger deep, searching thought. For middle schoolers, this all can be harder in one special sense: middle schoolers often lack the intellectual development, vocabulary, and emotional experience to access or process what they are going through. This can be harder still if we, as helpers, parents, and teachers fail to remember their innocence, an innocence that seems unreachable—these kids go deep, and for some of them life is painful and lonely for inexpressible reasons. Watching this pain, for some of us, can be anxiety-provoking and frustrating, and we must express calm and love, reassurance and patience. Not just for them, but for ourselves. We too were in 8th grade, some of us lost, and others not even up to that.

Suffering students, parents or teachers sometimes shed light on the school, too. The reflective, compassionate organization is always learning and softening when one among us suffers. Great teaching is therapeutic, but the leaders know the difference between therapy and teaching and we know when to express it.

Grauer Theatre students on their way to see the play "Familiar" at the Old Globe Theatre in Balboa Park - February 27, 2019

I don’t make referrals when I see these things happen now and then in any child, though if they happen now and then they might trigger some disciplinary intervention, pep talks, school course load adjustments, or encouragement. A great school team such as The Grauer School’s student support team is normally making interventions like this routinely. A lot of times, all it takes is the faith that tomorrow’s going to be a better day. Maybe even a few laps around the field. At school, before alarming someone, we only consider a referral to a professional such as a family physician, a psychologist, or a psychiatrist if we see a persistent pattern of behaviors.

Making a referral can be risky business. Sometimes when I suggest ruling out depression, parents become angry with me, or blameful. Once a parent said to me, “Where do you get off! Do you have a degree in psychology?” And I’ve heard worse said about me when I suggest depression might be an issue. I understand that reactions like this are just pain and fear prevailing over real help, and that they are age-old reactions. Once you set out on the path of blame, there’s enough of it to find under almost every rock and log. These reactions make things worse, of course, and they call for all the compassion I can find. The blaming parent will trash us in the parking lot, too, especially when they have already blamed or condemned some of the child’s teachers. I say: “Onward!” Doing good work is all I know. And talking to a psychologist is not a stigma—all it is is talking to a really smart and insightful person.

Another reason people might not see the need for a referral is that sometimes a teen is functioning academically, but shutting down emotionally, socially, or physically. All sorts of intelligences go into functionality. You can be happysadmadglad, but your parents might just think you are golden because of those straight A’s. 

So, dear reader, I hope my big three will be helpful—and that you never need them, though most of us will. As educators, making referrals when we see clear patterns is the only ethical option we have—especially considering the alternative, i.e., ignoring behaviors which are causing the unhappiness or even harm to a child or those around them.

In sum, teen depression causes a persistent feeling of sadness and loss of interest in activities. Symptoms of depression may include sadness, feeling negative and worthless, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, loss of interest in normal activities, and avoidance of social interaction. Our culture over-domesticates its kids in standards, rows and relentless media, and depression is on the increase.

If your child does indeed suffer from depression, they are hardly alone, and it is not necessarily a terrible, threatening, or permanent situation. There are many treatments, prognoses, and positive outcomes. In my twenties, while depression cast shadows over my own life, I discovered these words in The Prophet by Khalil Gibran:

... And the selfsame well from which your laughter rises was oftentimes filled with your tears. And how else can it be? The deeper that sorrow carves into your being, the more joy you can contain.

Through the passages and seasons, this insight has remained profound, precious, and present for me as I have attempted to navigate some of life’s gravest challenges alongside those closest to me, and those teens, families, and teachers I am committed to serving. Before we know it, it will be spring. I wish you courage and joy.

[1] The Exercise Drug for Depression, PsychCentral, Therese J. Borchard, July 8, 2018.

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