Adolescent Depression

Paul, late teens, exudes all the confidence on the outside that he lacks on the inside.   Deep pain lurks beneath every smile. Paul reveals that he watched a TED talk this morning about a girl discussing the time she tried to kill herself.  When asked how he feels about the video, he describes her as brave that she didn’t go through with her suicide attempt and that she is able to talk in front of millions of people about her experience.  However, Paul also feels sad that this girl now has to live with the judgment and stigma of suicide.  The video is the reason Paul scheduled the appointment this morning to speak.  Paul attempts to draw a sharp contrast between himself and this girl, that he’s popular, has a scholarship next year to a top college, and that he’s class president versus the TED talk girl who was a loner and yet Paul admits to feelings of sadness.   As the conversation turns to these feelings, Paul becomes increasingly upset, saying he “doesn’t want to ruin it…by being stupid.”  After reassurances from the clinician, Paul admits to being depressed for years, pretending that he’s happy while he is anything but, consumed by thoughts of being a phony.  Paul reluctantly opens up that he took his dad’s gun out of the safe this morning and held it in his hands while seated on his bed.  He had a pen and paper to write a suicide note but ultimately did not go through with killing himself because he couldn’t hurt his parents and brother in such a drastic way.  Ultimately he wants to be as brave as the girl in the TED talk.