Identifying and Supporting Girls with Depression

By Stephanie Filio

A recent Washington Post articleIdentifying and Supporting Girls with Depression grabbed the attention of educators by pointing out statistics that show a rising trend of depression in girls, and at alarmingly younger ages than before. One study showed that symptoms begin presenting as young as eleven. By age seventeen, 36.1 percent of girls have been or are depressed, compared to 13.6 percent of boys.

Coming fresh from a middle school hallway, processing suicidal ideation concerns, self-harm assessments, and crisis center enrollments, I unfortunately cannot say these statistics came as a shock. The article cites the urgency of this issue due to the prevalence of learning, attention, and social acclimation issues that often arise in students with depression. Classroom warriors know—this urgency is absolutely right.

Some of the disparity between girls and boys makes biological sense, specifically with timing, because girls hit preadolescence and puberty several years before boys do. However, this disparity does not disappear as boys hit the same hormonal threshold. Based on this, we can assert that young women are simply more likely to have symptoms of depression. While the article hints at why this difference exists, I can’t help but think that, like everything else, there must be several layers of explanation—as well as layers of potential support.

Identifying Depression in Girls
Symptoms typically presented with depression include feelings of isolation and detachment, hopelessness, emotional instability, chronic sadness, weight fluctuation, and physical listlessness. In hindsight, these symptoms might remind many of us of our own middle school careers. However, a diagnosis of depression includes a persistence of these feelings. Feelings of suicidal ideation may or may not be present.

As school counselors, one of the toughest lines to straddle is between recognizing a possible diagnosis and our professional authority to verbalize it. Since we are not technically in the clinical realm, suggesting a diagnosis can be seen as unethical. Making this even tougher is the fact that we have first-row seats to the barriers students can face in getting a diagnosis: access to healthcare, parental knowledge of mental illness, geographic distances, lack of internet and technological resources, and so on. For these reasons, many students struggling with depression may not receive professional treatment. Knowing local resources and having flyers on hand with symptoms and home interventions can help create a bridge.

Why Girls in Particular?
As girls grow, they are bombarded by hormonal changes that take a toll on the mental and physical health of their bodies. This happens at the same time they are experiencing cognitive growth, so they are subsequently bombarded by intense new thinking about abstract concepts and a new recognition of deeper meanings. Social relationships become more complex, as do interactions with parents. This all creates a windstorm ripe for emotional confusion and deepened feelings of hopelessness.

There may also be social factors playing into this female-centered crisis. I have an open-door policy, where kids get candy rewards for visiting and can say things that wouldn’t fly in the hallways. Teachers, too, can come in and vent, and we will never speak of it again. All are welcome to shoot a few baskets, put their feet up on my table, or take a cat nap. But there is one rule for my office: Do not, under any circumstances, use the phrases “mean girl” or “drama queen.” The poor lug who learns this the hard way is subjected to my soapbox explanation of how these pop culture references perpetuate female stereotypes. It’s frustrating to hear these in everyday communication, and the thought of my students adopting such self-fulfilling prophecies is just too devastating. How many girls are dismissed as simply being “dramatic,” and how many suffer in silence with the assumption that their deep feelings of sadness are a normal part of femaleness?

Is it going too far to assume that gender inequalities may have something to do with more young women than young men experiencing symptoms of depression? Ruth Bader Ginsburg was once asked when there would be enough women on the Supreme Court to exemplify equality. She said, “When there are nine.” People were shocked. But there had been nine men, and nobody ever raised a question about that. Though progress has been made for women, strong social stereotypes implying that women are too emotional, too bossy, and shouldn’t be loud or particularly heard still exist. That’s a lot of pressure. Is it possible that our young women are experiencing a collective existential crisis? How can we address this?

Supporting Girls
My world is full of students who suppress thoughts and feelings in fear of being a social outcast. Making sure young women have plenty of opportunities to voice their feelings on growing up female is an essential part of getting to the root of female emotions. As family life classes are increasingly scripted and teachers feel more pressure to hold strong barriers with personal communication, there are fewer outlets for young women to talk about their hormonal, emotional, and social changes. As counselors, we get to be the safe place for students to discuss anything without judgment or embarrassment. Students feel comfortable coming to us and breaking down their walls. As long as students are not in danger of harm, we respect their confidentiality so they can feel secure as we peel back the layers.

