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My goal with this unit is to give students a place where they can learn and talk openly about mental health.

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John Green on Mental Illness and Writing a Book That Mirrors His Own Life

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Turtles All the Way Down is the first novel from YA fan-favorite John Green since the release of his 2012 phenomenon The Fault in Our Stars.

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Marta Montiero for BuzzFeed News

At the time I first realized I might be fictional, my weekdays were spent at a publicly funded institution on the north side of Indianapolis called White River High School, where I was required to eat lunch at a particular time - between 12:37 p.m. and 1:14 p.m. - by forces so much larger than myself that I couldn't even begin to identify them. If those forces had given me a different lunch period, or if the tablemates who helped author my fate had chosen a different topic of conversation that September day, I would've met a different end - or at least a different middle. But I was beginning to learn that your life is a story told about you, not one that you tell.

Of course, you pretend to be the author. You have to. You think, I now choose to go to lunch, when that monotone beep rings from on high at 12:37. But really, the bell decides. You think you're the painter, but you're the canvas.

Hundreds of voices were shouting over one another in the cafeteria, so that the conversation became mere sound, the rushing of a river over rocks. And as I sat beneath fluorescent cylinders spewing aggressively artificial light, I thought about how we all believed ourselves to be the hero of some personal epic, when in fact we were basically identical organisms colonizing a vast and windowless room that smelled of Lysol and lard.

I was eating a peanut butter and honey sandwich and drinking a Dr Pepper. To be honest, I find the whole process of masticating plants and animals and then shoving them down my esophagus kind of disgusting, so I was trying not to think about the fact that I was eating, which is a form of thinking about it.

Across the table from me, Mychal Turner was scribbling in a yellow-paper notebook. Our lunch table was like a long-running play on Broadway: The cast changed over the years, but the roles never did. Mychal was The Artsy One. He was talking with Daisy Ramirez, who'd played the role of my Best and Most Fearless Friend since elementary school, but I couldn't follow their conversation over the noise of all the others.

What was my part in this play? The Sidekick. I was Daisy's Friend, or Ms. Holmes's Daughter. I was somebody's something.

I felt my stomach begin to work on the sandwich, and even over everybody's talking, I could hear it digesting, all the bacteria chewing the slime of peanut butter - the students inside of me eating at my internal cafeteria. A shiver convulsed through me.

"Didn't you go to camp with him?" Daisy asked me.

"With who?"

"Davis Pickett," she said.

"Yeah," I said. "Why?"

"Aren't you listening?" Daisy asked. I am listening, I thought, to the cacophony of my digestive tract. Of course I'd long known that I was playing host to a massive collection of parasitic organisms, but I didn't much like being reminded of it. By cell count, humans are approximately 50 percent microbial, meaning that about half of the cells that make you up are not yours at all. There are something like a thousand times more microbes living in my particular biome than there are human beings on Earth, and it often seems like I can feel them living and breeding and dying in and on me. I wiped my sweaty palms on my jeans and tried to control my breathing. Admittedly, I have some anxiety problems, but I would argue it isn't irrational to be concerned about the fact that you are a skin-encased bacterial colony.

Mychal said, "His dad was about to be arrested for bribery or something, but the night before the raid he disappeared. There's a $100,000 reward out for him."

"And you know his kid," Daisy said.

" Knew him," I answered.

I watched Daisy attack her school-provided rectangular pizza and green beans with a fork. She kept glancing up at me, her eyes widening as if to say, Well? I could tell she wanted me to ask her about something, but I couldn't tell what, because my stomach wouldn't shut up, which was forcing me deep inside a worry that I'd somehow contracted a parasitic infection.

I could half hear Mychal telling Daisy about his new art project, in which he was using Photoshop to average the faces of 100 people named Mychal, and the average of their faces would be this new, 101st Mychal, which was an interesting idea, and I wanted to listen, but the cafeteria was so loud, and I couldn't stop wondering whether there was something wrong with the microbial balance of power inside me.

Excessive abdominal noise is an uncommon, but not unprecedented, presenting symptom of infection with the bacteria Clostridium difficile, which can be fatal. I pulled out my phone and searched "human microbiome" to reread Wikipedia's introduction to the trillions of microorganisms currently inside me. I clicked over to the article about C. diff, scrolling to the part about how most C. diff infections occur in hospitals. I scrolled down farther to a list of symptoms, none of which I had, except for the excessive abdominal noises, although I knew from previous searches that the Cleveland Clinic had reported the case of one person who'd died of C. diff after presenting at the hospital with only abdominal pain and fever. I reminded myself that I didn't have a fever, and my self replied: You don't have a fever YET.

At the cafeteria, where a shrinking slice of my consciousness still resided, Daisy was telling Mychal that his averaging project shouldn't be about people named Mychal but about imprisoned men who'd later been exonerated. "It'll be easier, anyway," she said, "because they all have mugshots taken from the same angle, and then it's not just about names but about race and class and mass incarceration," and Mychal was like, "You're a genius, Daisy," and she said, "You sound surprised," and meanwhile I was thinking that if half the cells inside of you are not you, doesn't that challenge the whole notion of me as a singular pronoun, let alone as the author of my fate? And I fell pretty far down that recursive wormhole until it transported me completely out of the White River High School cafeteria into some nonsensorial place only properly crazy people get to visit.

