Misdiagnosed millennials: Are therapists missing signs of depression in a unique generation?

Are mental health professionals adequately equipped to recognise signs of depression that might hum a different tune in millennials?

In 2021, a UNICEF study stated that around 14 per cent of young adults in India have reported signs of depression. This number is a significant jump when compared to instances of depression among past generations. The narrative of depression in the younger generation often emerges because of student loans, stagnant wages, and an uncertain future. 

While these stressors undoubtedly contribute to the issue, a more nuanced conversation is the need of the hour. Are mental health professionals adequately equipped to recognise depression that might hum a different tune in millennials as compared to their predecessors? 

Are Therapists Missing the Marks in Recognising Depression? 

Depression is traditionally associated with symptoms like persistent sadness, low energy levels, and changes in appetite. However, for younger generations, these signs might be masked or expressed differently. They might show irritability and difficulty concentrating, leading to procrastination or a constant feeling of being overwhelmed. Social media, a constant companion for this generation, can complicate matters further.

“Therapists can encounter challenges in identifying depression across various demographics, but these challenges are not necessarily tied to specific age groups, genders, or cultural backgrounds,” says Dr Poonam Poonia, a senior consultant and clinical psychologist. The traditional diagnostic criteria for depression rely heavily on self-reported symptoms. However, younger generations might be less likely to express their struggles in the same way. 

“Depression can manifest differently in different age groups,” says Poonia. Signs of depression in women are also different from those of men. “Men may be less likely to acknowledge or seek help for emotional issues due to social norms around masculinity. This can lead to underreporting or underdiagnosis of depression in men,” adds Poonia. 

Societal attitudes also act as a unique filter, shaping how individuals perceive the world and their mental health. This filter can influence how readily they recognise mental health problems in themselves and others. “Some cultures may stigmatise mental health issues, leading individuals to hide their symptoms or seek help from traditional healers rather than mental health professionals,” explains Poonia.  

Can Therapist’s Decode Atypical Signs of Depression?

“Depression can manifest in various ways, and individuals may exhibit behaviours or symptoms that don't immediately appear to be related to depression. These ‘masks’ can sometimes obscure the underlying mood disorder.” says Poonia. The good news is that therapists are becoming increasingly aware of the need to adapt their approach for the younger generations. Here are some ways therapists can decode atypical signs of depression:

1. Outbursts and Rage: “Rather than expressing sadness or a low mood, some individuals with depression may outwardly display irritability, anger, or even aggression.” says Poonia. This could be a way to protect themselves emotionally or hide feelings of vulnerability.

2. Hyper-Drive and Busyness: Being constantly busy or being a workaholic can be a surprising sign of depression, a way to avoid or distract from underlying sadness. “This constant activity may serve as a coping mechanism to numb emotions or maintain a sense of control,” says Poonia. 

3. Unexplained Physical Ailments: “Depression can sometimes manifest in the form of unexplained aches and pains, headaches, digestive problems, or fatigue.” says Poonia. These physical complaints might be the main focus during doctor visits, potentially delaying a diagnosis of depression.

4. Focus on Social Media Habits: Exploring a client's online behaviour can be insightful for a therapist. Are they constantly comparing themselves to unrealistic portrayals on social media? Is their sleep disrupted by late-night scrolling? These habits could mask underlying depression.

The Link Between Social Media-Induced Insomnia and Depression

Sleep is a critical factor in mental well-being. A 2023 study by Statista found that about 46 per cent of Indian parents reported their teens spend between 3-6 hours daily on social media. This disrupts sleep patterns, and can be a major red flag for depression.

So, how can therapists address the impact of social media on sleep-disrupted patterns and mental health?  While therapists can guide their clients to develop a healthy self-esteem, thereby mitigating the negative comparisons fostered by social media, they can also, Poonia adds, “provide information about how screen time before bed can disrupt sleep patterns, and how social media can exacerbate feelings of stress, anxiety, or depression.” She furthers, “Through a combination of psychoeducation, skill-building, cognitive-behavioural techniques, and ongoing support, therapists can help clients develop healthier relationships with technology.”

Can Open Communication Help Recognise Early Signs of Depression? 

“In our country and in this time and age, depression is a big stigma. Depression is a choice and is like quicksand. With time you sink in deeper and deeper. But with time, open communication about depression can play a significant role in normalising seeking help and reducing stigma,” says Poonia. According to Medical News Today, the younger generations are more open to talking about and seeking help for their mental health issues. 

Poonia advises, “Open discussions about depression provide opportunities to educate the public about the prevalence, symptoms, and treatment options available. Increased awareness helps dispel myths and misconceptions surrounding mental illness and promotes understanding and empathy toward those experiencing depression.” 

“By openly discussing depression and the importance of seeking help, individuals are more likely to view such behaviour as a normal and acceptable response to mental health challenges,” adds Poonia. Sharing experiences and struggles also creates a sense of solidarity and dismantles the stigma associated with it. 

How Can Therapy Attempt to Break Depression's Silence?

An NIMH study shows that up to 90 per cent of people with depression experience social withdrawal and emotional numbness. This withdrawal, often accompanied by emotional numbness, can make it difficult for people with depression to connect with loved ones or express what they are feeling. Therapists create a safe space that enables you to express yourself freely. They actively listen to your words, and even the silences.

Poonia further elaborates, “Mental health professionals play a crucial role in facilitating open communication about depression by creating safe, supportive spaces for clients to discuss their experiences. They can foster an environment of trust, empathy, and non-judgmental listening, encouraging clients to explore their emotions and seek guidance.”

Taking Control of Your Well-Being

The growing awareness around depression and the openness among younger generations to seek help paint a hopeful picture. Therapists are constantly evolving their approach to bridge the communication gap with their clients. With continued research, open dialogue, and a focus on healthy online habits, both therapists and young people can be better equipped with the tools to decipher subtle signs of depression. 

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