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Kurt Cobain's cousin reaches out to suicidal teens

'When Nothing Matters Anymore: A Survival Guide For Depressed Teens'
By Bev Cobain

Web posted on: Monday, August 31, 1998 5:19:47 PM EDT

(CNN) -- On April 8, 1994, Kurt Cobain ended his long struggle with depression and chemical dependency by taking his own life. His suicide profoundly affected millions of fans around the world who identified with the music of Kurt and his band, Nirvana. Bev Cobain is Kurt's cousin, and this book is her way of dealing with his death -- and reaching out to teens with a life-saving message: You don't have to be sad, discouraged, or depressed. There is help and hope for you.


rule

Introduction

"Sometimes I feel I can't go on.
My life's not worth it; I don't belong."
-- Sydney, 14

Maybe you feel the same way sometimes -- sad, discouraged, alone, and tired. These feelings may seem scary, confusing, and overwhelming, especially if you think you're the only one feeling them. This book can help you see that many other teens -- perhaps some of your classmates, neighbors, or team members, or maybe even a close friend -- might be going through the same thing you are. This book can also help you feel good again. You can go on. Your life is worth it.

Do you know that:

  • an A student can be depressed?
  • a star athlete can be depressed?
  • someone who's handsome or beautiful can be depressed?
  • anxiety and helplessness are symptoms of depression?
  • a change in appetite can signal depression?
  • a sudden drop in your grades or trouble in school could be a sign of depression?
  • if you're often angry and irritable, you might be depressed?
  • when you feel like nothing matters anymore, you're probably depressed?

    Depression causes a variety of serious symptoms and can affect anyone at any time -- no matter who you are, what you look like, or where you live. People young or old can be depressed. People of every race, gender, ethnic heritage, and religion can be depressed. Even the rich, famous, or successful can go through depression.

    Here are some examples:

  • Abraham Lincoln, 16th president
  • Beethoven, composer
  • Buzz Aldrin, astronaut
  • Charles Dickens, novelist
  • Delta Burke, actress
  • Ernest Hemingway, writer
  • Eugene O'Neill, playwright
  • John Milton, poet
  • Leo Tolstoy, novelist
  • Margot Kidder, actress
  • Patty Duke, actress
  • Tennessee Williams, playwright
  • Vivien Leigh, actress

    According to the National Institute of Mental Health (NIMH), about 18 million Americans -- or more -- are depressed. Anywhere between 112,000 and 2,324,000 of them are teens. Some mental health professionals believe that as many as 20 percent of high school students are deeply unhappy or have some kind of psychiatric problem. Teens who seem continually sad, angry, confused, misunderstood, or rebellious are probably depressed. Depression affects more young people today than ever before.

    If you're feeling down, tired, anxious, angry, overwhelmed, hopeless, helpless, guilty, and/or worthless -- and if these feelings have affected you for some time -- you're probably depressed. If knowing you're depressed makes you even more depressed, take heart:

    1.Depression is common. 2.You're not the only one feeling this way. 3.You don't have to face this alone. 4.This book can help you. 5.Depression is treatable -- you don't have to feel this way forever.

    I wrote this book because my cousin Kurt Cobain, the lead singer of the rock band Nirvana, shot himself on April 8, 1994. I didn't know Kurt personally; like many families, ours wasn't as close as I would have liked. But his death still affected me deeply. Members of the Cobain family have struggled with the demons of depression, drug addiction, and suicide for generations, and we've lost other family members to suicide. I understood what Kurt was going through because I've gone through similar troubles.

    After Kurt's death, I spoke with teens, reporters, and well-wishers. Many people asked me why someone with such wealth and fame would kill himself, why Kurt was so "selfish," and why he didn't think about his wife and child. Nobody asked the most important questions: What problems was Kurt facing that seemed too huge to solve? What could someone have done to help him?