Ever since I was little, I've pressed my right thumbnail into the finger pad of my middle finger, and so now there's this weird callus over my fingerprint. After so many years of doing this, I can open up a crack in the skin really easily, so I cover it up with a Band-Aid to try to prevent infection. But sometimes I get worried that there already is an infection, and so I need to drain it, and the only way to do that is to reopen the wound and press out any blood that will come. Once I start thinking about splitting the skin apart, I literally cannot not do it. I apologize for the double negative, but it's a real double negative of a situation, a bind from which negating the negation is truly the only escape. So anyway, I started to want to feel my thumbnail biting into the skin of my finger pad, and I knew that resistance was more or less futile, so beneath the cafeteria table, I slipped the Band-Aid off my finger and dug my thumbnail into the callused skin until I felt the crack open.

"Holmesy," Daisy said. I looked up at her. "We're almost through lunch and you haven't even mentioned my hair." She shook out her hair, with so-red-they-were-pink highlights. Right. She'd dyed her hair.

I swum up out of the depths and said, "It's bold."

"I know, right? It says, 'Ladies and gentlemen and also people who do not identify as ladies or gentlemen, Daisy Ramirez won't break her promises, but she will break your heart." Daisy's self-proclaimed life motto was "Break Hearts, Not Promises." She kept threatening to get it tattooed on her ankle when she turned 18. Daisy turned back to Mychal, and I to my thoughts. The stomach grumbling had grown, if anything, louder. I felt like I might vomit. For someone who actively dislikes bodily fluids, I throw up quite a lot.

"Holmesy, you okay?" Daisy asked. I nodded. Sometimes I wondered why she liked me, or at least tolerated me. Why any of them did. Even I found myself annoying.

I could feel sweat sprouting from my forehead, and once I begin to sweat, it's impossible to stop. I'll keep sweating for hours, and not just my face or my armpits. My neck sweats. My boobs sweat. My calves sweat. Maybe I did have a fever.

Beneath the table, I slid the old Band-Aid into my pocket and, without looking, pulled out a new one, unwrapped it, and then glanced down to apply it to my finger. All the while, I was breathing in through my nose and out through my mouth, in the manner advised by Dr. Karen Singh, exhaling at a pace "that would make a candle flicker but not go out. Imagine that candle, Aza, flickering from your breath but still there, always there." So I tried that, but the thought spiral kept tightening anyway. I could hear Dr. Singh saying I shouldn't get out my phone, that I mustn't look up the same questions over and over, but I got it out anyway, and reread the "Human Microbiota" Wikipedia article.

The thing about a spiral is, if you follow it inward, it never actually ends. It just keeps tightening, infinitely.

I sealed the Ziploc bag around the last quarter of my sandwich, got up, and tossed it into an overfilled trash can. I heard a voice from behind me. "How concerned should I be that you haven't said more than two words in a row all day?"

"Thought spiral," I mumbled in reply. Daisy had known me since we were 6, long enough to get it.

"I figured. Sorry, man. Let's hang out today."

This girl Molly walked up to us, smiling, and said, "Uh, Daisy, just FYI, your Kool-Aid dye job is staining your shirt."

Daisy looked down at her shoulders, and indeed, her striped top had turned pink in spots. She flinched for a second, then straightened her spine. "Yeah, it's part of the look, Molly. Stained shirts are huge in Paris right now." She turned away from Molly and said, "Right, so we'll go to your house and watch Star Wars: Rebels." Daisy was really into Star Wars - and not just the movies, but also the books and the animated shows and the kids' show where they're all made out of Legos. Like, she wrote fan fiction about Chewbacca's love life. "And we will improve your mood until you are able to say three or even four words in a row; sound good?"

"Sounds good."

"And then you can take me to work. Sorry, but I need a ride."

"Okay." I wanted to say more, but the thoughts kept coming, unbidden and unwanted. If I'd been the author, I would've stopped thinking about my microbiome. I would've told Daisy how much I liked her idea for Mychal's art project, and I would've told her that I did remember Davis Pickett, that I remembered being 11 and carrying a vague but constant fear. I would've told her that I remembered once at camp lying next to Davis on the edge of a dock, our legs dangling over, our backs against the rough-hewn planks of wood, staring together up at a cloudless summer sky. I would've told her that Davis
and I never talked much, or even looked at each other, but it didn't matter, because we were looking at the same sky together, which is maybe more intimate than eye contact anyway. Anybody can look at you. It's quite rare to find someone who sees the same world you see.

Marta Montiero for BuzzFeed News

The fear had mostly sweated out of me, but as I walked from the cafeteria to history class, I couldn't stop myself from taking out my phone and rereading the horror story that is the "Human Microbiota" Wikipedia article. I was reading and walking when I heard my mother shout at me through her open classroom door. She was seated behind her metal desk, leaning over a book. Mom was a math teacher, but reading was her great love.

"No phones in the hallway, Aza!" I put my phone away and went into her classroom. There were four minutes remaining in my lunch period, which was the perfect length for a Mom conversation. She looked up and must've seen something in my eyes. "You okay?"

"Yeah," I said.

"You're not anxious?" she asked. At some point, Dr. Singh had told Mom not to ask if I was feeling anxious, so she'd stopped phrasing it as a direct question.

"I'm fine."

"You've been taking your meds," she said. Again, not a direct question.

"Yeah," I said, which was broadly true. I'd had a bit of a crack-up my freshman year, after which I was prescribed a circular white pill to be taken once daily. I took it, on average, maybe thrice weekly.

"You look..." Sweaty, is what I knew she meant.

"Who decides when the bells ring?" I asked. "Like, the school bells?"

"You know what, I have no idea. I suppose that's decided by someone on the superintendent's staff."

"Like, why are lunch periods 37 minutes long instead of 50? Or 22? Or whatever?"

"Your brain seems like a very intense place," Mom answered.

"It's just weird, how this is decided by someone I don't know and then I have to live by it. Like, I live on someone else's schedule. And I've never even met them."

