Depression in Boys Often Overlooked by Traditional Screening

July 27, 2023

By Courtney Wise

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Boys may be more depressed than data shows. It’s because we may be looking for the wrong signs.

Earlier this year, the Centers for Disease Control and Prevention published a report that showed nearly 60 percent of girls in the United States feel persistent sadness and hopelessness. The data cemented concerns about the state of youth mental health. In the aftermath, media coverage spotlighted the experiences of girls, prompting impassioned discussion about what can be done to stem the crisis. But Science News recently reported that while data shows rates of depression in girls has risen, they may also be surging – largely unnoticed – among boys.

From 2011 to 2021, persistent sadness or hopelessness in boys rose 8 percent and now affects nearly a third of all boys, according to the latest data from the biennial Youth Risk Behavior Survey. Still, researchers believe the true figure may be higher. Depression in boys and men doesn’t look like it does in girls, according to University of South Alabama psychologist Ryon McDermott. “We miss them in our assessments, and we miss them in our discussions,” he said. When boys and men are depressed, research suggests, it doesn’t consistently look like sadness, but rather hostility, aggression and impulsive behavior. “Rather than crying when feeling down, for instance, boys may act irritated or lash out,” Science News observes, adding that masculine norms equating sadness with weakness often keep boys from admitting feelings of depression.

Missing the signs of male depression is especially important since impulsivity may have a direct impact on suicides in depressed boys and men, suggests Johns Hopkins researcher Leslie Adams. Traditional screenings, which focus on sadness and hopelessness or ask who’s considered suicide, overlooks the nature of depression in boys.

Fortunately, new screening tools are being tested. Simon Rice, a clinical psychologist at an Australian nonprofit called Orygen, for example, has developed a Male Depression Risk Scale. It focuses on anger, aggression, somatic symptoms, and drug and alcohol use, Science News reports, and asks respondents to “rate questions such as how often they bottle up negative feelings, have difficulty managing anger or use drugs for temporary relief…None of the questions ask about sadness or hopelessness.” Tests have shown that 11% of men met the criteria for depression only on the Male Depression Risk Scale, leading some experts to suggest that boys may have been undercounted by the recent biennial youth survey.

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Dr. Barbara Greenberg on why families fight about weddings

There’s a reason that wedding movies are so popular: There’s major drama involved, And in a romantic comedy, the more, the better. But in real life, too much wedding drama may not end as joyously as “Four Weddings and a Funeral.”

As teen and parent psychologist Barbara Greenberg observes in her recent Psychology Today article, “The stress of planning a wedding can bring out the worst in some people.” She advises readers to try not to judge in-laws (and other participants) by how they behave in this volatile, stress-fueled time. In this column, a distraught mother is trying to buy a wedding dress for her daughter, only to encounter a controlling mother-in-law insisting that she should buy the dress instead. Read on to find out Dr. Greenberg’s advice.

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Texts from teens in crisis soar on the 988 hotline

The first time I received a text message, way back in 2002, I considered blocking the person who sent it. What kind of creep sends phone notes, I thought. Today, though, I’m more like my 15-year-old niece and her friends, preferring a quick text over a phone call from most people. And it turns out, allowing people suffering from a mental health crisis to text for help is driving up the numbers of teens seeking support from 988, 

“On a community-based level, we’ve become a little more isolated as time goes on, whether because of COVID-19 or otherwise,” Maryland-based hotline counselor Blair, whose last name is withheld by request of his employer, told MoCo 360. “I really think it’s necessary to have these services help fill in the gaps where our social interweaving has been lacking in recent generations.” EveryMind, a company that runs a 988 call center in Maryland, shared that fewer than 10 percent of their phone calls each month come from people under age 24. In contrast, nearly half of text 988 calls come from the same demographic. (This trend was underscored by federal data on 988: our Monday newsletter reported that compared to May 2022, answered texts in May 2023 had shot up by 938% while calls had increased by 45%.) 

It’s a good option for young people who are struggling but don’t know where to turn. According to the Substance Abuse and Mental Health Services Administration, less than 2 percent of 988 calls require an immediate emergency response, so the text lines offer vital information from a reliable, trustworthy connection. “Some young people have those friends, but they are also 12 and they don’t know what to do either,” Logan Shideler, a California crisis line supervisor, told EdSurge earlier this year. “The other people around them don’t have the tools to help them move through the conversation..”

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In other news…

In case you missed it, teens don’t only call into the crisis hotline for support. This PBS NewHour story shows that some teens in Oregon actually staff YouthLine, a call center designed for teens to call other teens when they’re struggling. 

With people of all ages facing long waitlists for therapy amid shortages of mental health providers, pediatricians are stepping up to help their young patients with mental health issues. Pediatricians in Chicago are being supported in their efforts through the Collaborative Behavioral Health Program, offered by the Chicagoland Children’s Health Alliance (CCHA).

“We know a lot of our doctors did not have [mental health] training in residency. And so they came into practice without a great deal of knowledge and skill on how to treat that,” CCHA’s Julie Holland told NBC Chicago. “We took a group of people who weren’t comfortable doing something, educated them gave them the skills, and now they can do it. And again, every kid that gets treated is another kid that doesn’t have to wait six or 12 months, or not see a mental health professional at all,” she said.

Worrying about your child is unavoidable; wanting the best for them is a given. Still, refrain from helicopter parenting, please. In “Let ‘em fly,” a feature  from Whitman College’s Whitman Wire, students explain why.

Similarly, if parental stress is driving you to hover over your child, seek help from professionals like yourself—other parents. Support systems are critical, said therapist Joey Trine. “A lot of people have this inherent independence to not want to be a burden or to not want to ask for help or they [think they] should be able to do it themselves. Absolutely not,” Trine told KHQA.

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If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

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