The Stress Doc Letter
Cybernotes from the Online Psychohumorist
SEP 2002, No. ll
In the shadow of a new
school year, the Stress Doc responds to a stream of heartfelt emails from depressed teens with
seemingly unresponsive or misinformed parents. Reaching out to working out strategies are
outlined for helping such vulnerable students begin to regain control of their psyches and their
Stress Doc's Survival Tips
for the Emotionally Vulnerable or Depressed Student
emails from adolescents grappling with ongoing depressed moods, if not clinical depression itself,
reminds me that the Fall school season is lurking, if it hasn't already started. I'm not
surprised. A significant change in one's routine, e.g., of schedule, social roles and
task-emotional demands, often is a catalyst for bringing to the surface psychic turmoil churning
below. Of course, if one is continuously fighting off or blocking out strong feelings of
anxiety or dark mood clouds, the prospect of managing school performance or peer pressure is
daunting at best, threatening or humiliating at worst.
And perhaps the saddest part of my
teen correspondents' plight is the perception that they cannot turn to their parents for guidance.
These youngsters believe (rightly or wrongly, though I suspect the former too often applies) that,
in some fashion, they will be told: "Oh, everyone goes through depression in
It's just a phase
Don't make such a big deal of it
Stop feeling sorry for
Just pull yourself together
Life is rough - deal with it!"
Sounds like a
dysfunctional home front, frankly. Reminds me of a pompous State Department Manager who
challenged me during a workshop, pointedly asking: "What do you call it if you don't have
any stress?" My immediate reply: "Denial!"
I don't know about Mr.
Bluster, but I suspect a number of the parents of these teens are:
1) struggling with their own
depression or alcohol-related conditions,
2) avoiding memories of depression in themselves or
family members growing up, and/or
3) so stressed out by day-to-day living that they cannot take
on any more pressures. A child struggling with depression becomes too burdensome or "too
Under a siege or state of helplessness and feelings of worthlessness, the child
shuts down (becoming invisible or putting up a false front) or erupts. Stress smoke signals
include an inability to concentrate or fighting at school, shoplifting, bingeing, acting out
sexually or, even, numbing the pain through cutting (and not just classes) or other suicidal
gestures and acts.
When feeling so isolated or alienated, what is a troubled teen to do?
Consider "The Stress Doc's Survival Tips for the Vulnerable, Depressed Student":
Trust Your Gut. A chronically stressed individual probably knows in his or her heart, if
not the head, the difference between moodiness and ongoing depression. Despite what others
around you may be saying, your pain is real. Unlike the emailers, even most teens, not just
some family members, try to deny or ignore the seriousness of this depressed state for fear of being
labeled "crazy" or emotionally "weak." While melancholia or anxiety are
exacerbated by prolonged or dramatically acute stress -- for example, a rape -- clinical states are
often associated with:
a) abandonment by a parent, premature death of a significant other or
childhood abuse, for example, an ongoing pattern of verbal, physical or sexual mistreatment and/or
a family history of depression, that is, there's a genetic predisposition which when combined with
ongoing distress induces a damaging change in hormonal or biochemical levels of functioning.
even clinical states of depression or anxiety do not mean you are crazy or you are worthless.
It means, presently, you don't have sufficient bio-psycho-social support or resources to regain
mind-body-spirit equilibrium and to engage productively and playfully in your designated social
Consider this analogy: If you were a mind-body car, depression is being
two quarts low on oil. Despite sensing some impairment in functioning you continue driving
yourself around. You avoid going into a gas station to get your full complement of oil.
(Now maybe if you repair the leak in the oil case, you won't need to resupply but one time.)
Escapist behavior, not getting your vital fluids checked (as well as other systems that may have
been affected by the oil seepage) is self-defeating. Over time, this draining/avoiding pattern
may be a sign of or catalyst for being out of control, a "mechanical" breakdown, i.e.,
some so-called craziness.