"Yes, well, in that respect and many others, American high schools do rather resemble prisons."

My eyes widened. "Oh my God, Mom, you're so right. The metal detectors. The cinder-block walls."

"They're both overcrowded and underfunded," Mom said. "And both have bells that ring to tell you when to move."

"And you don't get to choose when you eat lunch," I said. "And prisons have power-thirsty, corrupt guards, just like schools have teachers."

She shot me a look, but then started laughing. "You headed straight home after school?"

"Yeah, then I gotta take Daisy to work."

Mom nodded. "Sometimes I miss you being a little kid, but then I remember Chuck E. Cheese."

"She's just trying to save money for college."

My mom glanced back down at her book. "You know, if we lived in Europe, college wouldn't cost much." I braced myself for Mom's cost-of-college rant. "There are free universities in Brazil. Most of Europe. China. But here they want to charge you $25,000 a year, for in-state tuition. I just finished paying off my loans a few years ago, and soon we'll have to take out ones for you."

"I'm only a junior. I've got plenty of time to win the lottery. And if that doesn't work out, I'll just pay for school by selling meth."

She smiled wanly. Mom really worried about paying for me to go to school. "You sure you're okay?" she asked.

I nodded as the bell sounded from on high, sending me to history.

By the time I made it to my car after school, Daisy was already in the passenger seat. She'd changed out of the stained shirt she'd been wearing into her red Chuck E. Cheese polo, and was sitting with her backpack in her lap, drinking a container of school milk. Daisy was the only person I'd trusted with a key to Harold. Mom didn't even have her own Harold key, but Daisy did.

"Please do not drink nonclear liquids in Harold," I told her.

"Milk is a clear liquid," she said.

"Lies," I answered, and before we set off, I drove Harold over to the front entrance and waited while Daisy threw away her milk.

Maybe you've been in love. I mean real love, the kind my grandmother used to describe by quoting the Apostle Paul's First Letter to the Corinthians, the love that is kind and patient, that does not envy or boast, that beareth all things and believeth all things and endureth all things. I don't like to throw the L-word around; it's too good and rare a feeling to cheapen with overuse. You can live a good life without ever knowing real love, of the Corinthians variety, but I was fortunate to have found it with Harold.

He was a 16-year-old Toyota Corolla with a paint color called Mystic Teal Mica and an engine that clanked in a steady rhythm like the beating of his immaculate metallic heart. Harold had been my dad's car - in fact, Dad had named him Harold. Mom never sold him, so he stayed in the garage for eight years, until my 16th birthday.

Getting Harold's engine running after so long took all of the $400 dollars I'd saved over the course of my life - allowances, change ferreted away when Mom sent me down the street to buy something at the Circle K, summer work at Subway, Christmas gifts from my grandparents - so, in a way, Harold was the culmination of my whole being, at least financially speaking. And I loved him. I dreamed about him quite a lot. He had an exceptionally spacious trunk, a custom-installed, huge white steering wheel, and a backseat bench clad in pebble-beige leather. He accelerated with the gentle serenity of the Buddhist Zen master who knows nothing really needs to be done quickly, and his brakes whined like metal machine music, and I loved him.

However, Harold did not have Bluetooth connectivity, or for that matter a CD player, meaning that while in Harold's company, one had three choices: 1. Drive in silence; 2. Listen to the radio; or 3. Listen to side B of my dad's cassette of Missy Elliott's excellent album So Addictive, which - because it would not eject from the cassette player - I'd already heard hundreds of times in my life.

And in the end, Harold's imperfect audio system happened to be the last note in the melody of coincidences that changed my life.

Daisy and I were scanning stations in search of a song by a particular brilliant and underappreciated boy band when we landed upon a news story. "-Indianapolis-based -Pickett Engineering, a construction firm employing more than 10,000 people worldwide, today-" I moved my hand toward the scan button, but Daisy pushed it away.

"This is what I was telling you about!" she said as the radio continued, "-one-hundred-thousand-dollar reward for information leading to the whereabouts of company CEO Russell Pickett. Pickett, who disappeared the night before a police raid on his home related to a fraud and bribery investigation, was last seen at his riverside compound on September 8. Anyone with information regarding his whereabouts is encouraged to call the Indianapolis Police Department."

"A hundred thousand dollars," Daisy said. "And you know his kid."

"Knew," I said. For two summers, after fifth and sixth grades, Davis and I had gone to Sad Camp together, which is what we'd called Camp Spero, this place down in Brown County for kids with dead parents.

Aside from hanging out together at Sad Camp, Davis and I would also sometimes see each other during the school year, because he lived just down the river from me, but on the opposite bank. Mom and I lived on the side that sometimes flooded. The Picketts lived on the side with the stone-gabled walls that forced the rising water in our direction.

"He probably wouldn't even remember me."

"Everyone remembers you, Holmesy," she said.

"That's not-"

"It's not a value judgment. I'm not saying you're good or generous or kind or whatever. I'm just saying you're memorable."

"I haven't seen him in years," I said. But of course you don't forget playdates at a mansion that contains a golf course, a pool with an island, and five waterslides. Davis was the closest thing to a proper celebrity I'd ever encountered.

"A hundred thousand dollars," Daisy said again. We pulled onto I-465, the beltway that circumscribes Indianapolis. "I'm fixing Skee-Ball machines for $8.40 an hour and there's a hundred grand waiting for us."

"I wouldn't say waiting for us. Anyway, I have to read about the effects of smallpox on indigenous populations tonight, so I can't really solve The Case of the Fugitive Billionaire." I eased Harold up to highway speed. I never drove him faster than the speed limit. I loved him too much.

