Depression in Adolescent Males

Depression is soaring among adolescent males.

However, these young men frequently go undiagnosed and untreated, often because they don’t seem depressed.

Instead — after a lifetime being told boys don’t cry — they appear angry, oppositional, self-destructive, or maybe violent. Sometimes, they simply pretend everything is fine.

Depressed adolescent males hide behind these masks, doing their best to push away the world and hoping nobody notices they’re actually sad, lonely, vulnerable boys. In counseling I strive to help them remove these masks, explore the Guy Code, and resolve the stuckness that often results from depression.

Stuckness is a recurring theme in much of my work as a therapist, but can be especially relevant with depressed adolescent guys. I define Stuckness as an unwillingness or inability to do anything differently. In other words, the teen can’t or won’t change.

Teens who can’t change lack the skills to do so. Teens who won’t change lack the motivation. In my experience, most depressed adolescents fall somewhere between these extremes.

Additionally, can’t and won’t are likely to perpetuate each other. Teens who believe they can’t make change are unlikely to be motivated to try. Teens who are unmotivated to change probably won’t be receptive to new skills.

Sometimes, this Stuckness includes distress about Big Questions related to death, isolation, meaninglessness, and choice. In fact, this is quite common. Abstract thinking skills develop during the early teen years. Combine depression with this new thinking skill and some degree of existential angst is inevitable.

Therapists and other professional helpers often shy away from these existential themes when meeting with teens. It seems to me there are two reasons for this.

First, these themes just don’t fit into the solution-focused, goal-driven treatment approaches most commonly utilized when counseling adolescents. There’s nothing wrong with being solution-focused, but not everything can be fixed. It seems to me when we push away or ignore “unfixable” issues,  we end up reinforcing the Stuckness. Instead of pushing these topics away,  we should embrace them.

Second, some therapists seem to think depressed teens, especially trauma survivors or those with suicidal thoughts, are simply too fragile or damaged to explore these themes. This thinking suggests that acknowledging teens are  stuck will make things worse. That’s just not true.

It is important to be thoughtful, of course. I firmly believe we must start by establishing rapport and addressing critical presenting concerns. However, it’s also important to hold teens capable of exploring existential themes and other unfixable issues. Doing so emphasizes their resilience, suggests the possibility of a life beyond Stuckness, and helps them move forward.