The Prevalence and Symptoms of Major Depression

Usually sanguine, sixteen-year-old Chad started locking himself in his room more often, texting and calling his friends far less frequently, and attending fewer school and church social functions.

He’s sleeping more, even napping during the day for the first time in years. His recent report card revealed at least a letter-grade drop in every subject but one. He’s prone to snap at his younger siblings, and vents hostility toward his parents that’s exaggerated for the occasion. Even one of Chad’s teachers told his mom, “He isn’t the same boy who started the year in my class. It’s as if he doesn’t care anymore.”

If they could see inside him, they’d realize that not even Chad grasps what’s happening. He can’t point to a precipitating circumstance for the downward spiral in his mood. He can’t explain why he’s often sad, or why he wrote a poem about dying last week (which no one else has read).

Depression Among Young People

If 35-40 middle and high school kids attend your church, two or three probably identify with Chad’s depression, though not all depressed persons exhibit the same precise symptoms. Various studies show that anywhere from 3.2% to 8.9 % of adolescents experience moderate-to-severe depression at any given point in time.

The most tragic response to depression among teens is suicide. According to the U. S. Center for Disease Control and the National Institute for Mental Health (2016), about 4,600 persons age 10-24 kill themselves each year. Among teens, unsuccessful suicide attempts hover near 575,000 annually. It’s imperative that Chad’s parents get him a medical and psychological evaluation immediately. The choice isn’t his—it’s theirs.

The more of the following characteristics a teen displays, the more likely he or she qualifies for a diagnosis of major depression.

Frequent sadness, weeping
Hopelessness
Decreased interest in favorite activities
Persistent low energy, boredom
Social isolation
Drop in self-esteem
Extreme sensitivity to failure or rejection
Increased hostility, relationship difficulties
Drop in school performance
Major shift in eating or sleeping patterns
Thoughts of suicide or self-destructive behavior

An Adult Example

Blessings abound for Becky: three delightful school-age kids (her description); good physical health; her husband pastoring a loving, growing congregation and paying her plenty of attention, and no financial pressures.

That’s why she was surprised when a few weeks of sullen mood morphed into a full-blown depressive episode. A hard-to-put-your-finger on emptiness of spirit. A sense of despair that slowed her physical gait. Waking up more often during the night, which depleted her energy for daytime chores. Uncharacteristic irritability and pessimism. Bouts of weeping at the slightest provocation. Neglected hobbies. Her libido vanished.

Even Becky’s faith wavered. A sense of worthlessness overwhelmed her. She no longer believed God could love someone like her. Thoughts of suicide badgered her for the first time.

If 250 persons 18 and older attend your church, on average as many as 16 or 17 will, like Becky, experience a major depressive episode within a 12-month period. About 6.7% (over 16 million) adults in the U. S. have at least one major depressive episode annually.

Here’s how the Diagnostic and Statistical Manual of Mental Disorders (4th edition) defines a “major depressive episode”:

A period of two weeks or longer during which there is either depressed mood or loss of interest or
pleasure, and at least four other symptoms that reflect a change in functioning, such as problems
with sleep, eating, energy, concentration, and self-image.

Her husband’s insistence resulted in medical intervention for Becky. Within three months of taking an anti-depressant, she felt normal, cheerful. Once, she weaned herself off the medicine. But not long after, the dark mood returned.

Among adults who experience two episodes of major depression, 80% will have symptoms off and on for the remainder of their lives. Of course, medicine, therapy, as well as spiritual resources may alleviate the severity and frequency of the episodes. Also, regular exercise and reliance on close Christian friendships facilitate recovery from a depressive episode. For the past ten years, Becky has taken her medication. The few setbacks she’s had were mild compared to the debilitating symptoms prior to taking the medicine.

Words of Caution

Typically, persons diagnosed with major depression do not always feel despair. Episodes of intense emotional pain and dark mood may alternate with periods of blessing and stability. One factor that makes a depressive episode so difficult to handle is the contrast with the time of peace and equilibrium that preceded it.

Also, not everyone improves as much as Becky with medication. And sometimes, unlike Chad and Becky, a personal loss or precipitating circumstance may spawn a depressive episode. The condition is far too complex for a one-size fits-all approach, whether the issue is causation, symptoms, treatments, or the various types of depression. (In the near future I’ll interview a psychologist who’ll describe the different forms of depression.)

In future blogs I’ll delve into medical intervention and how it correlates with faith in Christ; tips for coping when counseling or medical intervention isn’t working; stories of depression-prone persons whose suffering actually enhanced rather than hindered their ministries, and biblical insights that, while not eradicating a depressive episode, offer sustenance, hope, and more “cope-ability” when the darkness descends.

My next post will introduce you to a book that blends raw honesty in reaction to trials with a rock-solid theology of suffering. Since depression is one form of affliction, you’ll discover why I heartily recommend Vaneetha Risner’s The Scars That Have Shaped Me.

Until then…

“The Lord’s lovingkindnesses indeed never cease, for His compassions never fail. They are new every morning; great is Thy faithfulness” (Lamentations 3:22-23).