Dear Therapist:

Our teenage son is struggling. He sleeps a lot of the day, is not doing well in yeshiva, and several people who know him are worried that he seems depressed.

The confusing part is that he insists he is fine. He says everyone is overreacting and does not understand why people are so worried.

What we are trying to understand is how someone who is clearly not doing well can be so disconnected that he thinks that everything is fine.

Can you help explain what is going on here and what we can do to help him get some insight into himself. Thank you.

Response:

You say that your son is struggling. You’re also concerned that he sleeps a lot and isn’t doing well in yeshiva. I don’t know whether the struggle you’re seeing is based solely on these two issues or whether there are other factors that you didn’t mention.

Although people who know your son are worried that he may be depressed, your son himself denies that he is. Certainly, depression comes in different forms. Some people who can technically be classified as depressed don’t feel the way they think depression should feel. Their depression may manifest through symptoms such as disinterest, hopelessness, irritability, or low energy.

However, this doesn’t mean that anyone who exhibits some of these symptoms is necessarily depressed. Teenagers go through hormonal and other developmental changes that can lead to changes in behavior. For instance, your son may be tired for reasons that have nothing to do with depression. Changes in sleep patterns, screen use, and heavy schedules are just a few factors that can contribute to fatigue.

Similarly, your son may not be doing as well in yeshiva due to tiredness, changing interests, or any number of other factors.

You seem to feel that your son is disconnected from his feelings and that he is depressed on some level. You believe that he needs greater self-awareness in order to acknowledge his underlying depression. While this may be the case, it’s also possible that he is simply experiencing a normal developmental stage that others are interpreting differently.

It is also important to recognize that insight is not an all-or-nothing proposition. People can be very aware of some aspects of themselves while having difficulty recognizing others. Sometimes a person acknowledges individual symptoms—such as low energy, lack of motivation, or excessive sleep—without viewing them as signs of depression. Other times, a person adapts so gradually to changes in mood that they begin to see them as normal.

Regardless of whether your son is depressed, it may be worthwhile for him to speak with someone. As you mentioned, gaining insight into himself can be beneficial in its own right. However, if there are no other significant concerns and your son genuinely does not feel depressed, there may be less cause for alarm than others assume.

If you remain concerned about his sleep patterns and performance in school, these are issues that can be discussed on their own, without necessarily framing them as symptoms of depression. If the conversation is not centered on a clinical label, he may be more willing to acknowledge the specific concerns that you feel should be addressed.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

  Woodmere, NY

  adjunct professor at Touro University

  Graduate School of Social Work

  author of Self-Esteem: A Primer

  www.ylcsw.com / 516-218-4200

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