The Virginian-Pilot
                             THE VIRGINIAN-PILOT 
              Copyright (c) 1995, Landmark Communications, Inc.

DATE: Friday, June 30, 1995                  TAG: 9506300667
SECTION: DAILY BREAK              PAGE: E1   EDITION: FINAL 
SOURCE: BY AMY SHAFFER, HIGH SCHOOL CORRESPONDENT 
                                             LENGTH: Long  :  176 lines

MORE THAN JUST THE SUMMER BLUES ``SUMMER IS WHEN I REALLY GET SAD, BECAUSE I HATE JUST SITTING AND WATCHING TV, AND THAT'S ALL I CAN DO. I FEEL LIKE I'M ENCLOSED IN A BOX.''

AS SUMMER gets under way, teenagers everywhere are relishing the freedom and fun that is finally theirs.

Yet there are thousands of nameless high schoolers all over the country for whom the clouds never lift. For them, summer means no more than struggling against their ailment alone rather than being surrounded by classmates.

They are among the teenagers in the United States who are clinically depressed.

``Summer is when I really get sad, because I hate just sitting and watching TV, and that's all I can do,'' said Ellen, a clinically depressed 15-year-old sophomore who requested anonymity. ``I feel like I'm enclosed in a box.''

Until recently, depression in youth was not classified as a verifiable disease and went largely untreated. Today, it is a recognized illness and treatments for it have been developed by psychothera-pists.

The National Foundation for Depressive Illness estimates that 5 percent to 10 percent of adolescents suffer from depression, and of these, 15 percent will end their lives by suicide. In fact, suicide is the third leading cause of death among adolescents, after accidents and murder.

Gail Hutchison, sexual assault counselor and youth liaison for the Outer Banks Hotline service, says that in an average month, the service receives seven to 10 calls relating to depression. Calls from teenagers are common.

``When you're a kid, your mind changes, your body changes,'' Hutchison said. ``Everyone thinks they don't fit in.''

Ellen's case is a perfect example of this. ``I don't interact very often,'' Ellen said. ``I don't want to humor my friends. They're having a good time and all that, and I just want to sit and think.''

This solitude often leads to feelings of abandonment. ``Most of our callers feel alone and betrayed by their friends,'' said Mike, an operator at the Youth Crisis Hotline in San Francisco. The hotline fields about 35,000 calls a month from teenagers nationwide. (Operators are not allowed to give their full names.)

Officially, there are two types of depression, unipolar and manic. In the unipolar type, a person may suffer feelings of sadness and hopelessness most of the time, as well as low self-esteem and thoughts of death. Symptoms of manic depression include racing thoughts and drastic highs followed by depressed lows.

Depressive illnesses can take control of a person's thoughts, attitudes, actions and physical health. It is believed to be caused by a combination of genetic vulnerability, psychological makeup and environmental factors. Bad life experiences and certain personality patterns - such as difficulty handling stress, low self-esteem or extreme pessimism about the future - can increase the chances of becoming depressed.

These symptoms are not restricted to adults. ``It's tough to be a teenager these days,'' said Hutchison. ``There's a lot of peer pressure, violence in schools, drugs. Teenagers have really serious issues (to face).'' GENDER GAP

It is a fact that more girls fall victim to depression than boys. Dr. Xiaojia Ge, who conducted a four-year study along with associates at Iowa State University and the University of North Carolina at Chapel Hill, found that ``while boys reported slightly more depressed feelings than girls prior to age 13, the trend reversed after that age, with symptoms of depression rising continuously upward for girls until at least age 16, and in many cases into young adulthood.''

Overall, symptoms of depression for boys remained lower than for girls and were relatively stable, Ge added. Girls, especially those between 13 and 15, reported more stressful life events than males in the study, which was supported by the National Institutes of Health.

``On the whole, what this tells us is that teenage girls are more at risk for depression for at least two primary reasons - because they undergo more life changes than boys and for reasons we don't fully understand, because they are more vulnerable to negative life events,'' Ge said.

Ge also found that girls who had supportive mothers who talked with them openly and offered support were less likely to be depressed. THE TIP-OFF

Last year, Ellen noticed that she was becoming increasingly moody and filled with an unreasonable fury.