    I read what the media had to say about his suicide. Newspapers, magazines, and TV reporters commented on Kurt's heroin and alcohol use, his "angst," and his inability to cope with success. These weren't the problem; they were symptoms of the problem. Kurt suffered from manic depression, a mood disorder that affects about 2 million people nationwide. His depression caused the emotional and physical pain that he so desperately wanted to escape. A self-inflicted death seemed like the only way to leave behind problems that felt too big or too awful to solve.

    I've listened to some of Kurt's fans -- both kids and adults -- say that suicide is a stupid, weak, shameful, and selfish act. What they don't know is that suicide is a cry for help. I realized that few people outside of the mental health field understand depressive disorders, how they relate to suicide and drug and alcohol problems, and how common these issues are. I hope my book will shed light on the terrible toll depression takes on young people. It's my hope that this book will help depressed teens find a light in the darkness -- perhaps it will even save a life.

    "When Nothing Matters Anymore" is divided into two parts. Part 1, "What's Wrong?" explores how it feels to be depressed, the causes and types of depression, and the connections between depression, suicide, and drug and alcohol abuse. Part 2, "Getting Help and Staying Well," discusses the benefits of professional treatment and how to help yourself stay healthy. If you think you might be depressed or suicidal, or if you're abusing drugs and/or alcohol, the best thing you can do to help yourself is talk to an adult you trust. It may be difficult to open up to someone, share your problems, or ask for help, so throughout Parts 1 and 2, I've provided lots of suggestions for what you can say. At the end of each chapter in the book, you'll also find a Survival Tip that can help you right now, during treatment, and for the rest of your life -- so you can live well and reduce the possibility of getting depressed again.

    This book wouldn't have been possible without the help of many courageous young people who allowed me a very personal glimpse into their lives to share what depression was like for them: what happens, what hurts, what's hidden, what haunts, and what helps. I hope reading their stories will help you see that you aren't alone.

    I believe that whatever you're willing to put up with is exactly what you'll have in your life. Don't put up with depression. Don't let it defeat you. I wrote this book for you -- because you're worth it.

    IN DEPTH

    Read Bev Cobain's open letter to Kurt

    Chapter 2

    "When my doctor said I was depressed,
    and that she knew how to help, I was relieved."

    -- Raquel, 15

    Types of Depression

    Amy was in ninth grade at a small, prestigious private school that took pride in offering the finest education. She was interested in English, art, and history, and she excelled in those classes. Her parents pushed her to study hard and make good grades. On the outside, Amy seemed fine. She was getting a good education, had a supportive family, and had several close friends she cared a lot about. But on the inside, she felt empty, hopeless, and fearful. Most of the time, she believed that all the other students were better than her -- better looking, better dressed, smarter, more popular, more athletic, and happier. She didn't think she could ever measure up. She'd watch the other students laughing, smiling, studying, talking, playing sports, and planning their weekends, and she'd wonder why she never seemed to be filled with as much life and energy.

    She began to spend more time alone, going to study hall between classes to lose herself in a book and staying at home after school and on weekends, instead of being social. Each day, she withdrew a little more. She still went to school, attended class, and did her homework, but she felt like she was just going through the motions. Everything seemed to take so much effort -- studying, talking to friends on the phone, doing chores around the house, and participating in family activities. She got annoyed when people asked her to do something, or even just asked her what was new in her life. Sleep was a source of comfort. She went to bed early and slept in late on weekends. When she was asleep, nothing bothered her -- she didn't have to worry about her grades, deal with her family, or think about how well everyone else was doing, compared to her.

    She lived this way for months and months. Her parents said she slept too much, and they accused her of being "moody." But because Amy was still bringing home A's and B's and seemed to spend a lot of time studying in her room, they assumed she was all right. No one realized that Amy was depressed.

    How can depression be so hidden? The symptoms aren't always obvious -- to other people or to the person who's depressed. Depression isn't like the flu, where the symptoms appear suddenly and are hard to mistake. Depressed people can feel awful for weeks, months, or even years before understanding that something is seriously wrong.

