Nowadays, everyone from celebrities and social media influencers to teens is being more open about their struggles with mental health and giving a face to issues such as social anxiety and depression.
Dr. Marissa Long, a California-based clinical psychologist, who is also the founder of mental health and wellness subscription box, Thrive WISE, attributed the increase in anxiety and depression to societal issues such as school shootings, cyberbullying and economic instability.
“Anxiety is the most common of mental health issues in the U.S., but depression is not far behind as the leading cause of disability in the U.S. for teens and young adults,” stated Dr. Long. “It’s important to differentiate between normal moodiness and serious signs of disorders so that appropriate treatment can be secured.”
With these alarming numbers and the fact that it’s Mental Health Awareness Month, we decided to enlist the help of Dr. Long and other medical experts to break down the many different types of anxiety and depression, as well as things you should do if you’ve started noticing the following and symptoms. But first you should know that we all get nervous, sad or anxious from time to time, but it’s when these feelings persist that we should pay close attention.
“I like to say that anxiety is stress and worry shaken and heated up, which ultimately impacts our body as well,” stated Dr. Long. “It changes the flavor of our experience by diluting the reality of the situation in front of us, and adding in unwarranted and rigid thoughts that support our fear. There are FIVE major anxiety disorders—each with their own symptom presentation.”
Dr. Long summarizes the five disorders, associated symptoms, and treatment options as follows:
1. Generalized Anxiety Disorder (GAD)
With GAD, the name says it all. It can show up as persistent negative thoughts or negative assessments of one’s self, situations and the world around them as being scary, resulting in avoidance and efforts to mitigate the anticipated anxiety.
Physical Symptoms: Muscle tension, poor sleep, upset stomach, and jaw pain.
2. Social Anxiety/Social Phobia
Social anxiety or social phobia is an intense fear of social situations due to concerns about being criticized, embarrassed or humiliated. Something as seemingly simple as making a phone call, sitting in a waiting room, speaking publicly, eating with others, sharing an opinion or even talking with friends can prompt serious anxiety. For some, social phobia can also be experienced relate to specific people or situations such as talking to your boss or parties. There are many different types of phobias but the main thing to keep in mind is that it involves an irrational level of fear about something that is disproportionate to the actual danger. On top of all of this, unfortunately, people can have more than one specific phobia.
Physical Symptoms: Shaking, nausea or diarrhea, sweating, blushing or feeling flushed.
3. Panic Disorder
The experience of a panic attack is a uniquely awful one, but having a panic attack in and of itself does not warrant a diagnosis of panic disorder. Panic attacks involve a gradual build to or sudden experience of intense, and often uncontrollable and racing anxious thoughts combined with physical symptoms. It is when a person has recurrent and disabling panic attacks and/or persistent fears for longer than a month that a diagnosis of panic disorder may be warranted. The occurrence of panic attacks varies from one person to the next, happening as often as several times per day to once every couple of years.
Physical Symptoms: Tightness in the chest, shortness of breath, shakiness, chest pain, dizziness and excessive perspiration.
4. Obsessive Compulsive Disorder (OCD)
OCD is characterized by intrusive and persistent anxious thoughts or behaviors that are carried out with the purpose of relieving the anxiety. The thoughts and behaviors work together as a super team against their host in this disorder, and are quite powerful even when the person is able to identify their thoughts as unrealistic and the compulsions as unnecessary. For teens and young adults, this can result in an inability to attend school, let alone engage in normal social interactions, thus disabling them from engaging with life in a seemingly normal way.
5. Post-Traumatic Stress Disorder (PTSD)
PTSD is a common outcome of a traumatic event that is experienced, witnessed or even heard about in such a way that causes trauma. Symptoms can include difficulty relaxing and feeling on edge; hypervigilance, nightmares or flashbacks related to the experience, avoidance of anything related to the traumatic event, and an emotional numbness. PTSD is diagnosed when symptoms have been present for at least a month, but symptoms may not present until long after the trauma.
In recent years, the surviving victims of school shootings have been prime candidates for subsequent PTSD diagnoses, though other events like sexual assault, car accidents or witnessing a death are all examples of traumas that may bring about PTSD.
1. Major Depressive Disorder
Dr. Long also weighed in on six forms of depressive disorders and their overall effects on teens and young adults: She explains that “major depressive disorder is the most common form of depression and is characterized by the occurrence of specific symptoms, over a period of at least two weeks, that impair regular functioning in school or social activities for teens and young adults.”
Far too often, parents and loved ones write off major depressive disorder in their children as hormonal changes or an act of rebellion against authority.