``I thought I was going crazy,'' she said. ``Nobody was listening to me unless I did something really bad.''

She got into a heated argument with her mother nearly every day and was enveloped by anger and sorrow. She had difficulty concentrating on schoolwork as well.

``I'm supposed to be learning,'' she said, ``but the only thing I can think about is things that have happened and how I want to get away from it all.''

After suffering alone for months, Ellen finally decided she needed professional help last November.

Hotlines, such as the one on the Outer Banks and many in the Hampton Roads area, are designed for people like Ellen whose desperation becomes unbearable. When someone calls, the operator immediately determines whether the caller is suicidal. ``Most callers feel that there is no answer to life,'' said Mike, the Youth Hotline operator.

Counselors listen to the caller's problems and offer options. ``We never give advice,'' Hutchison said. ``Kids don't like to be preached to.''

No matter why the teenager is depressed, hotlines attempt to validate their reasons so that the caller doesn't feel alienated or alone. ``Not having a date for the prom or having a pizza face is a very big deal for a teenager,'' Hutchison said. ``We don't want to lecture them.''

Operators try to let the callers know that their problems are not permanent. ``We want to reassure them that after hard times, you are a much stronger person,'' Mike said. ``And then you have the ability to help others, which can give you joy.''

After a caller has calmed down and gotten problems off his or her chest, operators can recommend local psychologists, and some hotlines, such as the one on the Outer Banks, will even pay for the first three or four sessions. Between 80 percent and 90 percent of people with depression can be helped, according to the National Institutes of Health. Doctors can prescribe anti-depressant medications to relieve symptoms, and psychological therapy can help patients learn to deal with their problems.

Not everyone responds equally to the different forms of treatment. Some patients need only medication, others only counseling, and still others a combination of both. The most important step toward overcoming depression is asking for help.

One method of escape that experts agree is not the answer is substance abuse. Using alcohol or illegal drugs may be a teenager's way of self-treating themselves. However, because many of the abused substances are depressants, the situation often is worsened.

``It's strange,'' Hutchison said. ``People drink to forget but then end up remembering more why they're drinking in the first place.''

Ellen says that her treatment program, which consists of medication and counseling once a week when her psychologist is available, is helping.

``It's slower before I get angry now,'' she said. ``I realize I'm going to and can warn my mom before she pushes my buttons.''

For now, Ellen is simply struggling to heal her mind before she goes out into the world. Having been a depressed teenager, she doesn't want to be a depressed adult as well.

Hutchison said that the effects of depression on teenagers can be lessened by finding someone close to them to talk to, such as a parent, teacher, minister or responsible friend.

``Communication is most important,'' she said. ``Parent-kid interaction is really important and doesn't happen often.''

And so thousands of teenagers often suffer alone with their pain. ILLUSTRATION: JOHN EARLE/Staff

Color photo

AMY SHAFFER IS A 1995 GRADUATE OF MANTEO HIGH SCHOOL.

Graphic

SYMPTOMS OF DEPRESSIVE ILLNESS

Thoughts of death or suicide

Loss of interest in activities that were previously enjoyed

Difficulty sleeping

Increasing or decreasing appetite

Constant feeling of hopelessness, sadness and despair

Decline in school achievement and difficulty concentrating on

schoolwork

Sudden irritability or anger for no reason

Withdrawal from social situations

Racing thoughts

Use of drugs or alcohol

Change for the worse in personal habits

Two or more symptoms that persist for two weeks or longer may

indicate a depressive illness.

Source: National Foundation for Depressive Illness

GETTING INFORMATION AND HELP

Places to call for information:

National Foundation for Depressive Illness, (800) 248-4344

National Depressive and Manic Depressive Association, (800)

82-NDMDA

National Mental Health Association, (800) 969-NMHA

Places to call for help:

Crisis Center, 399-6393

Tidewater Psychiatric Institute Crisis Line, 627-5433

Contact Tidewater Hotline, 428-2211

Youth Crisis Hotline, (800) HIT-HOME

Outer Banks Hotline, (919) 473-3366

by CNB