"Well, you know him better than I do, so to quote the infallible boys in the world's greatest pop group, 'You're the One,'" which was this super-cheesy song I was way too old to love, but loved nonetheless.

"I want to disagree with you, but that is such a great song."

"You're. The. One. 'You're the one that I choose. The one I'll never lose. You're my forever. My stars. My sky. My air. It's you.'"

We laughed, and I changed the radio station and thought it was over, but then Daisy started reading me an Indianapolis Star story from her phone. " 'Russell Pickett, the controversial CEO and founder of Pickett Engineering, wasn't home when a search warrant was served by the Indianapolis police Friday morning, and he hasn't been home since. Pickett's lawyer, Simon Morris, says he has no information about Pickett's whereabouts, and in a press conference today, Detective Dwight Allen said that no activity on Pickett's credit cards or bank accounts has been noted since the evening before the raid.' Blah-blah-blah... 'Allen also asserted that aside from a camera at the front gate, there were no surveillance cameras on the property. A copy of a police report obtained by the Star says that Pickett was last seen Thursday evening by his sons, Davis and Noah.' Blah-blah-blah... 'estate just north of 38th Street, lots of lawsuits, supports the zoo,' blah-blah-blah... 'call the police if you know anything,' blah-blah-blah. Wait, how are there no security cameras? What kind of billionaire doesn't have security cameras?"

"The kind who doesn't want his shady business recorded," I said. As we drove, I kept turning the story over in my head. I knew some edge of it was jagged, but I couldn't figure out which one, until I snagged a memory of eerie green coyotes with white eyes. "Wait, there was a camera. Not a security one, but Davis and his brother had a motion-capture camera in the woods by the river. It had, like, night vision, and it would snap a picture whenever something walked past - deer or coyotes or whatever."

"Holmesy," she said. "We have a lead."

"And because of the camera at the front gate, he couldn't have just driven off," I said. "So either he climbs over his own wall, or else he walks through the woods down to the river and leaves from there, right?"

"Yes..."

"So he could've tripped that camera. I mean, it's been a few years since I was there; maybe it's gone."

"And maybe it's not!" Daisy said.

"Yeah. Maybe it's not."

"Exit here," she said suddenly, and I did. I knew it was the wrong exit, but I took it anyway, and without Daisy even telling me to, I got in the right lane to drive back into the city, toward my house. Toward Davis's house.

Daisy took out her phone and raised it to her ear. "Hey, Eric. It's Daisy. Listen, I'm really sorry, but I've got the stomach flu. Could be norovirus."

"..."

"Yeah, no problem. Sorry again." She hung up, put her phone in her bag, and said, "If you even imply diarrhea, they tell you to stay home because they're so scared of outbreaks. Right, okay, we're doing this. You still got that canoe?" ●

Dutton Books for Young Readers

John Green is the award-winning, #1 bestselling author of Looking for Alaska, An Abundance of Katherines, Paper Towns, Will Grayson, Will Grayson (with David Levithan), and The Fault in Our Stars. His many accolades include the Printz Medal, a Printz Honor, and the Edgar Award. John has twice been a finalist for the LA Times Book Prize and was selected by TIME magazine as one of the 100 Most Influential People in the World. With his brother, Hank, John is one half of the Vlogbrothers and co-created the online educational series CrashCourse. You can join the millions who follow him on Twitter @johngreen and Instagram @johngreenwritesbooks or visit him online at johngreenbooks.com. John lives with his family in Indianapolis, Indiana.

To learn more about Turtles All the Way Down, click here. (If you're in the UK, click here.)
You can also watch a video of John Green reading the first chapter of the book here.

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Read The First Two Chapters Of John Green's New Book

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At the time I first realized I might be fictional, my weekdays were spent at a publicly funded institution on the north side of Indianapolis called White River High School, where I was required to eat lunch at a particular time - between 12:37 p.m. and 1:14 p.m.

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Write a personal narrative describing a time when you felt overwhelmed, stressed, or had difficulty coping with day-to-day activities as it relates to your mental health.

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Heavy [Official Music Video] - Linkin Park (feat. Kiiara)

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Throughout the unit students will keep a journal that they will use to answer prompts in class as well as free write at home.

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When you were a teenager, you might have kept a diary hidden under your mattress. It was a place to confess your struggles and fears without judgment or punishment. It likely felt good to get all of those thoughts and feelings out of your head and down on paper. The world seemed clearer.

You may have stopped using a diary once you reached adulthood. But the concept and its benefits still apply as a grown up. Now it's called journaling. It's simply writing down your thoughts and feelings to understand them more clearly. And if you struggle with stress, depression, or anxiety, keeping a journal can be a great idea. It can help you gain control of your emotions and improve your mental health.

Journaling benefits

One of the ways to deal with any overwhelming emotion is to find a healthy way to express yourself. This makes a journal a helpful tool in managing your mental health. Journaling can help you:

Journaling helps control your symptoms and improve your mood by:

Helping you prioritize problems, fears, and concerns

Tracking any symptoms day-to-day so that you can recognize triggers and learn ways to better control them

Providing an opportunity for positive self-talk and identifying negative thoughts and behaviors

When you have a problem and you're stressed, keeping a journal can help you identify what's causing that stress or anxiety. Once you've identified your stressors, you can work on a plan to resolve the problems and reduce your stress.

Keep in mind that journaling is just one aspect of a healthy lifestyle for better managing stress, anxiety, and mental health conditions. To get the most benefits, be sure you also:

Relax and meditate each day.

Eat a healthy, balanced diet.

