Cara was 15 years old. She was quiet, eyes downcast, and looked like she was about to burst into tears. She told me that for the past few months, she had felt sad, helpless and exhausted. These feelings started after several months of pretty intense bullying in school by a group of girls that singled her out and tormented her for the fall semester of her sophomore year of high school. Cara had eventually told her counselor at school about the bullying and school administrators had taken the appropriate steps to stop the bullying behavior. Although Cara was now in the last half of her second semester of the school year and the bullying had stopped several months prior, she continued to feel worse every day. The tears spilled over Cara’s eyelids when I asked her if she’d had thoughts of wanting to disappear or die. “Yes,” she very quietly replied.

Cara had been having trouble sleeping since the bullying began. She would toss and turn, often waking with intense dreams that made her feel anxious or afraid. She would lie in bed for hours, unable to sleep but too exhausted to even look at her phone. When she felt really sad, she would eat junk food. This had led to her gaining about 15 pounds over the past several months. She felt ashamed of her weight gain and told me “no one likes me because I’m fat and boring.” Cara also told me that she would sometimes use a sharp pencil tip and press it into the skin on her hand to the point that her skin would bleed. “I don’t know why I do it. I guess it helps me feel better,” she said. Cara’s grades were suffering and she rarely spent time with friends. She preferred to stay home and watch Netflix.

Cara’s mother was clearly concerned about her but felt she was “being lazy and rude.” She had tried getting Cara out of the house to go for hikes or to go grab ice cream with friends but these attempts often ended with Cara getting angry with her mother and yelling at her. Her mom was desperate for Cara to “snap out of it” and return to her previously happy and engaged self. I watched Cara shrink back further and further into her chair while her mother spoke to me. Cara told me she felt ashamed at her mother’s words and didn’t want to yell at her mother or disappoint her anymore.

With medication and therapy, Cara was able to overcome her episode of major depression. It took several months, and Cara did use her pencil to hurt her hands a few more times. But, eventually, she learned healthier coping skills to use when she felt overwhelmed and she started doing better in school. She joined the school choir her junior year and really thrived in this group of supportive friends. “I don’t wish I was dead anymore. I’m actually really happy to be alive. I learned that depression is something that happens to people sometimes and it’s okay. It doesn’t have to be forever and there are really nice people who want to help. I hope that anyone else who feels this way can ask for help. We all deserve to feel happy in our own lives.”