SACKETS HARBOR — Joan E.I. Cuddeback looks like anyone's daughter, sister, friend. The 17-year-old plays basketball and soccer for Sackets Harbor Central High School and is a cashier at Panera Bread. Her best friend, Stephanie M. Heaslip, calls her “crazy in a good way.”
But for years, Joan has fought a turmoil within.
Speaking to a reporter while tucked behind a corner table at Chrissy Beanz Bakery, Joan said quietly that when she turned 11, she began crying herself to sleep every night. Years ago, she added candidly, she began to think about physically hurting herself.
Last year, she began crying uncontrollably during the day.
“I don't really know what triggered it,” she said before taking a sip of her fruit smoothie. “I didn't tell anybody. I just dealt with it.”
Worried, her parents took her to see a doctor. Three months ago, Joan was diagnosed with clinical depression and was prescribed medication.
Joan was fortunate she received medical help. Children entering their teen years can experience mood swings, which can lead to rebellion and anxiety. Distinguishing depression from normal teenage frustrations can be a challenge for parents.
“It's misdiagnosed frequently, because teenagers can have a lot of anger,” said Daun M. Whittaker, Jefferson County Mental Health Association executive director. “The typical things become too difficult for them. They stop doing things they enjoy. Depression really robs people of their life.”
Approximately 5 percent of teens are experiencing major depression at any one time, according to www.teenhelp.com. At Joan's school, with a student body of 189 from seventh through 12th grades, that would be about nine other students needing similar help.
Teenage depression is not new, but with the increased use of social networks on the Internet, societal pressures to be attractive and popular and the changes in teenagers' hormones, students with depression can be easy targets for bullies. School officials are scrambling to increase awareness of depression and bullying.
Heather A. Smith, a 2001 Watertown High School graduate, returned to the school in April to tell students about her bout with severe clinical depression while in high school. Like Joan, Mrs. Smith was a bright and active student. During her freshman year, she was in myriad clubs and the marching band.
After contracting meningitis before 10th grade, however, Mrs. Smith noticed a shift in her personality. She started withdrawing from the activities she signed up for the previous year and withdrawing from her closest friends.
“It was an incredibly lonely and terrifying place to be,” she said during an assembly in the school's auditorium. “That connection wasn't there anymore.”
Her experience with depression began to spiral out of control. Over the next two years, she was in and out of hospitals and began cutting herself as a cry for help. She became suicidal as the years wore on.
“Talk therapy was not enough to lift me to a safer place,” she told students.
CLINICAL VERSUS NONCLINICAL DEPRESSION
Mrs. Whittaker said the majority of people who believe they have depression can be cured through diet and behavior.
“There are some people whose behavior causes their depression,” she said. “The wrong diet or lack of exercise can all change serotonin levels.”
She said depression is caused by a shift in serotonin. These shifts can be caused by junk food, high sugar intake, not sleeping enough and winter weather. Acting depressed — hunched posture and eyes to the ground — can lead to feeling sad.
“It takes 21 days for a body to accept change,” she said.
However, she said, there is a percentage of people who need medical attention to get help for a more severe type of depression, the kind that cannot be solved through sleeping more or eating better.
“I work with a lot of people who have been hospitalized,” Mrs. Whittaker said. “Changing your diet isn't going to help it if you have severe depression.”
Symptoms of clinical depression include withdrawal, anger, low-level aggression, unusual sleep patterns and feeling overwhelmed.
She said a teenager's best bet to figure out whether he or she has clinical depression is to visit a primary care physician, as Joan did.
“School counselors may miss depression because they face teenage culture on a daily basis,” Mrs. Whittaker said. “I think we tend to be a little dismissive.”
In a worst-case scenario, a teen may decide suicide is the only answer. In May, Watertown senior Erin K. Foley killed herself in the woods near Jefferson Community College. Although some suspected she had been the victim of bullies, she never mentioned being bullied to the people to whom she was closest. Family and friends now believe Erin repressed years of depression.
“In hindsight, I can see the signs I wished I'd followed up on instead of leaving it at 'I'm fine,'” said her father, Paul J. Foley. “In elementary and middle school, Erin was active and outgoing, but in high school, I could see her becoming more withdrawn.”
Shortly after Mrs. Smith's visit, Watertown City School District Superintendent Terry N. Fralick announced the high school will have an anti-bullying task force starting in the fall.
“Depression is connected to bullying,” he said. “There are a lot of young people who need our help and don't know where to turn.”
The task force will serve to address policies and activities at the high school and will consist of community members as well as depression and bullying experts.
Statewide, the Dignity of All Students Act against bullying at school as well as an anti-cyberbullying law were enacted at the month's beginning.
Joanne T. Heaslip, the mother of Joan's best friend, Stephanie, started a glee club at Sackets Harbor Central High School in September. The club was formed to provide a safe haven for students who are bullied or feel left out.
Joan and Stephanie are members.
“We talk about accomplishments,” Mrs. Heaslip said. “We talk about situations at school and about situations at home. They're getting a sense of security in the group. A lot of them have problems at home.”
Kristie L. Fuller, Indian River High School theater director, is attempting to expose the seeds of bullying in a new docudrama for the coming school year.
Lowville Academy and Central School Superintendent Kenneth J. McAuliffe initiated several supports at his schools to ensure students with depression or who abuse drugs and alcohol get the help they need. He said most households have both parents working today, and schools are being held more responsible for turning students into productive members of society.
Dorothy W. Lalonde, a Canton middle and high school health teacher, agreed. She starts covering depression and cyberbullying as early as sixth grade.
“I feel that a lot of kids today are carrying a lot of issues,” she said. “They try to battle it alone. They're not alone. They're not abnormal.”
ON THE OTHER SIDE
Mrs. Smith, the daughter of Watertown Board of Education member Yvonne E. Gebo, has been cured of her depression for nearly a decade. During the Watertown assembly, she recounted the successes in her life: graduating from the University at Albany with honors, working as a psychology research assistant at Columbia University and marrying the love of her life on June 23.
“I've worked in clinical studies with adolescents, but this is the first time I shared my story,” she said.
She wanted to make sure any anonymous high school students facing the deep lows of depression understood there is a way out other than suicide.
“Depression is just like any other illness,” Mrs. Gebo said after her daughter's talk. “It's treatable. Suicide is a permanent solution to a short-term problem.”
Unlike most depressed students, who begin to withdraw from others, Joan for the last two years amplified the number of school activities she took part in, trying to eliminate any free time when she might think about the insecurities and confusion in her head.
Even though she is still being treated, Joan is stable enough to plan for her future, which includes applying to the University of North Carolina in Wilmington during the coming year.
Her father, Shaun D. Cuddeback, a county sheriff's deputy, has seen the illness strike other family members and said he believes the experience will always be a part of her.
“I don't think it's over and done with,” he said. “I don't believe it's something she'll ever be over and done with.”