Exercise regularly-get in some activity every day.

Treat yourself to plenty of sleep each night.

Stay away from alcohol and drugs.

Use your journal to make sure you follow these guidelines daily.

How to journal

Try these tips to help you get started with journaling:

Try to write every day. Set aside a few minutes every day to write. This will help you to write in your journal regularly.

Make it easy. Keep a pen and paper handy at all times. Then when you want to write down your thoughts, you can. You can also keep a journal on your smartphone.

Write or draw whatever feels right. Your journal doesn't need to follow any certain structure. It's your own private place to discuss and create whatever you want to express your feelings. Let the words and ideas flow freely. Don't worry about spelling mistakes or what other people might think.

Use your journal as you see fit. You don't have to share your journal with anyone. If you do want to share some of your thoughts with trusted friends and loved ones, you could show them parts of your journal.

Keeping a journal helps you create order when your world feels like it's in chaos. You get to know yourself by revealing your most private fears, thoughts, and feelings. Look at your writing time as personal relaxation time. It's a time when you can de-stress and wind down. Write in a place that's relaxing and soothing, maybe with a cup of tea. Look forward to your journaling time. And know that you're doing something good for your mind and body.
Medical Reviewers:

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When you were a teenager, you might have kept a diary hidden under your mattress. It was a place to confess your struggles and fears without judgment or punishment. It likely felt good to get all of those thoughts and feelings out of your head and down on paper.

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What is teen depression?

The teenage years can be really tough and it's perfectly normal to feel sad or irritable every now and then. But if these feelings don't go away or become so intense that you feel overwhelmingly hopeless and helpless, you may be suffering from depression.

Teen depression is much more than feeling temporarily sad or down in the dumps. It's a serious and debilitating mood disorder that can change the way you think, feel, and function in your daily life, causing problems at home, school, and in your social life. When you're depressed, you may feel hopeless and isolated and it can seem like no one understands. But depression is far more common in teens than you may think. The increased academic pressures, social challenges, and hormonal changes of the teenage years mean that about one in five of us suffer with depression in our teens. You're not alone and your depression is not a sign of weakness or a character flaw.

Even though it can feel like the black cloud of depression will never lift, there are plenty of things you can do to help yourself deal with symptoms, regain your balance and feel more positive, energetic, and hopeful again.

If you're a parent or guardian worried about your child...

While it isn't always easy to differentiate from normal teenage growing pains, teen depression is a serious health problem that goes beyond moodiness. As a parent, your love, guidance, and support can go a long way toward helping your teen overcome depression and get their life back on track. Read Parent's Guide to Teen Depression.

Signs and symptoms of teen depression

It can be hard to put into words exactly how depression feels-and we don't all experience it the same way. For some teens, depression is characterized by feelings of bleakness and despair. For others, it's a persistent anger or agitation, or simply an overwhelming sense of "emptiness." However depression affects you, though, there are some common symptoms that you may experience:

You constantly feel irritable, sad, or angry.

Nothing seems fun anymore-even the activities you used to love-and you just don't see the point of forcing yourself to do them.

You feel bad about yourself-worthless, guilty, or just "wrong" in some way.

You sleep too much or not enough.

You've turned to alcohol or drugs to try to change the way you feel.

You have frequent, unexplained headaches or other physical pains or problems.

Anything and everything makes you cry.

You're extremely sensitive to criticism.

You've gained or lost weight without consciously trying to.

You're having trouble concentrating, thinking straight, or remembering things. Your grades may be plummeting because of it.

You feel helpless and hopeless.

You're thinking about death or suicide. (If so, talk to someone right away!)

Coping with suicidal thoughts

If your negative feelings caused by depression become so overwhelming that you can't see any solution besides harming yourself or others, you need to get help right away. Asking for help when you're in the midst of such strong emotions can be really difficult, but it's vital you reach out to someone you trust-a friend, family member, or teacher, for example. If you don't feel that you have anyone to talk to, or think that talking to a stranger might be easier, call a suicide helpline. You'll be able to speak in confidence to someone who understands what you're going through and can help you deal with your feelings.

Whatever your situation, it takes real courage to face death and step back from the brink. You can use that courage to help you keep going and overcome depression.

There is ALWAYS another solution, even if you can't see it right now. Many people who have survived a suicide attempt say that they did it because they mistakenly felt there was no other solution to a problem they were experiencing. At the time, they couldn't see another way out, but in truth, they didn't really want to die. Remember that no matter how badly you feel, these emotions will pass.

Having thoughts of hurting yourself or others does not make you a bad person. Depression can make you think and feel things that are out of character. No one should judge you or condemn you for these feelings if you are brave enough to talk about them.

If your feelings are uncontrollable, tell yourself to wait 24 hours before you take any action. This can give you time to really think things through and give yourself some distance from the strong emotions that are plaguing you. During this 24-hour period, try to talk to someone-anyone-as long as they are not another suicidal or depressed person. Call a hotline or talk to a friend. What do you have to lose?

If you're afraid you can't control yourself, make sure you are never alone. Even if you can't verbalize your feelings, just stay in public places, hang out with friends or family members, or go to a movie-anything to keep from being by yourself and in danger.

If you're thinking about suicide...

Why am I depressed?

Despite what you may have been told, depression is not simply caused by a chemical imbalance in the brain that can be cured with medication. Rather, depression is caused by a combination of biological, psychological, and social factors. Since the teenage years can be a time of great turmoil and uncertainty, you're likely facing a host of pressures that could contribute to your depression symptoms. These can range from hormonal changes to problems at home or school or questions about who you are and where you fit in.

