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Teen depression is the great unlearned lesson of Columbine. (Dylan Klebold was driven by suicide. I cover this extensively in my Columbine book, and so does Sue Klebold in her book, A Mother's Reckoning.)

 

The U.S. Preventive Services Task Force estimates that 6% of U.S. adolescents suffer clinical depression. That’s 2 million kids. It's time to act.

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When I speak to high schools, I ask how big the class body is. If it has 1,000 kids, that means 60 kids right now are suffering clinical depression. They are not just sad, they are in real danger. Diagnosis is easy, yet most are unaware. It’s treatable, too.

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Teachers and principals: Teen depression must be addressed in schools. Awareness among kids is crucial. A version of this page appears as the depression unit in my  Columbine Teacher's Guide in a different format, which might be more tailored to some users.

Resources

Warning Signs of Depression

From National Institute of Mental Health

  • Persistent sad, anxious or "empty" feelings

  • Feelings of hopelessness and/or pessimism

  • Feelings of guilt, worthlessness and/or helplessness

  • Irritability, restlessness

  • Loss of interest in activities or hobbies once pleasurable, including sex

  • Fatigue and decreased energy

  • Difficulty concentrating, remembering details and making decisions

  • Insomnia, early–morning wakefulness, or excessive sleeping

  • Overeating, or appetite loss

  • Thoughts of suicide, suicide attempts

  • Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment

Warning Signs of Suicide

From The Trevor Project

  • Increased isolation—from family and friends

  • Alcohol or drug use increases

  • Expression of negative attitude toward self

  • Expression of hopelessness or helplessness

  • Change in regular behavior

  • Loss of interest in usual activities

  • Giving away valued possessions

  • Expression of a lack of future orientation (i.e. "It won't matter soon anyway")

  • Expressing suicidal feelings

  • Signs of depression

  • Describes a specific plan for suicide

  • History of suicide in the family

  • A person who has been extremely depressed in the past may be at an increased risk for suicide if the depression begins to cease, as they may now have the psychological energy to follow through on a suicidal ideation.

Essential Reading

I recommend everyone concerned with this topic read the powerful essay by Dylan Klebold's mother, Sue Klebold.

 

If you're interested in more from me on the subject, I recently wrote two pieces for Slate's XX Factor: "Understanding Sam Hengel, the Gunman at Marinette High School" and "Columbine's Lost Lesson." That lost lesson is depression.

Sue Klebold also has great suggestions at her site.

Discussion Topics on Depression

For teens, parents or teachers. (Students have used this list to organize papers or class projects)

  1. What is depression?

  2. Distinguishing depression from “sadness”

  3. Prevalence: 6% of U.S. teens

  4. Consequences:

    • Impact on kids: drug and alcohol, teen pregnancy, school dropout, misery, suicide

    • Impact on the school system—and the economy when it continues to adulthood

  5. Detection and prevention

  6. Treatment: options/efficacy

  7. Depressives who kill:

    • The role of depression in Columbine

    • Prevalence of depression in other attacks

  8. Your peers

    • Spotting it in your friends

    • Approaching friends in danger

    • Who could you turn to for help?

  9. Yourself

    • Spotting it in yourself

    • Options

    • Who could you turn to?

  10. Your school, college, or community:

    • What is in place now?

    • How could it be improved?

    • What can you do?

Facts About Teen Suicide

From The Trevor Project

  • Suicide is the third leading cause of death among 15 to 24-year-olds, accounting for over 12% of deaths in this age group; only accidents and homicide occur more frequently (National Adolescent Health Information 2006).

  • Suicide is the second leading cause of death on college campuses (CDC 2008).

  • Lesbian, gay, and bisexual youth are up to four times more likely to attempt suicide than their heterosexual peers (Massachusetts Youth Risk Survey 2007).

In-Depth Discussion of Depression

  This section is in two parts:

  • Questions on the affliction.

  • Questions on Dylan Klebold as case study.

Questions on the Affliction of Depression

  1. Explain the difference between clinical depression and “sadness.” What makes depression so dangerous?

  2. Identify five common consequences of depression. Discuss how each one can devastate the life of a teenager.

  3. Did you know 6% of U.S. teens suffer clinical depression? Discuss the impact to schools and individuals. Alternative: discuss the economic impact on adults.

  4. Outline the two major strategies for treating depression. How successful are they?

  5. Discuss the controversies surrounding pharmacological treatment. Is there legitimate cause for concern?

  6. Discuss the suicide rate among teens. What are the key warning signs? How do you approach a classmate you fear is in danger? What can you do if you fear it in yourself? 

  7. React to the statement: “Parents and schools are drugging our kids out of our  problem.” Are anti-depressants over-prescribed? Under-prescribed? Take a position.

  8. What causes depression? Are there genetic predispositions? How significant are external factors in bringing it on (e.g., breakup with a boyfriend/girlfriend)? Who is most at-risk?

  9. Does a depression diagnosis still carry a social stigma? How might that change?

  10. What have organizations like the U.S. Preventive Services Task Force recommended as strategies for diagnosis and treatment?

  11. What is in place in your school to diagnose and treat kids in trouble for depression? How effective is it? How could that change?

  12. How well do most depressed teens understand their own condition? Are they aware they are depressed?

  13. Do most depressed teens hide it? Who are they most and least likely to tell? Why are their parents least likely to know?

  14. Outline recent advances in the diagnosis or treatment of depression. What lies on the horizon?

  15. In severe cases, do depressives usually cry out for help in some way before committing suicide or murder?

  16. Anti-depressants carry a risk warning of potentially increasing the risk of suicide among some patients, primarily during the very early stages of treatment. Explain why this phenomenon occurs. How significant is the incidence of this problem? Is it greater or smaller than the number believed to be kept from suicide by the same treatment?

Case Study:

Questions on Depression and Dylan Klebold

  1. What role did depression play in the attack? Would Dylan have killed people if he’d been diagnosed and treated?

  2. Describe the misery Dylan Klebold was going through. What was so painful for him? Did that change over time? How did his responses to it change?

  3. How did Dylan see himself? How did his self-image compare to objective assessments (e.g., based on his social calendar, how his friends saw him and related to him, etc.)

  4. Why was Dylan never diagnosed with depression? Should he have been? How do you think that would have affected the outcome?

  5. How often do angry depressives commit murder? Outline the progression from suicide through single murder to mass murder.  What causes a person to make that progression?

  6. Read the essay published by Dylan's mother, Susan Klebold in 2009. List five warning signs she could identify in retrospect. How common are each? How does a parent, teacher or friend know when to take each one seriously? Parkland.

Teen depression 101
The Great Unlearned Lesson of Columbine

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