    There are many different kinds of depression, too: melancholia, endogenous depression, exogenous depression, reactive depression, Seasonal Affective Disorder (SAD), and postpartum depression, to name a few. If you ever felt like reading the Oxford Psychiatric Dictionary, you'd find up to twenty-five types of depression; they vary in the number of symptoms and how severe they are.

    Teens are most likely to experience:

  • major depression,
  • dysthymia (pronounced dis-THIGH-mee-a), or
  • bipolar disorder.

    Major Depression
    Imagine that your high school has 1,000 students. According to a recent study, 77 of them will suffer from major depression during a one-year period.2 Major depression (also known as clinical depression) is the most widespread type -- you might even call it the common cold of brain illnesses.

    If you're a girl, you may be more prone to major depression because of the physical and hormonal changes of puberty, especially if you're struggling with identity problems and a drop in your self-esteem. In fact, studies have shown that although boys and girls have about the same rate of major depression during childhood, at age fourteen, suddenly twice as many girls as boys suffer from major depression.

    Watch for symptoms like these:

  • feeling sad, empty, guilty, anxious, worthless, irritated, and/or hopeless
  • feeling tired, fatigued, or slowed down
  • a loss of interest in activities, hobbies, and/or relationships
  • interrupted sleep or oversleeping
  • trouble concentrating, remembering things, and making decisions
  • a change in appetite (with unintentional weight gain or loss)
  • restlessness
  • violent outbursts and obnoxious behavior
  • use of alcohol or drugs to try to feel better
  • physical symptoms (headaches, pain, digestive problems) that won't go away
  • thoughts of suicide or death, or suicide attempts.
  • (If you're thinking about suicide, please talk to an adult you trust right away. You can also call a Crisis Hotline or Suicide Hotline listed in your Yellow Pages.)

    Major depression isn't something you can grow out of, and it usually won't go away on its own. Untreated major depression can last a year or two -- or more. Your symptoms might bother you for a long time, making it hard to keep up in school, have fun with your friends, get along with your family, and enjoy your life.

    If you think you might have major depression, you need to talk to someone about it. Maybe you're too depressed to share your feelings with anyone, or maybe you have doubts about asking for help. You need to know that getting help works. It's worth it; you're worth it. You can feel better.

    Dysthymia
    Dysthymia causes many of the same symptoms as major depression but in a milder form. It's a "low-grade" depression (kind of like a low-grade fever), where you start living life almost as if you're going in slow motion. When you have dysthymia, you're usually able to carry out your daily routines, but it may take a lot of effort for you to do things that other people seem to do easily.

    Dysthymia is chronic -- it goes on and on. In fact, teens usually have dysthymia for a minimum of a year.

    If you have dysthymia, you might feel:

  • unloved self-critical
  • sad
  • negative
  • angry or irritable
  • hopeless
  • tired
  • anxious.
  • guilty

    You might also:

  • have trouble concentrating or making decisions
  • have a sudden drop in your grades
  • sleep too much or too little
  • act out or become disobedient (lie to your parents, misbehave at school, cheat on tests, shoplift, drive under the influence, etc.)
  • have aches and pains with no apparent cause
  • think about suicide or death, or attempt suicide.
  • (If you're thinking about suicide, please talk to an adult you trust right away. You can also call a Crisis Hotline or Suicide Hotline listed in your Yellow Pages.)

    You don't have to live with chronic sadness and fatigue. You can experience all the joy and excitement the world has to offer. Talk to an adult about your depression before it gets worse (you don't have to feel afraid, embarrassed, weird, or ashamed about asking for help). According to some experts, 70 percent of young people with dysthymia will eventually develop major depression, so it's important to get help as early as possible.

    What's SAD?
    You may have heard the term "SAD," which stands for Seasonal Affective Disorder. It's a kind of depression that occurs only during fall and winter, when the days get shorter and it gets dark earlier. If you have SAD, you may feel sluggish, irritable, and anxious. You might also binge eat (especially carbohydrates like bread and pasta), then gain weight. Come spring, your dreary mood will probably lift and you'll feel more energetic.

