Is My Teen Defining Herself by her “Depression”?

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The following transcript has been automatically generated by an AI system and should be used for informational purposes only. We cannot guarantee the accuracy, completeness, or timeliness of the information provided.

Reena Ninan:
I’m seeing more and more girls build their identity around mental health labels.

Dr. Lisa Damour:
TikTok mental health has seeped in very, very powerfully. Teenagers use diagnostic language very, very liberally and not always accurately.

Reena Ninan:
So how do you have these conversations if they believe strongly. They’ve seen it on TikTok, but mom and dad just don’t get it?

Dr. Lisa Damour:
Adults are making a mess of this right now. Adults constantly conflate distress and a mental health concern.

Reena Ninan:
What’s the difference between depression and sadness?

Dr. Lisa Damour:
This is really important.

Reena Ninan:
It’s full pumpkin spice season, officially. Are you a pumpkin spice lover?

Dr. Lisa Damour:
I’m pumpkin spice agnostic, Reena.

Reena Ninan:
Really? Wow.

Dr. Lisa Damour:
I don’t have strong feelings either way though. Though, my older daughter is the queen of pumpkin spice, and I will tell you it is a very nice thing to have a college kid who’s the queen of pumpkin spice because I can put together a pumpkin spice care package and send it to her. It’s not always easy to know what to send your college kid, but that is always a home run.

Reena Ninan:
She likes everything pumpkin spice like pastries and?

Dr. Lisa Damour:
Anything. I mean soap, like air spray stuff that actually I find kind of gross. She’ll take it. She likes it.

Reena Ninan:
That’s interesting.

Dr. Lisa Damour:
How about you? Are you a pumpkin spice hater?

Reena Ninan:
I feel like the pumpkin spice moment has passed us three years ago. Why are we still doing this?

Dr. Lisa Damour:
I don’t know.

Reena Ninan:
People are into it, but what I do love is it means fall is officially here.

Dr. Lisa Damour:
Which is my very favorite season. Very favorite of all.

Reena Ninan:
Yeah. I love this season. I love this moment, but you realize that it’s also a time when sometimes kids can be struggling with things that might pop up as you’re further into the school year. So I’m going to read you this letter.
Dear Dr. Lisa, I’m a mom of three teens and I’m also a therapist who works with teenage girls. What’s your wisdom on how to navigate honoring the perspective of a teenage girl who believes that she is “depressed” or is “having anxiety” without reinforcing those labels around these diagnosis, especially when they’re at such an important age when it comes to identity development? I’m seeing more and more girls build their identity around mental health labels and also encouraging others to do so. I have a good working relationship with my youngest daughter who has what appears to be typical ups and downs during these years, but really wants to identify as someone who has “depression”. I try to validate the feelings and the challenges and not to focus as much on the label, but I can tell it bugs her that I’m not wholeheartedly agreeing with her that she has depression. Would love your thoughts. Thank you.
There’s a lot here.
First off, I want to ask you, is this common? Are you seeing this a lot among teens and teen girl or even boys that they feel like they’ve got this “depression” or “anxiety” label and they’re defining their life by that?

Dr. Lisa Damour:
It’s more common than it used to be, but it’s also not new, and I think that’s important. I think sometimes when stuff is happening with teenagers, we’re like, “Look at this weird thing they’re doing now. Where did this come from?”

Reena Ninan:
Yes.

Dr. Lisa Damour:
I can tell you the entire time I have been a practicing clinician and done school consultation and things like that. I have had kids come my way and they’re like, “I have depression.” And then they go on to describe what’s happening and I’m like, “You’re sad. This is not a diagnosis. You’re sad and you have every right to be sad, but good news, this doesn’t meet the criteria for depression.” And I think we should unpack actually how you have that conversation because this is really part of what’s on this person’s mind.
It is more common, though. We are seeing it more. I think a lot of it is inspired by conversations that are happening in online environments.
I think TikTok mental health has seeped in very, very powerfully to kids’ discourse and we’re seeing kids, teenagers, but I will also say adults use diagnostic language very, very liberally in a very elastic way and not always accurately. So we’re seeing it. We’re seeing it more, but it is not brand new.

