Given that subthreshold depression is so widely common among teens, it makes great sense to seriously question whether the illness model really applies well here. Is a 45 to 70 percent rate of some level of depression really an epidemic of medical illness? Or, might subthreshold depression, based upon its rates and the related science, more accurately be seen as a normal developmental process, that only if ignored, untreated, and unsupported tends to slip into a more severe and debilitating major depression?
My own clinical perspective, based upon the data and listening to teens, is that many, perhaps even the majority of adolescent depressions, are the hard work of quest, holding potential for spiritual individuation that makes the teen stronger and more resilient for the rest of adult life. Nearly every adolescent suffers from developmental depression at some point; it’s the general rule of growth, not the exception. The opportunity for spiritual individuation usually comes with hard work, doubts, dangling questions of ultimate significance, emptiness, and dark emotions. In a severe depression, medication may help, as long as the individuation work continues. For some it may be moderate to mild in that they are challenged but not overwhelmed by the developmental demands. Perhaps they have spiritual resources already well developed or at least emerging enough to help them manage as they go. Whatever the degree of challenge and depressive experience, research shows that the lifetime course of depression can be strongly affected by the spiritual developmental work of adolescence.
Miller, Dr. Lisa. The Spiritual Child (p. 280). St. Martin's Publishing Group. Kindle Edition.
The two major developmental tasks of adolescence are to find answers to the questions, “Who am I ? and “Where, in society, do I belong?” The struggle with these questions can generate anxiety, confusion, depression, the so-called adolescent “angst.”
What help is available in our society for these normal adolescent challenges? There is family, school, peer group, media, but increasingly, rarely church. Nurturance of an interior spiritual life is notably missing and yet this is what adolescents crave, what John Bradshaw called, “the hole in the soul.” And what does the adolescent try to fill this hole in their soul with? Romantic love, chemicals, risky behavior, rebellion, a cause.
In traditional cultures there was a coming of age vision quest which marked the transition from childhood and dependence on parents to adulthood and self sufficiency. In our modern culture such rituals are absent in a socially consensual way other than going off to college, entering the Armed Services, finding a job and moving in with roommates, and increasingly staying at home, playing video games, and withdrawing into a cocooned existence where things are safe, secure, and predictable.
Lisa Miller suggests that nurturing an interior spiritual life is a positive factor in building resilience not only for adolescent development but for a life time.
- What was your experience growing up through adolescence?
- What kind of an interior spiritual life did you have and how was it nurtured if it was?