"I don’t remember her name, but I’ll never forget her eyes.  Or the sad—deeply sad—look all about her."  The author shares experiences of working with depressed teens.  What is it like to see depression at its worst?
 

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    I don’t remember her name, but I’ll never forget her eyes.  Or the sad—deeply sad—look all about her.

    It was several years ago, and I was a therapist on the adolescent unit of a mental hospital.  She was a patient.  Out of respect for her, I’ll call her Ms. Smith.  She came to the hospital following a difficult incident in her life.  She was not alone.

    I recall that her diagnosis was depression.  Lots of the girls in the hospital received that diagnosis, though usually, being depressed was not what landed them there.  Drug abuse, shoplifting, running away, or worse—things they turned to because of their depression—was generally involved before a person ended up confined to treatment.

    I have forgotten her name, as I said, but I remember the day I met her.  She was not my patient, but she would be in the “group” session I co-led.  I had scanned her treatment record before the session, as I did for all new patients.  Nothing in it really surprised me.  The ink in her “chart” hardly prepared me to meet her.

    Upon my entering the group room, she and the other patients were already seated, as usual.  She sat across the room, knees clutched to her chest, head drooped forward splaying her long hair over her knees.  When she looked up, I saw the sad eyes.

    Of the hundreds of teens I counseled, most are now only a blur, but memories of Ms. Smith still linger.  She was seventeen—really only three months from being eighteen.  I remember her life was hard.  She didn’t get along with her parents, though they were not abusive or neglectful—not, at least, in the legal sense.  Perhaps worse, they were indifferent and unsupportive, caring neither if she passed or failed, caring nothing about her friends, her desires, her hopes, or dreams.  She felt unheard and unloved.

    She had discounted her friends too.  She felt they were all fakes pretending to be happy when they weren’t.  In her mind, the world was stacked against her and nothing suited her, nothing was satisfactory.

    Perhaps the luckiest thing that had happened to her in a while was coming to the hospital when she did.  I don’t remember if it was stealing, running away, or prostitution that had resulted in her drug abuse being discovered.  Really, that is not important.  Had it happened three months later, she would have been sent, not to the adolescent unit, but instead to the one for adults.

    I worked there too.  It was, even to me, scary.  Life-long drug abusers shuffling down the hall, their fingers and teeth stained by tar, their mouths drawn up with those ugly wrinkles created by years upon years of puffing cigarettes, their eyes sunken in, and skin thinned by the hard drugs...  They would have been her companions in treatment, had she come three months later.

    But Ms. Smith came to the adolescent unit, and that was better for her.  Days passed, and she seemed to improve.  The M.D.’s, her therapist, and I began to talk about her discharge and follow-up care.  Her individual therapist set her up to see one of the better psychologists in our metropolitan area.  Things looked good.

    However, when asked how she felt about leaving the hospital, she simply shrugged.

    “It’ll probably be all the same when I get out.  Nothing in here has changed anything out there,” she said.

    “But are you different?” she was asked.

    “Maybe.  So what if I am?”

    It was not at all what I expected.  To her, it was as if changing her life was like turning the Titanic.  I understood that.  So much time had passed and she had gone so long feeling unheard and unloved, a week or so in a place where she was cared for made little difference.

    About then, I started to wish I had known her years before. I wished she might have been in my youth group when I worked at the church.  I wished she could have been in my class when I taught basic computer programming, or could have been on the track team I coached. I wished she could have been a student at the school where I was the guidance counselor.  I wished I could have known her while working any of the other jobs I had had over the years—while working at any place other than the mental hospital.  I wished she could have met me—or someone – anyone—who would have been happy to listen to her, and who could have helped her steer clear of the troubles that came her way.

    Then it dawned on me that she had.  No, she had not met me.  But surely she had met teachers, coaches, or other adults in her life that would have given her attention.  Certainly, she had not lived seventeen years with no opportunity to talk to a caring adult.  More likely, she simply never knew they cared.  More likely, with her head hung low, she simply passed them by, never seeing the hand they were willing to extend.

    Ms. Smith left the hospital, and I never learned what happened to her.  Ethics in mental health prevented me from keeping up with her—she was not even officially my patient.

    I like to think that she passed the next three months into adulthood remembering the people from the hospital that cared for her.  I like to think she realized that she did not have to go it alone.  In my mind, though I will likely never know, I made for her a happy ending.

    I had to do something like that.  Her look the day I met her—her sadness, her pain, and those eyes—were unforgettable.

•    Sadness for no reason
•    Withdrawal from family or friends
•    Quitting activities that were once enjoyed
•    Increased irritability or agitation
•    Changes eating – significant weight loss
•    Insomnia
•    Excessive sleep.
•    Frequent physical complaints
•    No enthusiasm, motivation, or energy
•    Activities or thoughts with excessive themes of aggression toward self or others.
•    Activities or thoughts that involve persistently sad themes
•    Indecision, lack of concentration, or forgetfulness
•    Feelings of worthlessness or guilt
•    Recurring thoughts of death or suicide

•    Talk to a caring adult in your life—if you cannot talk to your parents, try a minister, teacher, coach, or other youth leader.
•    Avoid keeping it to yourself hoping it will just go away.  Usually, unless something changes, it will not.
•    Be careful about overly burdening your friends with your problems.  Although they care for you, most of the time, they cannot help you alone.  Sometimes, you will get the reputation of being “needy” which can make things worse.
•    Try to exercise and eat well.  Coupled with insight gained from caring adults, diet and exercise can improve how you feel greatly.

Copyright 2007, Bill Snodgrass. All rights reserved.

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