As a teen, you're more likely to suffer from depression if you have a family history of depression or have experienced early childhood trauma, such as the loss of a parent or physical or emotional abuse.

Risk factors for teen depression

Risk factors that can trigger or exacerbate depression in teens include:

1. Serious illness, chronic pain, or physical disability.

2. Having other mental health conditions, such as anxiety, an eating disorder, learning disorder, or ADHD.

3. Alcohol or drug abuse.

4. Academic or family problems.

5. Trauma from violence or abuse.

6. Recent stressful life experiences, such as parental divorce or the death of a loved one.

7. Coping with your sexual identity in an unsupportive environment.

8. Loneliness and lack of social support.

9. Spending too much time on social media.

If you're being bullied...

The stress of bullying-whether it's online, at school, or elsewhere-is very difficult to live with. It can make you feel helpless, hopeless, and ashamed: the perfect recipe for depression.

If you're being bullied, know that it's not your fault. No matter what a bully says or does, you should not be ashamed of who you are or what you feel. Bullying is abuse and you don't have to put up with it. You deserve to feel safe, but you'll most likely need help. Find support from friends who don't bully and turn to an adult you trust-whether it's a parent, teacher, counselor, pastor, coach, or the parent of a friend.

Whatever the causes of your depression, the following tips can help you overcome your symptoms, change how you feel, and regain your sense of hope and enthusiasm.

Overcoming teen depression tip 1: Talk to an adult you trust

Depression is not your fault, and you didn't do anything to cause it. However, you do have some control over feeling better. The first step is to ask for help.

Talking to someone about depression

It may seem like there's no way your parents will be able to help, especially if they are always nagging you or getting angry about your behavior. The truth is, parents hate to see their kids hurting. They may feel frustrated because they don't understand what is going on with you or know how to help.

If your parents are abusive in any way, or if they have problems of their own that makes it difficult for them to take care of you, find another adult you trust (such as a relative, teacher, counselor, or coach). This person can either help you approach your parents, or direct you toward the support you need.

If you truly don't have anyone you can talk to, there are many hotlines, services, and support groups that can help.

No matter what, talk to someone, especially if you are having any thoughts of harming yourself or others. Asking for help is the bravest thing you can do, and the first step on your way to feeling better.

The importance of accepting and sharing your feelings

It can be hard to open up about how you're feeling-especially when you're feeling depressed, ashamed, or worthless. It's important to remember that many people struggle with feelings like these at one time or another-it doesn't mean that you're weak, fundamentally flawed, or no good. Accepting your feelings and opening up about them with someone you trust will help you feel less alone.

Even though it may not feel like it at the moment, people do love and care about you. If you can muster the courage to talk about your depression, it can-and will-be resolved. Some people think that talking about sad feelings will make them worse, but the opposite is almost always true. It is very helpful to share your worries with someone who will listen and care about what you say. They don't need to be able to "fix" you; they just need to be good listeners.

Tip 2: Try not to isolate yourself-it makes depression worse

Depression causes many of us to withdraw into our shells. You may not feel like seeing anybody or doing anything and some days just getting out of bed in the morning can be difficult. But isolating yourself only makes depression worse. So even if it's the last thing you want to do, try to force yourself to stay social. As you get out into the world and connect with others, you'll likely find yourself starting to feel better.

Spend time face-to-face with friends who make you feel good -especially those who are active, upbeat, and understanding. Avoid hanging out with those who abuse drugs or alcohol, get you into trouble, or make you feel judged or insecure.

Get involved in activities you enjoy (or used to). Getting involved in extracurricular activities seem like a daunting prospect when you're depressed, but you'll feel better if you do. Choose something you've enjoyed in the past, whether it be a sport, an art, dance or music class, or an after-school club. You might not feel motivated at first, but as you start to participate again, your mood and enthusiasm will begin to lift.

Volunteer. Doing things for others is a powerful antidepressant and happiness booster. Volunteering for a cause you believe in can help you feel reconnected to others and the world, and give you the satisfaction of knowing you're making a difference.

Cut back on your social media use. While it may seem that losing yourself online will temporarily ease depression symptoms, it can actually make you feel even worse. Comparing yourself unfavorably with your peers on social media, for example, only promotes feelings of depression and isolation. Remember: people always exaggerate the positive aspects of their lives online, brushing over the doubts and disappointments that we all experience. And even if you're just interacting with friends online, it's no replacement for in-person contact. Eye-to-eye contact, a hug, or even a simple touch on the arm from a friend can make all the difference to how you're feeling.

Tip 3: Adopt healthy habits

Making healthy lifestyle choices can do wonders for your mood. Things like eating right, getting regular exercise, and getting enough sleep have been shown to make a huge difference when it comes to depression.

Get moving! Ever heard of a "runner's high"? You actually get a rush of endorphins from exercising, which makes you feel instantly happier. Physical activity can be as effective as medications or therapy for depression, so get involved in sports, ride your bike, or take a dance class. Any activity helps! If you're not feeling up to much, start with a short daily walk, and build from there.

Be smart about what you eat. An unhealthy diet can make you feel sluggish and tired, which worsens depression symptoms. Junk food, refined carbs, and sugary snacks are the worst culprits! They may give you a quick boost, but they'll leave you feeling worse in the long run. Make sure you're feeding your mind with plenty of fruits, vegetables, and whole grains. Talk to your parents, doctor, or school nurse about how to ensure your diet is adequately nutritious.

Avoid alcohol and drugs. You may be tempted to drink or use drugs in an effort to escape from your feelings and get a "mood boost," even if just for a short time. However, as well as causing depression in the first place, substance use will only make depression worse in the long run. Alcohol and drug use can also increase suicidal feelings. If you're addicted to alcohol or drugs, seek help. You will need special treatment for your substance problem on top of whatever treatment you're receiving for your depression.