The counselor’s secret weapon is the ability to build relationships. When we see symptoms of depression or other concerns, we can discuss treatment options with students and help them communicate more openly with their parents. I am honest with parents about my observations, and I give literature with ease, but I believe it is essential for students’ long-term success that they are able to articulate their feelings and build stronger relationships with their parents.

Starting a Girl Group
In addition to recognizing symptoms of depression and having open dialogue, we can be agents for change by helping girls be comfortable as loud, proud, and smart leaders. Groups are a fantastic way to reach students and also give them a built-in support system. I find this especially true for students who feel isolated or socially uncomfortable in their own skin. By helping them build bonds with peers and see that they are not alone, while also being present to guide conversation in a solution-focused way, you offer a model for healthy relationships.

When the students I work with were in seventh grade, I started noticing that some of my female students were hiding their leadership qualities behind a timid veil, and I decided to start a girl group. I wanted it to be an extracurricular instead of a therapeutic group so the girls wouldn’t feel I was pathologizing female characteristics. So many intervention models approach young women as broken, with the group intended to fix their deficiencies. I wanted something that would act as a mirror, celebrating all parts of my students, and helping them be more comfortable as the gregarious, wonderful kids they were.

Soul Force Ladies was created based on Martin Luther King Jr.’s concept of nonviolent resistance to oppression. We should be far beyond the concept of feminism as taboo, and I wanted to let young ladies know that it is okay to tell the world they are proud to be female. I promoted the group with open invites, specified invites, announcements, and by encouraging friend pairs. We started the first meeting by discussing the concept of womanhood and gender disparities, threw out ideas for future meetings, and created a code of conduct.

I was blown away as I became more of an observing advisor than an active leader, and these young women inspired me to be positive and proud and to endure obstacles. They were relative strangers at first, but after chatting about everything from friendships to rapid emotional changes, they became a sisterhood. Each girl in the group alluded at least once to typical signs of depression, such as insomnia and feelings of worthlessness. The rest of the group would typically respond with “Ugh, I hate that!” and give comparable examples from their own lives. They supported one another and made one another feel wonderfully, abnormally normal.

While chatting, I also provided literature to read and discuss, and we completed a planned activity. Here are some of the things we did in our girl group:

  • We wrote encouraging and positive messages on little pieces of paper, folded them up, and walked all over the school putting them in random lockers.
  • Slime was the in thing when we started, so we did a couple of science experiments. We mixed and made a mess while talking about women in science and math fields and reasons for gender disparities in professions.
  • For International Women’s Day, we made cards for various women in our lives. Moms, teachers, sisters, and aunts were the recipients of several very special letters. We discussed what a good role model is, and girls shared many examples of strength and perseverance as we talked about our heroes.
  • We had poster-making sessions where we made female empowerment posters to hang around the school. We promoted our group while also giving an extra smile to other preteens in need of some love.
  • Our favorite activities were our infamous pop-up potlucks! We each brought in food special to our individual cultures or families. While we ate our feasts, we told stories, laughed, and planned our next meal. Often, women from around the building would join us (especially if someone brought in Filipino pancit), and we just enjoyed one another’s company.

Stringing It Together
Data about depression in young girls clearly indicates that they are struggling. However, there is a difference between strained and broken. The intense hormonal changes in preadolescent females are biological but not a defect. As we continue to question perspectives on gender inequality, we find more effective ways to reach and embolden young girls. As we observe our students and note possible signs of depression, the best thing we can do is use our school counselor powers to have open dialogue with families. In doing so, we can empower our girls instead of victimizing them, and they can grow from the strength of their bravery. We might not be able to solve the crisis nationally, but in our own hallways, we can stop seeking a quick fix and instead help larger student populations grow from the process.

NOTE: It cannot be stressed enough that when we see red flags that indicate suicidal ideation, it is essential to be proactive and respond swiftly to ideation (and not just to behaviors). All of the work above can be saved for later. An assessment should be done and parents must be contacted before any other intervention.

Stephanie FilioStephanie Filio is a middle school counselor in Virginia Beach. She received her undergraduate degree in interdisciplinary studies from the University of Virginia and her M.Ed. in counseling from Old Dominion University. In a discussion with one of her UVA professors about her desire to stay in school forever, her mentor wisely responded, “If you want to be a lifelong learner, go into education,” and so she found her place. Prior to her six years as a school counselor, Stephanie worked in private education, specializing in standardized tests, test preparation, and future planning. She writes about her career and hobbies at her blog, Weekend Therapy, and can be found on Twitter @steffschoolcoun. Stephanie also enjoys spending time with her books, crafts, and family.

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