Young Adults’ Experiences of Depression in the U.S.

Depression, bias, and disadvantage

Roughly one in ten young adults have depression*, and people in all kinds of circumstances can experience it. However, people who live in poverty are more than twice as likely to have depression as people at or above the poverty level*1. The stress and stigma caused by forms of discrimination and prejudice common in American society – for example sexism, racism, classism, homophobia and transphobia -- can also increase the frequency of depression and other mental health issues and/or worsen their impact*2.

Many young adults we interviewed described relationships between their depression and other parts of their lives including but not limited to gender or sexual identity, economic circumstances, or race/ethnicity. This part of the website explores experiences at the intersection where depression meets economic disadvantage and what we are calling “bias” – that is, discrimination and hostility towards groups of people who may not fit into the categories set by mainstream society or have limited access to power and resources. 

Bias and gender identity

Many people we interviewed who are women or transgender described how gender biases they encountered interacted with their depression – most often, by creating a sense of being trapped or confined by how society treats or defines them. Women said that feeling judged by boys or men fueled low self-esteem, and then depression. Sara described how in middle school she “… gained a little bit of weight… and boys would make fun of me and call me names and I would come home from school just crying all the time… I didn’t want to go to school, and I was diagnosed with depression.” Maya said the pressure on her as a woman to never rest and always be “doing something more” makes her depression harder.
We interviewed two young adults who identify as transmale (transitioning from woman to man). Both discussed various ways their depression symptoms are related to their transgender (or trans) identity. They discussed challenges in accessing competent service providers and appropriate resources. There were additional challenges associated with being able to comfortably engage in activities that would help alleviate symptoms.
Jackson says that with time he was able to understand within himself that his identity is “not wrong or freakish or anything, it's just… different,” but arriving at this place was difficult, especially while still living at his University where even the Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ) community had a lot of biases. 

Casey remains hopeful that achieving more of his transition-related goals (such as taking hormones or having surgery) will help ease his depression; his therapist told him that it is not uncommon for symptoms to be reduced as people are able to access resources to help them with their gender transition. But Casey also noted that despite hormonal changes related to transition he still has disappointing cycles of “feeling shitty.” He also struggles with ways that social bias and health policy made it harder to cope with his depression during transition.
Bias and sexual identity

Gay, lesbian and bi-sexual young adults we interviewed described how their emerging sexuality intersected with depression. For some, reactions from parents and other adults were a significant issue. Natasha, for example, said it was easy to come out to her mother, but finds it “depressing still” that she can’t tell her father. Sierra Rose describes being unintentionally “outed” as bi-sexual by a friend. As a result, her living situation disintegrated and her mental health spiraled rapidly downward. Others talked about the stigma associated with being gay or lesbian in small towns adding to the isolation and sadness of depression. A number of people also described feeling better in many ways after they managed to move to a city or part of the country with large Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ) communities and less rampant bias. A couple of people found that a “queer” identity helped them feel more authentic and less alienated.
Deprivation and poverty

People we interviewed also talked about the reciprocal relationship between growing up and/or living in poverty and depression. As Devin summarized, “a lot of depression will come from not having enough money.” Whitney noted that having no money “made me depressed ‘cause I just can’t afford things like I want to be able to.” Several people talked about how homes of origin where resources were strained connected to an overall “bad environment” for mental health (see “Young adults’ views about what causes depression”). One person who grew up in a neighborhood with high crime rates noted that her mother protected her by keeping her indoors. As a result, she “didn’t leave the house, didn’t talk to people, didn’t have friends, didn’t have outlets” and her depression deepened.
Race, ethnicity, and bias

Racism and other “discriminatory events” are documented sources of stress linked to mental health issues among racial and ethnic minority groups*2 in the United States. Black people living in the United States have lower overall rates of “major depressive disorder” than non-Hispanic whites, but studies suggest they have poorer access to services, receive poorer quality of care, and are overrepresented in populations with most severe issues*3.

Many (but not all) Black and Asian young adults we interviewed spoke about their own experiences with bias or cultural norms and how these influence depression. Several people spoke about how in the Black or Asian communities in which they grew up, depression was just not “part of the vocabulary,” or was “frowned upon,” so it was difficult to go public with feelings of depression (see ‘Going public with depression’). Jeremy notes that growing up as one of few non-white children going to predominantly white schools, he always felt like “the odd person out” and noticed that “white people just ignore[d]” him. In contrast, Natasha (who is African American) says that for her, race “wasn’t really a thing” growing up, or with respect to her depression.
Depression, bias, and challenges for healing

People we talked to offered many examples of how bias interferes with their ability to effectively address depression. For example, people with limited financial resources described restricted access to health services of all kinds (see ‘Barriers to care for depression’), as well as difficulty finding or holding a job which could help get them out of poverty. James described how growing up in a “rough neighborhood” led to a cycle of poor education, encounters with law enforcement, limited opportunity and mental health struggles which is hard to overcome. Jeremy has avoided seeking long-term professional help for his depression in part because he feels that historically “… a lot of black people were misdiagnosed because… their psychologist doesn’t understand them [and]…mislabeled them.” Crystal said the quality of care she received while living at home was poor because her family couldn’t afford a good psychologist.
Prejudice and perception in perspective

A number of people we interviewed said they had found ways of coming to terms with stigma, bias, and other forms of prejudice – and of celebrating their individuality. Some moved to parts of the country (especially on the West coast) where they felt less isolated, found healthier communities, and built networks of people who could support and understand them. Others cultivated commitments to the arts or other expressive practices. (See 'The positive sides of depression'.)
See also ‘Young adults’ views about what causes depression’, ‘Barriers to care’, ‘Getting professional help for depression’, and ‘Going public with depression?’.

References
*”Major Depression Among Adolescents.” National Institutes of Health, n.d., Web. 7 February 2016.
*1Pratt, Laura, and Debra Brody. “Depression in the U.S. Household Population, 2009-2012.” National Center for Health Statistics Data Brief 172 (2014).
*2 Brown, Tony N., et al. "“Being black and feeling blue”: the mental health consequences of racial discrimination." Race and Society 2.2 (2000): 117-131.
*3 Williams, David R., et al. "Prevalence and distribution of major depressive disorder in African Americans, Caribbean blacks, and non-Hispanic whites: results from the National Survey of American Life." Archives of General Psychiatry 64.3 (2007): 305-315.

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