Aim for eight hours of sleep each night. Feeling depressed as a teenager typically disrupts your sleep. Whether you're sleeping too little or too much, your mood will suffer. But you can get on a better sleep schedule by adopting healthy sleep habits.

Tip 4: Manage stress and anxiety

For many teens, stress and anxiety can go hand-in-hand with depression. Unrelenting stress, doubts, or fears can sap your emotional energy, affect your physical health, send your anxiety levels soaring, and trigger or exacerbate depression.

If you're suffering from an anxiety disorder, it can manifest itself in a variety of ways. Perhaps you endure intense anxiety attacks that strike without warning, get panicky at the thought of speaking in class, experience uncontrollable, intrusive thoughts, or live in a constant state of worry. Since anxiety makes depression worse (and vice versa), it's important to get help for both conditions.

Tips for managing stress

Managing the stress in your life starts with identifying the sources of that stress:

1. If exams or classes seem overwhelming, for example, talk to a teacher or school counselor, or find ways of improving how you manage your time.

2. If you have a health concern you feel you can't talk to your parents about-such as a pregnancy scare or drug problem-seek medical attention at a clinic or see a doctor. A health professional can guide you towards appropriate treatment (and help you approach your parents if that's necessary).

3. If you're struggling to fit in or dealing with relationship, friendship, or family difficulties, talk your problems over with your school counselor or a professional therapist. Exercise, meditation, muscle relaxation, and breathing exercises are other good ways to cope with stress.

4. If your own negative thoughts and chronic worrying are contributing to your everyday stress levels, you can take steps to break the habit and regain control of your worrying mind.

How to help a depressed teen friend

If you're a teenager with a friend who seems down or troubled, you may suspect depression. But how do you know it's not just a passing phase or a bad mood? Look for common warning signs of teen depression:

Your friend doesn't want to do the things you guys used to love to do.

Your friend starts using alcohol or drugs or hanging with a bad crowd.

Your friend stops going to classes and after-school activities.

Your friend talks about being bad, ugly, stupid, or worthless.

Your friend starts talking about death or suicide.

Teens typically rely on their friends more than their parents or other adults, so you may find yourself in the position of being the first-or only-person that your depressed friend confides in. While this might seem like a huge responsibility, there are many things you can do to help:

Get your friend to talk to you. Starting a conversation about depression can be daunting, but you can say something simple: "You seem like you are really down, and not yourself. I really want to help you. Is there anything I can do?"

You don't need to have the answers. Your friend just needs someone to listen and be supportive. By listening and responding in a non-judgmental and reassuring manner, you are helping in a major way.

Encourage your friend to get help. Urge your depressed friend to talk to a parent, teacher, or counselor. It might be scary for your friend to admit to an authority figure that they have a problem. Having you there might help, so offer to go along for support.

Stick with your friend through the hard times. Depression can make people do and say things that are hurtful or strange. But your friend is going through a very difficult time, so try not to take it personally. Once your friend gets help, they will go back to being the person you know and love. In the meantime, make sure you have other friends or family taking care of you. Your feelings are important and need to be respected, too.

Speak up if your friend is suicidal. If your friend is joking or talking about suicide, giving possessions away, or saying goodbye, tell a trusted adult immediately. Your only responsibility at this point is to get your friend help, and get it fast. Even if you promised not to tell, your friend needs your help. It's better to have a friend who is temporarily angry at you than one who is no longer alive.

Depression support, suicide prevention help

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Dealing with Teen Depression - HelpGuide.org

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Depression is common in teens. Here's what you can do to help yourself or a friend feel better.

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Depression is the leading cause of disability in the world; in the United States, close to ten percent of adults struggle with the disease. But because it's a mental illness, it can be a lot harder to understand than, say, high cholesterol. Helen M. Farrell examines the symptoms and treatments of depression, and gives some tips for how you might help a friend who is suffering.

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Depression is the leading cause of disability in the world; in the United States, close to ten percent of adults struggle with the disease. But because it's a mental illness, it can be a lot harder to understand than, say, high cholesterol. Helen M.

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Last week, Ned Vizzini, the young author of "It's Kind of a Funny Story" and other popular works for young adults, sadly took his own life. Here is a tribute from James Blasingame, associate professor of English Education at Arizona State University, and the 2010 president of the Assembly on Literature for Adolescents of the National Council of Teachers of English.

By James Blasingame

The world just lost a wonderful human being. On Dec. 17, at 32 years of age, Ned Vizzini, author of several popular young adult novels, including the semi-autobiographical "It's Kind of a Funny Story," said goodbye to a world that had not always been a very happy one for him.

"It's Kind of a Funny Story" is about a teen spending a week in mental institution after considering suicide. The book was made into a successful movie with Emma Roberts and Zach Galifianakis and won multiple awards, such as the American Library Association's 2007 Best Books for Young Adults. I have used it as required reading in my adolescent literature course at Arizona State University since it came out.

Every semester, the class has read the book, done a number of activities centered on the psychological/emotional issues of adolescence as they are so ingeniously portrayed in the book, and then each student has had the opportunity to ask Ned a question when he Skyped into the class. Even after he became so very famous and successful, writing for MTV, NBC, and more, he continued to Skype into our class every semester. Only a few weeks ago, Ned Skyped in for the last time, taking his lunch break at work to meet with us when three attempts to schedule a session had failed due to demands on his time. Ned ate his lunch and answered my students' questions, treating every question as if it were the most important query he had ever received. He was so kind, so friendly, and so very understanding of other people.

