The Self-Regulation Handbook for Teens and Young Adults by Dr. Kathy Wu (Book Excerpt)
Excerpted from The Self-Regulation Handbook for Teens and Young Adults by Dr. Kathy Wu. Copyright © 2025 Ulysses Press. Reprinted with permission from Ulysses Press. New York, NY. All rights reserved.
UNDERSTANDING DEPRESSION
Your age group often faces unfair scrutiny for how you express yourselves. Society tends to misinterpret your emotional variability as signs of instability or immaturity. I witness this firsthand when I mention that I work with teens and young adults; people often react with a mix of pity and bemusement, as if to say, “You’re brave—good luck!” In response, I emphasize that your emotional sensitivity reflects the normal ups and downs that come with navigating a complex stage of life filled with significant changes. In fact, it’s you who are the brave ones!
Things get more complicated when feelings of sadness, hopelessness, or emotional numbness persist, potentially leading to depression. These feelings can creep in gradually or strike suddenly. While the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) states that symptoms of depression must last at least two weeks to qualify as a major depressive episode, depression can manifest in unique ways for teens and young adults that may go unnoticed.20
Many young people may not show classic signs of sadness; instead, you might experience increased irritability, withdrawal from social interactions, or changes in appetite and sleep patterns. This can lead to your struggles being misinterpreted as “typical teenage behavior,” obscuring the seriousness of your emotional pain. Additionally, the pressure to maintain a certain external image can heighten feelings of inadequacy and loneliness, creating a situation where your internal struggles remain hidden.
When you’re depressed, it can feel like walking through thick mud—every step requires immense effort, and the harder you try to move forward, the more you feel pulled back. Just getting out of bed can be a struggle, even when you should feel well-rested. Everyday responsibilities—like going to work or school, managing chores, or socializing—can seem monumental. This constant fatigue and lack of motivation can lead to procrastination, creating a backlog of responsibilities that heightens feelings of inadequacy and guilt.
Take Billie Eilish’s song “Bellyache,” for example. In this track, Eilish captures the essence of being overwhelmed by her thoughts, wrestling with sadness, guilt, and confusion. Her lyrics about wondering where her mind went, or thinking she’d feel better, perfectly convey the sense of being trapped in your emotions.21 If her music resonates with you, it may be because she articulates those hidden feelings of sadness and frustration that can be hard to express.
Recent studies indicate that hormonal changes, such as fluctuations in estrogen and testosterone, can lead to mood swings and increase the risk of depression.22 These hormonal shifts can disrupt emotional regulation, resulting in deep sadness or irritability. Family dynamics also play a crucial role; conflicts at home or a lack of support can intensify feelings of depression and anxiety, making daily stressors harder to manage. Major life events—like academic pressure or a challenging breakup—can cause moods to shift downward. Additionally, social media can add another layer of stress, with research showing that excessive use can diminish self-esteem and amplify feelings of inadequacy, especially when comparing yourself to the seemingly perfect lives portrayed online.23
Living with depression can feel isolating, even when surrounded by loved ones. This disconnection can be worsened by a reluctance to share your feelings, often stemming from fears of being judged or misunderstood. The stigma surrounding mental health can make seeking help even more challenging, leaving you to struggle in silence.
Reflecting on your experiences with depression can provide valuable insights into your emotional state and coping strategies.
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Endnotes:
20 American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (DSM-5) (American Psychiatric Association, 2013), 165–68.
21 Billie Eilish, “Bellyache,” Don’t Smile at Me (EP), Darkroom / Interscope Records, 2017, https://www.youtube.com/watch?v=gBRi6aZJGj4.
22 Margaretha Wilhelmina Laurence Morssinkhof, “Waves of Change: Sex Hormones, Depression and Sleep” (PhD thesis, Vrije Universiteit Amsterdam, 2024), https://doi.org/10.5463/thesis.676; Eric R. Lewandowski, Mary C. Acri, Kimberly E. Hoagwood, Mark Olfson, Greg Clarke, William Gardner, et al., “Evidence for the Management of Adolescent Depression,” PEDIATRICS 132, no.4 (2013): e996–1009, https://doi.org/10.1542/peds.2013-0600.
23 Natalie L. Colich, Margaret A. Sheridan, Kathryn L. Humphreys, Mark Wade, Florin Tibu, Charles A. Nelson, et al., “Heightened Sensitivity to the Caregiving Environment During Adolescence: Implications for Recovery Following Early‐Life Adversity,” Journal of Child Psychology and Psychiatry 62, no. 8 (2020), https://doi.org/10.1111/jcpp.13347; Lidia Piccerillo and Simone Digennaro, “Adolescent Endnotes 305 Social Media Use and Emotional Intelligence: A Systematic Review,” Adolescent Research Review , July 21, 2024, https://doi.org/10.1007/s40894-024-00245-z.
Author Bio:
Kathy Wu, PhD, is a licensed psychologist committed to supporting young people in their personal growth, creativity, and overall well-being. A former college professor, she brings a rich educational background to her clinical work, blending trauma-informed care with evidence-based practices. She has experience across a wide range of settings—including corporations, psychiatric hospitals, community health centers, public schools, and universities throughout the Northeast. She now leads a thriving private practice in Houston, TX. Find her online at wupsychology.com