Reena Ninan:
I want to step back for a second. What’s the difference between depression and sadness?

Dr. Lisa Damour:
This is really important and I actually think it’s a great question because we want to be able to have these conversations with our kids, especially if they’re throwing around a term like depression and we don’t think they’re depressed. Sadness is about something. You are sad because your dog died. You are sad because you didn’t get the place on the team that you wanted. In depression, part of what is often true is that you can’t actually point to the source of your sadness. You feel low and down, but it’s sort of a generic broad, like the whole sky is cloudy as opposed to this cloud has covered by sun.
Sadness comes and goes when people are sad, it’s not a persistent feeling, whereas depression, again, it’s like clouds that move in and cover the sun and they don’t move away. In sadness what we find, and this for me is often how I’ll make the diagnosis in my office, is if a person’s sad and then something fun happens, like their best friend calls and they go to a movie, the sadness eases.
They feel better for a little while, and in depression, one of the really cardinal signs of depression, and if I hear this in my office, I will be much more inclined to give the diagnosis is if a person says, it used to be that if my friend called and we went to a movie that helped me feel better, but now even that doesn’t feel fun. That to me is really a red flag.
Okay, depression has all this other stuff, depression can, and not every one of these shows up and has to show up to make the diagnosis. It can mess with your sleep. It can mess with your appetite. It can start to turn the corner into difficulty concentrating. It can involve feeling nothing, right? It’s not necessarily sad. It can involve feeling blank. It gets really scary when it starts to involve feelings of hopelessness or helplessness, right? That’s when we worry that a person might hurt themselves in some way. So depression is real and there are kids who say, I am suffering from depression, who in fact are probably getting it right, but it is really helpful to have a good sense of the distinction between sadness and depression so that if a kid’s bringing it up, we can ask some more questions and there’s a good chance we can say, well, “I think you’re sad and you have every right to be sad, but based on what I know about depression, and we can look it up online, good news is I don’t think you have that diagnosis.”

Reena Ninan:
This teen feels a little bit annoyed with mom that she’s not taking this seriously. So how do you have these conversations if they believe strongly, they’ve seen it on TikTok, they’ve checked off all of the boxes for this, but mom and dad just don’t get it. “I have this.” How do you have that conversation?

Dr. Lisa Damour:
That really is right. The meat of this, right, which is, okay, I can bring my tidy, oh, here’s anxiety, here’s sadness, here’s depression. Not to worry, reassure the child. There is something else and you are right on it that is going on in this, which is the kid is like, “You are not listening to me. My friends all see that I am depressed. Why are you being so dismissive?” The facts may not actually matter all that much to the kid in this moment. What they are asking for is validation around this belief that they suffer from a diagnosis, so you’re going to have to tackle that head on. So my belief always right, you play your card’s face up, you address the problem in front of you. So I think there may be a way that a parent in this position could say, “I really hear you, that you feel that you are suffering from depression based on everything you’re telling me, everything you’re observing, everything. I’m checking on reputable sources. I don’t think you are. If I thought you were, I would get you to a clinician yesterday. I really take seriously what you are saying, but there’s no reason for us based on what you’re telling me to think that that is the case, but I hear you that that feels dismissive. Talk to me about what I’m getting wrong or if there is something I am missing here.”
So trying to move it more to, “Here’s where we’re having a disconnect and I’m interested in the disconnect.” I think that may be a place to go with a kid who’s pretty insistent on this. What do you think? Would that work for you?

Reena Ninan:
Yeah, no, I can see how that can get you into the conversation. I’m also curious, Lisa, about what’s going on here, Exactly?

