As a doctor, I can probe, culture, prescribe antibiotics, and aggressively treat and track contagious STDs. But depression is different. It’s more elusive, yet equally, if not more, dangerous. It can come and go, or it can settle in, making itself so comfortable in an adolescent’s psyche that it’s nearly impossible to extricate. There, just as many STDs do, depression causes permanent damage that may not become apparent for years. To many teenagers, depression can make them feel as though another entity has moved into their body, taking over everything they think, feel, and do.
For the thousands of teens I’ve treated and counseled, one of the major causes of depression is sex. I consider it an STD with effects as devastating as—if not more—HPV, chlymadia or any other.
Just ask any doctor, therapist, or teacher who works closely with teenagers and they’ll tell you: Teenage sexual activity routinely leads to emotional turmoil and psychological distress. Beginning in the 1970s, when the sexual revolution unleashed previously unheard-of sexual freedoms on college campuses across the country, physicians began seeing the results of this “freedom.” This new permissiveness, they said, often led to empty relationships, to feelings of self-contempt and worthlessness. All, of course, precursors to depression.
Teens are particularly vulnerable to the negative effects of early sexual experience because of the intense and confusing array of emotions they’re already experiencing. Adding sex to the picture only makes those feelings more intense and more confusing.
Like most STDs, depression remains hidden and under-diagnosed, even though its prevalence among our teenagers has skyrocketed in the past 25 years, paralleling the rise in STDs. We don’t know exact numbers because so many of its victims can’t put a name to their feelings, while too many adults pass off depressed behavior in teenagers as part of “normal adolescence.” Other teenagers are so depressed they lack the energy or desire to seek help. For while physical pain drives patients to physicians, emotional pain keeps them away.
Still, the numbers we do have on depression in teens are terrifying. According to Dr. John Graydon, professor of Psychiatry and Neurosciences at the University of Michigan, one in eight teenagers is clinically depressed and most teens’ depression goes undetected.1 Because the rates of completed suicides among adolescents have skyrocketed 200% in the past decade,2 suicide now ranks as the third leading cause of death in teenagers, behind accidents and homicides3 (both of which may involve depressed adolescents, who often drink and engage in violent behavior to anesthetize their depressed feelings).
Also frightening is the fact that teens today are more likely to succeed in killing themselves when they try. One study found that completed suicides among 10- to 14-year-olds increased 80% from 1976 to 1980 and 100% for 15- to 19-year-olds.4 From 1980 to 1997, the rate of suicide increased 11% in all 15- to 19-year-olds, 105% in African-American teen boys, and a startling 109% in 10- to 14-year-old children.5 Even more sobering is the fact that for every adolescent who succeeds in committing suicide, 50 to 100 attempt it.6 In fact, a 1995 study found that a staggering 33 out of every 100 high school and middle school students said they’d thought of killing themselves.7
One-third of our adolescent population has thought of killing themselves!
This statistic terrifies me, as it does countless parents, teachers, and grandparents in the country. Indeed, many experts on adolescent suicide and psychiatric illness refer to this dramatic increase as “a national tragedy.”8 And I strongly believe, as do many of my colleagues, that the situation is much worse, that depression is highly under-diagnosed in teens. The bottom line is that depression has invaded millions of our teens. And that’s just what we see on the surface.
I believe even more strongly that there is a correlation between the explosion in sexual activity and the epidemics of STDs and depression in our teenagers. I know this because of what I’ve heard from the thousands of teens I’ve counseled over the past 20 years, and from my own experiences raising four children. What I hear and see is that sexual freedom causes most of them tremendous pain. Now, research is just beginning to show a correlation between teen sex and STDs. One study shows such a strong link between STDs and depression that the authors advised all physicians to screen every teen with an STD for depression.9 I go one step further—I screen all sexually active teens for depression, STD or not.
We already know that adults with STDs struggle with depression, guilt, and feelings of isolation and shame. And we know from several significant research studies that the breakup of teenage romantic relationships often leads to depression and alcohol abuse. One study of 8200 adolescents, ages 12 to 17, found that those involved in romantic relationships had significantly higher levels of depression than those not involved in romantic relationships.10 “Something about dating and dating relationships can be toxic to girls’ health,” says Susan Nolen-Hoeksema, Ph.D., a psychology professor at the University of Michigan in Ann Arbor, and an expert in adolescent depression.11