2. Seek Out a Trustworthy Adult. If you have
really made several attempts to talk with your parents and they can't or won't be the gas station
attendant or mechanic, look elsewhere. Try enlisting an ear from adults in your family or home
environment, that is, do you have a close relative? Perhaps there is a parent of a friend you
might confide in, or a spiritual advisor. Hopefully, these adults help reaffirm that agitation
or depression is a real medical, psychological and social-family condition (not "just in your
head"). And perhaps they can advocate for you with your parents. But remember, many
adults do not fully understand the nature of clinical conditions like depression. They don't
understand how a child can have a false self; how he or she can present a seemingly normal, i.e.,
moody, if not happy, front to the outside world while one's true self is seething, withering or
3. Call a Crisis Hotline. Sometimes it's easier to connect
anonymously with a counselor, especially when struggling with feelings of shame or inadequacy.
It's why teens email me or find a website like "The Bright Side" such a safe haven.
But when the black hole pain doesn't go away after a couple of weeks, go beyond the virtual.
Consider calling your local hotline to connect with someone who likely understands your complex
situation. This crisis specialist will help you begin to sort out your emotionally entangled
or seemingly overwhelming life. Such counselors know face-to-face resources and may even
provide tips on how to approach defensive or disbelieving parents or other adults. But first
and foremost, hopefully, you will talk with an adult who seems trustworthy.
While this is
unlikely, you may feel an adult you are confiding in is trying to take advantage of you. This
can occur with questions that feel too prying or invasive (and the adult won't back off even after
you ask him to). Real discomfort and fear can also emerge in an in-person situation if the
person with who you are sharing engages in touching that you find uncomfortable. Again, if the
person does not respect your boundaries, report this experience to an adult you trust. And,
believe me, I know such a step takes uncommon courage.
4. Talk to a School
Counselor. While school may be the latest stress trigger, sometimes the feared situation
can become "the pass in the impasse." You just might find a trusted and
knowledgeable adult in the role of guidance counselor, school social worker or, even, a past
teacher. Don't wait till grades are faltering or failing to reach out.
Again, while we
often believe our plight or circumstances are unique (to some extent they are, of course) that no
one can understand, these professionals likely have grabbed the arm of other drowning or suffocating
students and pulled them out of agitated or depressive quicksand. These individuals also have
the authority and responsibility knowing you are hurting to call in your parents, explain your
situation, recommend individual and/or family therapy or, if necessary, recommend a consult for
And meeting with a psychiatrist to evaluate the appropriateness of
medication does not mean you are crazy. Remember our "two quarts low" example?
Sometimes a brief trial of medication can help rebuild the energy and capacity for concentration
that you need to tackle various schoolwork, home and social demands. And once you've
experienced some clarity, if not mastery, the vicious cycle can gradually be replaced with a
naturally vital one.
5. Make a Stress Buddy. Whether you are ready to
reach out to an adult or not, forging a friendship with a peer with whom you feel safe, with whom
you can share your strengths and insecurities is key part of growing up. Of course, this is
difficult when feeling way depressed or stressed out. Still, there is likely one other student
in your classes or in the cafeteria with whom you can walk those mean halls together. (You
don't have to be a social butterfly. Again, just as you must use judgment in deciding whether
an adult is trustworthy, the same for a prospective close friend. The wrong person or gang can
drag you deeper into the abyss.)
Perhaps this person can be a homework buddy as well.
When we are having difficulty concentrating or are feeling isolated, just the presence of a friendly
face across a table can help us focus.
6. Begin an Exercise Program. You
and your "study buddy" will eventually need a stress break. Going for a walk, jog,
bike ride, rollerblading, etc., is a great way to also alleviate tension. Non-stop exercise
for 30 minutes releases mind-body natural mood enhancers and pain relievers called endorphins.
While endorphins won't cure major depression, they will provide some relief -- they produce a
calming effect -- from preoccupation and moodiness. Your world seems less chaotic.
when everything seems bleak or uncertain, an activity like exercise creates a success ritual.
Brisk walking or jogging two miles provides a beginning and end point for a tangible sense of
accomplishment and control.