Physical Symptoms: Decrease or increase in appetite, insomnia or hypersomnia, psychomotor agitation or retardation, constant fatigue, feelings of worthlessness or excessive and inappropriate guilt, recurrent thoughts of death and suicidal ideation (with or without specific plans for committing suicide) and cognitive difficulties like the inability to think, concentrate or make decisions.
2. Persistent Depressive Disorder (Dysthymia)
Dysthymia can be quite sneaky, especially among teens and young adults. It is often thought of as the disorder suffered by the beloved cartoon character, Eeyore (from Winnie the Pooh), who moped about his life on a rather consistent basis. The pervasive nature of it often allows people to view it as being the personality of the depressed individual rather than the health issue it actually is.
Persistent depressive disorder commonly goes undiagnosed into later adulthood but presents itself as a consistently low, dark or sad mood. For adolescents, the symptoms need to persist for more than one year, whereas adults require two or more years of persistent symptoms to meet the diagnosis. It’s important to note that symptoms experienced in dysthymia are not as severe as with major depression, and the persistence of symptoms does not mean that those with this disorder would be unable to have happy moments or days. Major depression may co-occur with dysthymia, or precede it, making it that much trickier to catch and diagnose.
Physical Symptoms: Poor appetite or overeating, low self-esteem, poor concentration, difficulty making decisions, low energy or fatigue, feelings of hopelessness, and insomnia or hypersomnia.
3. Premenstrual Dysphoric Disorder (PMDD)
While an extension of premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD) should be understood to be much more severe and at times disabling. For teens and young adults, there is a tendency to, again, write the emotional experience off as being moody or “extra” until the heightened physical symptoms bring cause for concern and attention. Symptoms of PMDD usually begin seven to ten days before the start of a menstrual period and continue through the first few days of the period.
Physical Symptoms: Breast tenderness, bloating, fatigue, changes in sleep and eating habits, anxiety or tension, sadness or hopelessness, moodiness, irritability or anger.
4. Depressive Disorder Due to Another Medical Condition
When medical conditions bring about depressive symptoms, it’s called depressive disorder due to another medical condition. This can be tremendously difficult to diagnose because there is generally an assumption that teens and young adults are physically healthy, unless there is a glaringly obvious weight gain or loss. A simple blood panel and urinalysis can determine if a patient is suffering from another medical condition, like hypothyroidism, for example.
Physical Symptoms: Fatigue, weight gain, sleep changes, irritability, memory loss and low mood.
5. Seasonal Affective Disorder (SAD)
Adolescents and young adults with SAD struggle with the symptoms of a major depressive disorder, but it is limited to a specific time of year, specifically winter. The cause of this is related to decreased exposure to sunlight during the shorter days of winter months. For teenagers, this change could cause them to isolate from their friends and avoid participating in physical activities.
6. Bipolar Depression
Bipolar depression is a mixture of depression and manic episodes. It is treated in similar ways as depression, but with more intensive therapy needed.
Physical Symptoms: The feeling of being on a high, but not in a good way, with thoughts of grandiosity. Also, be on the lookout for increased, uncomfortable energy, insomnia and unhealthy hypersexuality.
“Journaling is highly recommended as a tool that can help relieve the symptoms of depression and anxiety, stated Latonia Francois, a mental health expert and founder of Let’s Write Life, which is a journaling and event company. “It’s a healthier alternative to antidepressants and other forms of harmful self-medication. On a mild level, journaling can be recommended as a form of self-care and a way for mental health professionals to help their clients express themselves, track patterns of progress and spark conversations that clients may not be able to vocalize.”
Self-Care Days and Activities
Family doctor and the best-selling author of How to Avoid the Superwoman Complex, Dr. C. Nicole Swiner (#docswiner), recommended the following forms of self-care to help you focus outwardly, instead of turning your attention inward to your anxiety: exercise, journaling, coloring, listening or producing music, being creative in the arts or volunteering to help others.
“Regular exercise increases endorphins aka the feel-good hormone,” Dr. Swiner stated. “Restful sleep, [maintaining] fulfilling relationships, and [adopting] healthy hobbies outside of school and work can help mild cases of depression. You just have to be aware of when things get out of control.”
Medication and Therapy
“One way to treat depression is, of course, with use of medications,” Dr. Swiner advised. “I’d say the biggest thing in our community that prevents us from seeking help with depression and similar issues is that we’re too proud to talk about it. Or, it’s because we don’t want to be put on a ‘crazy pill’ and have bad side effects (like weight gain or decreased sexual desires). Medicine is not the only way to treat these things, however, so keep an open mind and talk to someone about it in counseling and therapy.”