Two semesters ago, when Ned Skyped in, he made fun of the broken institutional-style clock on the classroom wall which was so clearly hours off from the correct time. We all had a laugh about that and were pleasantly surprised when Ned sent a brand new Bulova wall clock to the class. Students loved it. He was someone you couldn't help but love.

I met Ned Vizzini nearly 10 years ago, in 2004 in Indianapolis at the National Council of Teachers of English Assembly on Literature for Adolescents convention. I was on a panel about "The Art of Humor in Young Adult Literature," and my component of the presentation was about the humor in a book by this very young author whom few people in our field had ever met. It was actually Ned's second book, entitled "Be More Chill."

The premise of the book was about a supercomputer in a pill the protagonist took that would guide him toward being cool or "chill," as the pop culture of the time called it. Before taking the pill, Jeremy, the protagonist, never knew what to say or what to wear, and he suffered a million "small humiliations" every day as a world-class super-geek. But after the pill, he turned into the most popular kid in school, always wearing the latest fashions and quick with the witty comment in any situation. In the end, as in most fairy tales, fulfilled wishes turn bad, and Jeremy realizes that a pill is not the answer in life. I was using a recent theory about humor in an attempt to explain why this poor teen's troubled life was so funny.

At the end of that presentation, a young man came up, and said, "Thank you for talking about my book. I really appreciate it." It was Ned Vizzini. He was 22. He looked like he was 14, and actually, Ned was only a few years out of Stuyvesant High School, one of nine special Manhattan high schools that implement accelerated curriculum and only accept a fraction of applicants. Stuyvesant may very well have been the model for the high pressure Executive Pre-Professional High School, the protagonist, Craig, attends but hates. Ned and I exchanged email addresses. He promised to keep me in the loop on his next book, and I promised to give him consideration for a feature in the NCTE's The ALAN Review, of which I was co-editor at the time, and for coverage in the International Reading Association's Journal of Adolescent and Adult Literacy, for which I was the book review and author interview editor.

And so our relationship began. We corresponded by e-mail regularly. Ned was interested in being a teacher, and as a professor of secondary English education at Arizona State University, I was thrilled. We even talked about him coming to Arizona and working on a degree in English education with a focus on young adult literature. He tried the New York City Teaching Fellows program to teach high school math, but his career path as a writer was undeniable.

Meanwhile, Ned provided me an advanced reading copy of his new book, tentatively entitled "It's Kind of a Funny Story." After reading it, I knew it would be perfect for a review and author interview in my column in the Journal of Adolescent and Adult Literacy. On Friday, as I read the news about Ned in Publisher's Weekly, I was reminded of that conversation: "In a 2007 interview with the Journal of Adolescent and Adult Literacy, Vizzini told writer James Blasingame that "It's Kind of a Funny Story" was based on my real life and is 85% true."

At the end of the book there is a note that Ned was in the psych ward at Methodist Hospital, in Brooklyn, from 11/29/04 to 12/3/04 and that he wrote the book over the course of three weeks following his experience.

I had forgotten how much of the book Ned took right from his own experience and also how quickly he chronicled it all, while it was still fresh in his mind. "It's Kind of a Funny Story" does not capture the agonizing battle against mental illness as Joanne Greenberg did in "I Never Promised You a Rose Garden." Nor does it reflect the smothering depression, brutal attempts at suicide, or barbaric medical treatment of Sylvia Plath's "The Bell Jar." Vizzini's story is actually quite a sweet and optimistic one, which has readers empathizing with and coming to love the characters, both patients and medical personnel, which is so very much like Ned.

Nevertheless, "It's Kind of a Funny Story" is honest. In the end, Craig is released to go home and when he does so, he makes sweeping changes in his life to make it better: new high school, new girlfriend, new life. However, as Ned knew to be true, Craig explains that you're never cured of this condition, you can only change your behavior, especially your reaction to painful feelings:

I'm not better, you know. The weight hasn't left my head. I feel how easily I could fall back into it, lie down and not eat, waste my time and curse wasting my time, look at my homework and freak out and go and chill at Aaron's and look at Nia and be jealous again, and take the subway home and hope it has an accident, go and get my bike and head to the Brooklyn Bridge [the site of Craig's first suicidal thoughts]. All of that is still there. The only thing is, it's not an option now. It's just . . . a possibility. . . not a very likely possibility. (441)

Craig goes on to consider what has happened in his brain:

"I don't know where my brain went. It got knocked off-kilter somewhere. I got caught up in some crap it couldn't deal with." (443)

And as he leaves the hospital, he has a plan:

Get into a school. Celebrate. Have a party. Write a thank-you note to someone. Hug your mom. . . . . Travel. Fly. Swim. Meet. Love. Dance Win. Smile. Laugh. Hold. Walk. Live. Live. Live. Live. (444)

Everyone who knew him, loved Ned Vizzini. If we had him back for a day to tell him how much we loved him, we surely would do so. When my good friend and successful author Bill Konigsberg texted me that Ned was gone that morning, I felt like part of my heart had been cut out. Students from my adolescent literature course for the last four years have been emailing or calling to say how bad they feel but also how privileged they were to have the opportunity to know, even for just an hour of conversation, someone like Ned Vizzini.

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A farewell to 'It's Kind of a Funny Story' author

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Last week, Ned Vizzini, the young author of "It's Kind of a Funny Story" and other popular works for young adults, sadly took his own life. Here is a tribute from James Blasingame, associate professor of English Education at Arizona State University, and the 2010 president of the Assembly on Literature for Adolescents of the National Council of Teachers of English.