Hales believes that a teen's sense of self and self-esteem is so fragile that one cruel word or look can shatter it and thrust the teen into depression. Hales also believes that teens view themselves as always being scrutinized and therefore believe that their every fault will be noticed. That thought causes major stress, which can add to depression. Other causes of teenage depression may include lack of affection from parents, drug use, loneliness, stress and low self-esteem. Low self-esteem is a major cause of depression because of the importance placed on looks in society today.
Stress can come from the worry about looking attractive enough.
Erikson says that in this time of uncertainty, teens ask themselves if they will grow to be more attractive, make the right choices in life or discover their true identities. If two or more of these warning signs are persistent for more than two weeks and interfere with daily life, then help is necessary. According to Heights head nurse, Dawn Heintzelman, many students who go to the nurses office complaining of physical pains are really having emotional problems. Heintzelman believes that it is more socially acceptible for a teen to have medical problems, rather than emotional problems. Heintzelman also believes that students tend to somaticize, or have physical pain to cover mental anguish, to cope with problems.