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One of the odd things about depression is that you can be depressed and not know it. Your brain can slow down so much you feel bad, even suicidal, but you can have enoug basic smarts to still be functional. When you in your teens, depression can show up as feeling irritable and "off," without the physical fatigue that usually accompanies depression later in life. Depression can cause jumpiness as welll as fatigue.

When you feel like life is not worth living, that is, when you suffer anhedonia, and you suffer disturbances of weight and sleep that you cannot control (whether it's weighing and sleeping more or weighing and sleeping less), and there isn't some other obvious psychiatric illness, such as schizophrenia or a delusional disorder, and you aren't on drugs, the problem probably is depression. This is a serious medical problem. It is not easy to treat, although the doctor usually eventually hits on a genuinely helpful medication or combination of medications.

Other Causes Of Depression-Like Symptoms

Borderline personality disorder and dissociative disorder both involve depression, but are more than depression. A borderline personality disorder involves intense real or imagined. fears of abandonment. For a variety of biological and psychological reasons, people with this disorder are desperate not to be alone. They become charming, manipulative, and sometimes mean. They suffer unbearable depression when they are alone. They tend to put people on a pedestal and knock them off. They suffer poor impulse control.

Dissociative identity disorder involves what used to be called split personality. It's not feeling you are nobody. That's depression.  It's knowing for sure who you are, only who you know you are changes from day to day or even hour to hour.

Treating Depression

Depression is bad enough and can cause very unpleasant symptoms without having any other conditions. The question is, what do you. do about it?

As a general rule, if you feel bad enough you want to die, you need to see a doctor. 

It is not just that suicide attempts often go wrong, leaving the suicidee in a worse condition than before. It is that wanting to die all the time, or even some of the time, is a terrible way to live. Your friends would want you to get treatment so you won't die, but get treatment so you will feel better.

If your depression does not involve suicidal thinking, then medication usually the way to go. I would classify St John's wort as an herbal medication. Just like any other medication. it takes time to work. It doesn't mix with the modern antidepressants in the SSRI class. You shouldn't mix herbs and prescription drugs for the simple reason that the combination can work too well. Instead of fatigue you could get headsches and high blood pressure. A (very) few people have become mildly manic (hypomanic) when taking both St John's wort and Prozac. Paxil, or Zoloft.

It also helps to stay away from weed and alcohol when you are depressed. Cocaine and methamphetamines are not a long-term solution. either.

One thing that is especially helpful for teens with depression is time with friends. Simply socializing increases the production of the feel-good chemical dopamine. To be honest, the medical literatursuggests that sex, sugar, and antic hijinks increase dopamine production too, but don't relieve your depression in the short term with something that will give you depression over the long term.

Depression doesn't have to ruin your life. Get professional assistance. Keep on doing things with friends. Be forewarned that getting past depression usually takes months, but know it eventually ends. Plan for better times and keep depression to a brief period in your life.

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