Dr. Lisa Damour:
Yeah. A couple times in this letter, the word identity comes up. And also it comes up around peers, and this is a clinician who’s seeing this with lots of kids. And Reena, I will say, and I feel like I saw more of this in the pandemic though it wasn’t the first of it. Kids are looking for connection. Kids are looking for belonging. Kids are looking for something that makes them like their peers. It is absolutely happening that there are kids who are coming together around, we all suffer from a mental health diagnosis. Now, I’m not saying none of those kids do, but there’s an interesting peer dynamic that is cropping up that I don’t think you and I grew up with. I think in a bad way, mental health diagnoses were all entirely stigmatized when we were growing up, and so if you were suffering, you didn’t talk about it.

Reena Ninan:
That’s right. That’s right.

Dr. Lisa Damour:
I think we’re now in this murky place where there are kids who are suffering from a diagnosis and hopefully getting help so that they can move through and past it who are able to talk about it openly. That is absolutely an improvement. And then I think that is also getting mixed up with kids who may be feeling like they’re not sure how they fit in or where to fit in, and so then starting to talk about themselves in that way. However, inaccurately becomes a way to start to feel connected to peers.

Reena Ninan:
Now it’s sort of out in the open and people are using it almost to bond. Is that where this is coming from? It’s like a bonding experience, like, “I’m on the soccer team.” “Well, I have depression” and this is what, and then other people talk about. I’m just curious about how this all got started.

Dr. Lisa Damour:
I don’t know how it got started, Reena. I really don’t. I mean, I will say, and now I keep referencing the pandemic. I felt like I saw in the pandemic when kids weren’t actually able to do all the things they usually do. Like, “Hey, we’re on the soccer team together. Hey, we’re in our club together.” That I think that that may have actually sparked more of this, “Hey, we suffer together in these same ways.”
That may have been a thing, but we’re still seeing it and maybe I think seeing it less than we did in the pandemic, but we’re still seeing it. I’m never inclined to lay a problem at the feet of teenagers. I’m never inclined to say, “they started this. It’s all their fault.” And fault doesn’t really come into this. I will say kids exist in the universe that we’ve created as adults for them, we are shaping the environment around them. Adults are making a mess of this right now. Adults are constantly, I’m watching newspapers constantly conflate distress and a mental health concern all the time. When I’m looking at headlines about adolescent mental health crisis, I then read down the article and I’m like, no, they’re talking about adolescent distress, which is also important, but is not the same as a mental health concern. I think we have to really, really be mindful of adults. You’re asking, where’s this coming from? Okay, well, these kids are growing up in a soup where the adults around them are saying, “I feel low. Oh my gosh, do I have depression?” Right? This is much more common, or we’re talking these days and you and I are thinking these days all the time about what it’s like to be. You’re in perimenopause. I am well into menopause. Our moods are all over the place, right?

Reena Ninan:
Yes, very true. Feel it.

Dr. Lisa Damour:
And I think sometimes it’s a hormonal effect and probably sometimes it’s not, but they’re watching the adults around them be like, “Oh, it’s this. Oh, it’s diagnostic.” Sometimes true, maybe sometimes not, but we do that way more than we ever used to, the adults and the kids alike.

Reena Ninan:
So when you’re in this situation, your child feels like they’ve got this medical condition, maybe you do have a diagnosis, maybe you don’t. How do you still maintain rapport? I guess what I’m asking is how do you react to it trying to stay neutral, even though you might be enraged inside, “This is not what you have,” or maybe it is, but they’re just taking it to an extreme. What’s your advice to parents?

Dr. Lisa Damour:
I’m actually thinking about something Christopher Pepper said in our conversation about “Talk to Your Boys” where he was saying, get curious. Get curious.
A kid who’s saying, I’ve got depression, why don’t you take my depression seriously? They’re trying to tell you something about how they feel. That’s really what’s at heart here. So I think the right thing to do is say, “Tell me about it. What is making you feel this way? What is making you think this?” Really ask where it’s coming from and maybe do a little research in advance, but they’re feeling something. They wouldn’t be using these terms if they didn’t have some distress that they were trying to communicate. So get really, really, really interested in that. I also think there’s an outside chance you’ll be like, whoa, the kid’s, right? We actually have missed this. So I would leave that possibility open in your own mind. My hunch is if a teenager feels that you are actually super curious about what is the experience that is causing you to come to this term, the term itself may fall away. What they’re trying to get is investment in something that is uncomfortable for them. And if you do that, now you’re having a conversation, now you’re back in relationship with your kid, now you’re taking seriously whatever their distress is, even if it is garden variety, adolescent distress, they’re still trying to connect with you about it.

