Hang around some teenage girls and this is what you often hear: “I’m so depressed!”

And that statement is usually followed by: “I just found another pimple,” or “I hate studying for tests,” or “The ice cream store didn’t have any more pistachio left.”

Hang around some teenage girls at a Links Shabbos (Links is an organization that reaches out to children whose parent(s) has died) and “I’m so depressed,” sounds more serious. Because for a Links girl it is not about pimples or tests or pistachio ice cream (although sometimes it most certainly is!).

Here is an email we received from a grieving girl and I think it really captures what many of you are thinking and feeling: I’m sad (and I think that’s fine) about a lot of stuff that’s going on in my life since the loss of my parent. I’m terrified of getting depressed. How do I know if I’m sad or depressed? How do you treat sadness? How do you treat depression?”

Sadness is an emotion that all humans feel at some point in their lives, along with other emotions like frustration, upset, jealousy, anger, joy, pride, excitement, and selflessness. Depression, on the other hand, is a mental disorder or illness, not an emotion.

Here are some common feelings both to sadness and depression:

Feeling irritable. Tired and lethargic. Unable to sleep, or sleeping too much. Trouble concentrating on tests or work or even simple conversation. Disinterest in stuff you used to really like doing. Feeling guilty about things you have no right to feel guilty about because you did nothing wrong (and even if you know that, you still insist on feeling guilty). Physical symptoms like headaches, stomachaches, or even aches in weird places that every doctor tells you in simply in your head (and you know it too even though you keep going to doctors or getting bloodwork done). Feeling worthless. Thinking about death. Wishing you could die, even.

There’s this book called the DSM 5 (Diagnostic Manual of Mental Disorders, if you really want to know). And inside this book (which sits on the desk of every therapists—or in my case, on my shelf), that itemizes every single, bingle mental disorder a person can have. And depression is in there. And this book not only lists the stuff I just wrote in the last paragraph, but it also tells you what makes sadness different than depression.

The simple difference between sadness and depression is that sadness may be for a few minutes, a few hours, or even a few days. But if your sadness lasts more than two weeks, then it may really be depression. And wishing to die is always a sign of depression not sadness. So if that happens, you know right away you are depressed and not just sad.

Now, our letter-writer wrote that she is really terrified of getting depressed because of her sadness, and she is right to be worried. There are certain people who are at risk for getting depressed (Am I depressing you with this article? Wouldn’t it be much more fun to read about ice cream in Sprinkles Ice Cream Store? Or rollerblading in Prospect Park? Yes, it would. Which is why I am taking a commercial break from this depressing article and sticking those two topics into here. Vanilla ice cream with hot caramel sauce. Rollerblading down that curvy hill, flying in the wind. Okay. Commercial break over. Back to depressing depression), and here’s a nice list I compiled for you reading pleasure:

People at risk for depression are people who have had trauma. Others, are people who are having a hard time coping with a catastrophic event like death or severe illness (and so many of you have experienced both!). People with low self-esteem. People who don’t have supportive family or feel isolated from any community. People who are struggling with other illnesses, physical illnesses like handicaps or diabetes; or mental illnesses like anorexia or bipolar disorder.

So that means that girls that have lost a parent definitely go into this at-risk category. Girls that have additional trauma like divorce and abuse, (even milder issues like pimples or ADHD) are even more at risk. And sometimes living through illness and death can cause low self-esteem and some other of the ugly stuff like unsupportive family and feelings of isolation from the community.

(Believe it or not, depression can actually be a side effect of some medications. So before you do anything else about your depression, first ask your prescribing doctor if the medication you are taking (for whatever reason) doesn’t have the side effect of depression!)

What makes depression so different from sadness is that depression is not only how you are feeling, it completely interferes with your ability to function normally. And when I say normally, I mean with things that make a person normal (and this is when my teenagers—when they read my stuff—say, “But Ma, your normal is not exactly our normal, and since when are parents normal anyway?” To which I very cleverly—and most unoriginally say, “And teenagers are notoriously not normal.”), including teenagers.

When clients come into my office and we talk about “normal” I like to give them guidelines of normalcy that makes sense to them and this is what I say, “A person is doing okay when she is able to engage successfully in three areas of her life: work, play, and people.

Work means either in the workplace, or work can mean in school which is a student’s job. And the work of school can be academics or the extracurricular activities which can be just as taxing.