    Experts believe that the pineal gland, a small structure located near the center of the brain, plays a role in SAD. The pineal gland is activated by light. Many people who suffer from SAD have been able to relieve their symptoms through exposure to a special artificial light for thirty minutes or more each morning and evening.

    Bipolar Disorder
    Bipolar disorder, also known as manic depression, involves episodes of major depression and "mania." Although professionals call bipolar disorder a mental illness, you're NOT crazy or insane if you have it.

    "Bipolar" means your moods go back and forth between two (bi) opposite (polar) emotional states. When you're depressed, you may feel sad and hopeless. When you're manic, you may be extremely angry, irritable, or happy; have extraordinary mental and physical energy; and have boundless confidence. Your mood might swing from overly high and irritable (during the manic phase) to low and hopeless, then back to manic again. The cycles of depression and mania can happen several times a year, or as rapidly as once a day or more.

    The symptoms of mania (a manic episode) include:

  • feelings of exceptionally high energy, happiness, and creativity
  • extreme irritability
  • a tendency to be easily distracted
  • a decreased need for sleep
  • racing thoughts and hyper-alertness
  • increased moving and talking
  • grandiose ideas, overconfidence, and/or a feeling of being invincible
  • difficulty making decisions
  • obnoxious behavior
  • denial that there's a problem
  • risk-taking behaviors, including drug/alcohol abuse.

    Bipolar disorder tends to run in families and may be inherited, but just because someone in your family has the illness doesn't mean you'll get it, too. Children under twelve have been diagnosed with bipolar disorder, but it usually starts in adolescence or early adulthood (and continues throughout life). The number of teen boys and girls with bipolar disorder is the about the same.

    Bipolar Disorder Resources
    "A Brilliant Madness: Living with Manic Depressive Illness by Patty Duke and Gloria Hockman" (NY: Bantam Books, 1993). Actress Patty Duke describes her experience with manic depression, or bipolar disorder. Her book offers hope for those who live with mood disorders and for their families, friends, and caregivers.

    "An Unquiet Mind: A Memoir of Moods and Madness" by Kay Redfield Jamison, Ph.D. (NY: Alfred A. Knopf, 1995). Jamison has struggled with bipolar disorder since adolescence -- this book is her personal testimony of how the illness shaped her life.

    "We Heard the Angels of Madness: A Family Guide to Coping with Manic Depression" by Diane Berger and Lisa Berger (NY: William Morrow & Company, 1992). This inspirational story describes how eighteen-year-old Mark and his family coped with manic depression. The book includes resources and information about medications, doctors, medical insurance, and therapy.

    Many people don't realize that they have bipolar disorder and struggle needlessly for a long time. Dr. Rich Adler, a Seattle psychiatrist who works with teens, says: "What young people need to know about the disorder is that very early in the illness -- in the early teens -- there may not be obvious mania or clear depression. Instead, they may be irritable, agitated, or aggressive without knowing why. Hyperactivity is the hallmark of bipolar disorder." It's easy to miss the signs of bipolar disorder. You and your family (even your doctor) may have assumed that something else is causing your moods and behavior.

    Bipolar II disorder is a milder form of the illness, which causes "hypomania," or periods where you suddenly feel energized, more friendly, less shy, intensely interested in things, and even powerful, sensual, and euphoric. If you think this mood feels "good," you might deny that anything's wrong. But the mood isn't normal. You may soon be very moody, irritable, or reckless, and you'll eventually sink into a depression.

    Amber's Story

    Amber is fifteen. Her experience with bipolar disorder began for certain when she was eight years old, but probably earlier. Her story shows how difficult it can be to diagnose the illness and how hard bipolar disorder is on family members.

    AMBER: I've always had angry outbursts. As a toddler, when I had temper tantrums, I banged my head against the wall and screamed. My mom didn't realize at the time how serious this was. As I got older, my anger worsened.

