Christina B. recalls a happy childhood in Cortlandt Manor—until her parents divorced when she was 12. “That’s when everything started to unravel,” she says. In high school, Christina juggled a sterling list of activities—dance, volleyball, community-service club—while maintaining a straight-A average. Secretly, she had begun drinking and threw herself into “tumultuous” relationships.
“Everything looked good on the outside but didn’t really feel right on the inside,” says Christina, now 23. Her downward spiral accelerated when her boyfriend refused to take her to prom. “He was sick of my highs and lows.”
Christina says she didn’t spend one night sober for the whole summer, and when she arrived at Manhattan College as a freshman, the “fog” around her had only thickened.
“I’d come home weekends and just cry in my bed,” she says. “It was crippling. I wouldn’t use the bathroom for 36 hours. When I had to get up, I remember agonizing over what to do first: Pull off the covers? Take off my socks? I’d forgotten how to take a shower or wash my hair; I was so far gone.”
Still, it was only after a failed jump from the Bear Mountain Bridge—“My mother had called the cops, who came to the bridge and got me down,” Christina recalls— that she was diagnosed with depression and bipolar disorder, finally receiving the help she needed. Sadly, her experience isn’t unique—especially here.
“Westchester is an incredible place to live and raise kids; it’s also incredibly competitive,” says Angela Giuffra, LCSWR, a Scarsdale psychotherapist. “The school system has high expectations—for better and for worse.”
Depression in teens is “especially acute” in Westchester, she says, because teens are still developing the skills to contend with the rich stimulation surrounding them.
“The outside world is saying, ‘Go, go, go!’ and there’s no time for the nervous system to download it all,” Giuffra says.
Recent statistics show that 9.2 percent of US teens—roughly 1 out of 10, or 2.2 million adolescents—suffer from depression, making it the leading cause of disability and illness among teens. Adolescent suicide is the second leading cause of death, following accidents, with 5,000 deaths out of 500,000 attempts annually. Dr. Marc Weiler, a child and adolescent psychologist in Cross River, believes that Westchester’s rate of teen depression aligns with national figures. The peak age is 15 and 16; girls are three times as likely as boys to be afflicted.
“True depression is like having a hundred-pound weight on your shoulder,” Mary Borowka, licensed social worker
“Is depression a problem in Westchester? Yes; one in 10 teens is pretty high,” says Dr. Weiler. “I believe the stressors are the same across the communities for adolescents: belonging and acceptance, major changes in the body and in cognition. There are high standards—how beautiful, bright, or successful you are—which make it very difficult to be accepted. In other communities, the standards may be different, but the stressor of acceptance is the same.”
And the pressures begin to bear down early. “I see kids as young as seventh grade sitting in my office and stressing about their futures,” says Mary Borowka, a licensed social worker in Chappaqua. “If they don’t get into advanced math, they won’t be on the honors track, they won’t get into AP math, and they won’t get into the colleges of their choice. That doesn’t leave a lot of time to be a kid and continue to grow, neurologically and emotionally.”
Well-intentioned parents who want to smooth the bumps of adolescence may actually aggravate the problem.
“We want to teach our children to strive and be their best; some of that takes maturity. When you overlay that expectation onto your children, it’s an external force that feels like pressure,” Borowka says. “Parents jumping in with homework or talking to their kids’ coach—it robs kids of building their own internal sense of resiliency and arsenal of coping skills.”
“There will always be purely biological reasons for depression,” she adds. “These are environmental contributors.”
With medication and therapy, teens with depression have a good prognosis. Obstructing that road to recovery, says Dr. Weiler, is the “acceptance” in Westchester of self-medicating with drugs and alcohol, and the tendency of adolescents “to think not in terms of illness but in terms of right and wrong, punished and not being punished. The teen mindset is: ‘If I have a pimple on my nose, I’m a pimple.’ They don’t want to have people think, What are you, crazy?”
How do parents spot depression in a teen who, like Christina, is outwardly composed and even thriving? Look for significant behavioral changes, says Dr. Weiler: eating differently, sleeping differently, physical isolation.
“Typical adolescent irritation comes and goes; I think of it as a window that opens and shuts,” Borowka says. “But when that window is shuttered and the mood doesn’t vary, that is cause for concern.”
Irritation, moodiness, and snark around the house—what Borowka calls “the gift that’s often saved for parents”—shouldn’t raise a flag.
“True depression is like having a hundred-pound weight on your shoulder,” she says, “and it’s too hard to function. So the teen might start to disengage in school, jobs, activities. You have to go with your parental gut, and the best thing you can do is initiate conversation: ‘I’m concerned; you don’t seem yourself. Are you okay?’ They might not walk through that door, but just by opening it, you’re sending the right message.”
Kathleen Pimm (not her real name), of White Plains, recalls standing by helplessly as her son suffered from depression and anxiety, but his school balked at providing resources “because his grades were too good.” She finally decided to send him to a wilderness program with intensive therapy, to build resilience and (literal) survivor skills.
“Certain friends of mine thought I was really harsh—how could I do that?—but I wasn’t willing to watch my son go to the point of no return. He was taught to talk about his feelings, instead of suppressing them, and now he’s able to deal with conflict in a way that’s more mature than even I can.”
Even in today’s climate of “oversharing”—candidly discussing physical struggles such as cancer or concussions—mental illness remains engulfed in stigma.
“Among parents, Westchester is the ‘land of the fabulous,’” says a Westchester social worker who asked that her name not be used. “How are the kids? Fabulous! Travel league? College prospects? Fabulous! But that answer masks the underlying problems—and how common they really are.”
To make matters worse, says Giuffra, “it’s that out-of-balance perfectionism that leads to depression and self-destruction.”
The National Alliance on Mental Illness in Westchester (NAMI Westchester) recently had to create an entire second support group for parents of depressed teens, due to overflow. It also maintains a program called Ending the Silence, inviting those who struggled with depression as a teenager to talk at Westchester middle schools and high schools.
Among the speakers is Christina, who’s currently studying to become a social worker. With daily medication and weekly therapy, she is no longer weighed down.
“I thought I was the only one,” says Christina. “But if I’d had someone tell me then how I wasn’t alone, it would have made all the difference. Once I got diagnosed, I realized that I’m not a lunatic. I can fix it—there’s a light at the end of the tunnel. My goal is to tell high school students: ‘I’m a survivor. I’ve pulled through to the other side. And you can, too.’”
Melissa F. Pheterson is a frequent contributor to Westchester Magazine.