So check yourself out. Are you involved in the work of school? Studying, do well on test, engaged in class? Or even, are you involved in the play? The production? Making up dances or choirs or scripts? If you cannot say yes to any of these, maybe your sadness has become depression.

Play refers to the ability of a person to have fun. Little kids play with toys, but teenagers have fun with hanging out with friends, playing guitar, making a puzzle, baking, having a hobby like photography or drawing, going out for pizza, shopping with sisters. And sometimes it’s simply being able to talk on the phone and laugh. When was the last time you had fun and laughed? The answer may help you know if your sadness is more than just sadness.

Having people in your life is another sign of normal functioning. Friends. A social life. Do you have friends on the block? From camp? In school? At your workplace? Real friends with whom you can share and be yourself with? Friends you can hang out with and talk with? Friends who you enjoy their company and are not bored by? If you can’t answer yes decisively to these questions, it’s possible that it is depression that is affecting your ability to be social.

Now, of course, since I’m a therapist, you think that I’m going to recommend therapy. Surprise! I’m not. I have often said in previous articles, that believe it or not, therapy is not the first line of help for grieving a loss of a loved one. In the grieving process, the number one most effective tool is finding support group of other people who have suffered similar losses. Which is why LINKS is so crucial to all of you. You may not realize it, but through this magazine, through Rabbi Paysach Krohn’s Good Shabbos messages each Friday, through the hotline you can call in for chizuk, through the Shabbaton where you connect live with others, through all the ways in which Links creates that supportive community for you, the grieving is processed in healthy ways.

All of us working with bereavement know that people who are able to reach out after a loss and form support with others do much better emotionally than those who deny their need for support. So the fact that you are reading this article is already a step towards emotional health.

But while you grieve, you may feel sad. And you may wonder if that’s okay. Or how that can be okay when it feels so…so sad.

First I am going to encourage you to allow yourself to feel sad. Even every day. There is no treatment for sadness. We need to be sad sometime. It’s important to be sad; It is important to be miserable and blue and gloomy and down and unhappy. It is important to grieve, to mourn, to lament, to wail, to kvetch, to whine, to moan, to complain, to grumble, to protest, to snivel, to sob, to whimper, to cry (notice my spectacular use of the thesaurus!). But even as you are listening to my instructions, I want you to check if it’s possible, despite the sadness, to enjoy little pockets of time. Like you can still laugh at jokes. Or enjoy talking to your friend. Or still take school seriously.

And then I’m going to encourage you to make changes in your life that may chase away depression or not allow the sadness to morph into depression.

Do stuff like connect with other people. Even if you are not in the mood. Maybe connect in places that interest you. Taking lessons in piano or painting together. Make sure to do something every single, bingle day that you enjoy. Even if it’s taking a hot shower. Or long bath (with bubbles). Read funny things. Engage in physical activities. Try that Zumba class or basketball game at the sports center. Physical activity affects your mood positively.

If you love animals, get a hamster. Or rabbit. Or even a bird. (Don’t get fish. They are the most boring, depressing, living things in the world…. except for the kissing fish. They kiss all day long so that’s nice to watch.). Volunteer. With tutoring kids, with visiting old people, with animals, with food (the food will really, really appreciate your taking of it)—delivering for Tomchei Shabbos, for example.

When all of this doesn’t seem possible, when you want to simply sleep away your day, when you can’t engage in work and play and people, when your sadness goes on way longer than two weeks, then you may want to try first reaching out to a mentor, mother, or teacher. And if that fails to help (drumroll coming up!), it’s time to visit your friendly, local therapist. Just to figure out what’s going on and what therapy can do to help.

Maybe just visit that that stupid, ol’ therapist to prove that you are not depressed!

And when you visit, we can eat ice cream.

NOTE: This was originally written in LINKS MAGAZINE, a publication geared for children who have experienced parental loss and grief

 

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You can check out my previously published articles onmy former blog Therapy Thinks and Thoughts at frumtherapist.com/profile/MindyBlumenfeldLCSW

You can read more of my updated articles in my bi-weekly column THERAPY: A SNEAK PEEK INSIDE in Binah Magazine, available on newsstands every Monday. 

LOOK OUT FOR MY UPCOMING BOOK THERAPY SHMERAPY,  available in bookstores April 2017