    By the time I was twelve, I felt angry all the time. I broke things. No matter what anyone said to me, I took it personally and went into a rage. I said things just to make my mom feel bad; when we walked down the street together, I'd say, "Why don't you just jump in front of that truck?" I didn't know why my life felt so awful. I hated my mom because I thought she didn't understand me. I believed that my feelings and actions were her fault. I would think, "Why can't I be different? Why do I act and feel so hateful?" Sleep was nearly impossible for me. I'd dance, sing, and write poetry all night, then go to school in the morning.

    By the time I was thirteen, I was into alcohol and illegal drugs. I ran away, got arrested, and was always in trouble. I stayed away from home for weeks at a time. I had a twenty-one-year-old boyfriend. I knew I was doing bad things, but I never considered the consequences.

    Two days before my fourteenth birthday, I went to juvenile detention. I was there for two weeks, and I did a lot of thinking. I felt that I had dug myself into a hole and was spiraling downward, faster and faster. I was skinny and strung out. My friends were disappearing because they had no way to predict when my moods would change.

    My mom thought I had a chemical imbalance in my brain, and I began to wonder if she might be right. I saw a doctor who realized I have bipolar disorder, and I was put on lithium1 I didn't change overnight, but gradually I started feeling different. I still felt like me -- Amber -- but better. I stopped flying into rages. I still got angry, but I could talk about it now. I still felt happy sometimes, and I still felt sad sometimes. Instead of always feeling crazy, I just lived.

    My brain isn't chaotic anymore. I can sit and have a calm conversation, and I'm in control of my thoughts. I see a counselor to talk about my problems, and I'm learning about morals, consequences, and boundaries. I'm also learning to deal with the things I ran from my whole life. I have fun now, I laugh, and I go to sleep at night like other people.

    AMBER'S MOM: When Amber was younger, she cried a lot and threw things, but I thought she was just a pretty little girl with a mind of her own. It never occurred to me then that something might be wrong. She would go for days with no sleep at all or for weeks with only a few hours of sleep a night. While everyone else slept, she was awake, writing and dancing. When she started running away for weeks at a time, I'd look at what she'd written and cry. Some of it made no sense at all.

    She got mad about everything. If I acted silly, she got mad. If I got mad, she got mad. If I told her I liked something about her, she'd say I was lying. I tried not to laugh, joke, or talk around her. I thought about how horrible it must be for her to feel so miserable. Seeing her hurt herself really hurt me. When she would run away, I'd be out looking for her at midnight, banging on the doors of her friends' homes. Sometimes I'd find her and bring her home, but she'd just run off again. She told me she was taking drugs to "feel the way everybody else felt." I couldn't hang on to her and couldn't get through to her. I was watching my daughter destroy herself, and I felt helpless, frustrated, and angry. I refused to give up on her, though.

    Taking medication was hard for Amber in the beginning, but today it's working. We occasionally argue, but if either of us starts yelling, I just leave the room for twenty minutes to calm down. When I return, Amber has calmed down, too, and we hug. We need that little break. One day not long ago, Amber turned to me and said, "Mom, I love you. I want you around when I get married and have children." And I said, "Amber, haven't we come a long way? Not so long ago you told me to throw myself in front of a moving vehicle." We laughed about it together. We've discovered that Amber has a wonderful sense of humor that had been strangled all those years by her illness.

    Last summer, Amber worked at a camp for autistic and developmentally disabled children. She was so patient with them and grew to love even those who struck her or bit her. Amber reminds me not to believe that she's perfect now, but I trust her because she's finally able to think of consequences and to consider the feelings of others. I finally have my daughter back.

    A Message from Amber:
    "Maybe you happened to be born with bipolar disorder. It doesn't mean you're a bad person. Getting help can be like starting a new life."

    Copyright 1998 by Bev Cobain. All Rights Reserved
    ISBN: 1575420368
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