7. Discover a Hobby or Creative Pursuit.
Hopefully, if you've begun to implement the above strategic steps, you are starting to sense some
sunlight is breaking through the black clouds. Use this light to explore new hobbies or
interests, or even old ones that you have lost touch with in your darkened fog. Actually,
people with moody, depressive conditions often have the psychic raw material that fuels creative
expression -- painting, music, poetry, theatre, dance, etc. Transforming one's pain into a
novel or imaginative product or process definitely helps escape, at least for a time, one's
burdensome or vulnerable state.
Of course, it's more than an escape. A conscious and
unconscious mind when creatively engaged is able to shape, even play with, that heretofore-amorphous
smothering mush or maelstrom of hormones and feelings. Channeling emotions of hurt,
helplessness and humiliation into an artwork or story in which we leave our own mind-body imprint
yields uncommon satisfaction and pride, as well as a sense of hope. For a moment we have
For the phoenix to rise from the ashes
One must know the pain
transform the fire to burning desire!
And when we capture our uncommon essence --
strengths as well as weaknesses -- in some harmonious whole, then others can see, hear or taste
(cooking can be another creative endeavor), can understand and empathize with and, maybe, learn from
our plight or pain. Talk about coming full circle or a sense of rebirth.
Write On. While mentioned briefly above, writing doesn't have to be creative to be
helpful. Journaling can be a very therapeutic window into our psyche and soul. Research
has shown that when people write out or write about issues bothering them -- capturing both their
emotions and analyzing the tension-inducing factors -- the process helps people step back and
examine their tumultuous life from a more calm or less frantic perspective. Problem solving
options arise from the page. And, bottom line, these writers report being less stressed.
Join or Create a Support Group. One of the wonderful things about the Internet is there
are many opportunities to discover and possibly connect with kindred spirits or, at least, peers in
a similar boat. There's a chat group for almost any imaginable issue. (Again, caution is
advised. Look for a chat group with a mature, if not a professional, facilitator.)
course, don't be limited to just virtual support. Schools, community centers, "Y"s
and religious institutions often provide venues for group discussion and supportive problem solving.
The 12-step group Alcoholics Anonymous, for example, has a group called Al Ateen, for children
impacted by the drinking of an adult family member, or who are grappling with their own substance
For teens struggling with depression and, not surprisingly, feeling
self-conscious, opening up in a public forum may seem hellish. I just know that my years in
group therapy, which began just a few years past adolescence, provided immeasurable help in
gradually coming out of the depressive closet. Even if you don't say anything, you will learn
much and feel considerably less isolated by listening to others' stories, trials and small triumphs.
Life As an Evolutionary Achievement. Alas, evolving from childhood to adulthood is often a
time of many trials and traumas, tears and tantrums. And adulthood is hardly a piece of cake.
But meeting challenges, developing behavioral, cognitive and emotional skills, forging peer
friendships and adult relationships that support our climb up the mountain of self-identity,
skill-based competency and psychological resiliency are some of the most rewarding aspects of life.
And the climb sometimes can feel like two steps forward, three steps back. Yet, with the right
guidance and our own persistence we are often surprised by how far and high up we can go with our
so-called "damaged goods"; we marvel at how wide the horizon from this hard-earned vantage
As the famed discover of one of the cures for the dreaded polio disease, Jonas Salk,
observed, life is not about perfection or straight line progression:
Evolution is about
getting up one more time than we fall down; being confident one more time than we are fearful; being
trusting just one more time than we are anxious.
Surely these are words to help us stand
up, reach out and bravely engage with the depression, school and family battlefronts. With the
above ten tips, surely these are words to help us all
Practice Safe Stress!
Gorkin, LICSW, "The Stress Doc" , an international speaker and syndicated writer,
is America Online's "Online Psychohumorist" The Doc runs his weekly "Shrink Rap
and Group Chat" on AOL/Digital City DC Stress
Chat . See his award-winning, USA Today Online "HotSite" -- www.stressdoc.com Stress Doc homepage
(recently cited as
"comforting" resource in a National Public Radio feature on "Bad Bosses").
Email for his monthly newsletter recently showcased on List-a-Day.com. For more info on the
Doc's "Practice Safe Stress" programs, email email@example.com or call 202-232-8662.
Mark Gorkin 2002
Shrink Rap Productions