Young & the lonely: a team of top experts answers your questions about loneliness and depression

Do you often feel lonely? Irritable, angry, or with-drawn? "It's just a phase," a parent may counsel. "You'll get over it," advises a friend. After all, says conventional wisdom, you're an adolescent--and stormy emotional ups and downs come with teen territory. Or do they?

Until roughly the last two decades, medical researchers pinned adolescent angst on the natural course of human development. But slowly they've come to distinguish teenagers' normal feelings of sadness and anger from a genuine, often crippling mental-health disorder: depression. What's the difference between common loneliness and depression? "Feeling lonely occasionally is universal," says leading teen expert Dr. Harold Koplewicz. "Depression is a real disease." Increasingly, researchers have come to consider depression a biochemical disorder in the brain, where imbalances of neurotransmitters (chemical messengers between brain cells) like serotonin and dopamine adversely impact emotional control. But the causes of such biochemical imbalances--and whether they're fleeting or permanent--remain somewhat of a mystery.

Nevertheless, about 3 million 14 to 18-year-olds in the U.S. are clinically depressed, according to the National Institute of Mental Health. Depression knows no economic, social, or racial borders. From teeming cities to tiny towns, many Americans battle sporadic or frequent bouts of depression--sometimes suffering for years in silence, without diagnosis or treatment. So when SW wanted to tackle the issues of loneliness and depression, we turned to students in Maureen Van Ackooy's science class at LaGrange Middle School in Lagrangeville, New York, and asked them to submit the pressing questions they wanted answered. After all, their questions are yours.

Q: What starts depression?

Jamie Stenson, 12; Kurt Nicoliasen, 11; Kathryn Lee, 11

Depression occurs when a person's brain has trouble managing stress, says Dr. Harold Koplewicz, director of the New York University Child Study Center and author of More Than Moody: Recognizing and Treating Adolescent Depression (Putnam, 2002). When certain stressful crises occur--like a divorce, loss of a valued friendship, the death of a loved one, or economic hardship--people typically feel sad. Usually after a period of time, they're able to recover their normal feelings of well-being. "But for those people with a chemical imbalance in their brains, these stressful events can cause them to become depressed," Koplewicz says.

Q: Is depression inherited, or is it from your environment?

Stephanie Carrick, 11; Eric Rothdeutsch, 11 Researchers currently think an interplay of factors are responsible for depression. One factor is genetic, says Koplewicz: "Depression runs in families, which means you're more at risk if your mother, father, or sibling is depressed." However, he points out, most teens who battle depression don't have any relatives with the disease. That's because other determining factors include: one's family environment, such as the presence of physical or emotional abuse, or neglect; individual personality traits, such as low self-esteem or overdependence on others; and again, a person's unique brain chemistry.

Q: Does depression occur at a certain age? Paul Fielek, 11

Depression is more common during adolescence than at any other time of life, says Koplewicz: "Particularly being 13 or 14 years old is the most common age for depression to occur."

Q: What's the number one reason why teens get depression? Alyssa Minicucci, 11; Jaclyn Schauer, 11; Rachel Queenan, 10; Wylie Borum, 11; Dylan Britton, 11; Heather Peruffo, 11; Dana Capicotto, 11; Joe Murray, 11; Mark Kuczyra, 12; Peter Speak, 10; Cathleen Fitzpatrick, 11; Sean Reilly, 11; Anthony Rispoli, 11

While hormonal surges at puberty impact mood swings, new research shows the teen brain is literally in flux, Koplewicz explains: The frontal lobes, which help regulate emotional moods and self-control, alter

dramatically between puberty and adulthood. The lobes' gray matter (tissue connecting various cells and nerve branches) undergoes a growth spurt between age 11 or 12. But then, oddly, a pruning or reduction of brain-cell connections occurs that lets maturing teens focus more specifically on new information--from factual knowledge to abstract concepts--and emotionally absorb that information more deeply. Says Koplewicz: "For a small percentage of teens, this exciting but dramatic brain change--coupled with genetic or environmental factors--triggers depression."

Q: What does depression feel like? Sabrina Acompora, 11

"Some depressed people cry a lot and have trouble getting out of bed," says Alan Hilfer, pediatric psychologist at Maimonides Medical Center in Brooklyn, New York. Depression can also make you very tired--oversleep or cause sleeplessness, and make you overeat or lose your appetite. The person who turns depression inward as anger may seethe with constant rage. "It feels like an enormous weight, weighing you down," Hilfer says. "One thing we try to do in therapy is to get people to identify their anger, and learn to express and manage it properly."