Reena Ninan:
What would be ultimately your final thoughts on stepping back for a second and the approach that parents should take if you find yourself in this situation?

Dr. Lisa Damour:
This word identity, I keep getting coming back to it. I think that really that is, I mean, am totally with this clinician that is the worry, and that’s always been my worry as a clinician. When a kid comes in, I have anxiety and they describe it like a factory setting, and I’m thinking, are you kidding? We can treat the pants off of anxiety. It’s not fun, but we can work with it. And it is worrisome when you start to feel like a kid is changing their lives and making decisions based on a diagnosis that even if it’s true, is treatable. So for me, I think the big thing is if there’s an identity question starting to come up like, oh, I identify, “my story, my story is that I have depression.” I would really try to understand where their kid is coming from in terms of why they feel that way.
And then I would also take very, very seriously if you see it going down the identity road, what else can they be all about? Is there a club that they could join? Is there a service project they could be doing? Is there a sport? I am absolutely obsessed right now with my kids’ sports. I have a ninth grader who’s running cross country, and one of the things I love about our schools, things are pretty low key. Nobody gets cut. You don’t have to be fast. So are there environments like that where your kid can participate if they’re not super talented in the thing and have a good time? If it’s going down the identity road, I would be looking for something else for that kid to identify with.

Reena Ninan:
I never thought of this until I read this letter that this would be an issue. And it’s also good for parents whose kids aren’t struggling with this to sort of understand a little bit more about the situation. What do you have first, Lisa, for Parenting to Go?

Dr. Lisa Damour:
Here’s something I think we can never miss an opportunity to say, if your kid is coming to you saying, “I’m depressed. I’m depressed.” Whether you believe them or not, I think that’s a really important time to say, okay, let’s look into this. “Let’s think about this together. Have you had any thoughts of hurting yourself or ending your life?” You need to ask that question. If a kid’s telling you they’re depressed, that is the question you need to ask because you need to get an answer to that question. And kids can be suicidal without being depressed. So even if you disagree with the depression, you may discover your child’s suicidal, and that is something you of course need to know. If a kid says, I have thought about it, then you say, alright, you stay here right by me. We’re going to call your pediatrician. We’re going to find out next steps. You figure out whatever it is you need to do to make sure that child is safe. It may be an emergency, it may not be an emergency, but you don’t need to be the one to make that call. I think that’s important. I think we can be quick to be like, “Oh, you’re fine,” and they may be fine, but if they’re opening the door with a word like depression, you’re going to want to walk through that door and double check to make sure that they are safe.

Reena Ninan:
So this isn’t one that you just sort of, let’s see how they feel in the morning and call the doctor.

Dr. Lisa Damour:
You do, and we know Reena, that asking does not make kids suicidal. That is always the worry that people have. We know from the data, you will not make your child suicidal by asking if they’re thinking about suicide. They’re going to be glad you asked. We know that too, so don’t miss a chance to ask this question.

Reena Ninan:
It’s really important. It’s really important as a parent, you do feel like you’re opening the door of something they might not be aware of, but what you’re saying is that research doesn’t show that.

Dr. Lisa Damour:
Nope, it does not.

Reena Ninan:
Well, Lisa, thank you for this conversation. It’s deep and it’s wide, and there are things that I think a lot of parents can still walk away whether your child is going through this or not, a lot of stuff in this episode today. Thank you.
I’ll see you next week.

Dr. Lisa Damour:
I’ll see you next week.