Depression Beyond Sadness

Depression gets talked about like it’s just sadness, but the reality is messier and more important. Sometimes it shows up as irritability, numbness, exhaustion, lost motivation, or a teen who can’t seem to care about anything they used to love. We wanted a clearer map, so we sat down with our resident expert, Dr. Peter Montminy, to break down what depression is, what it isn’t, and how to tell when a normal dip has crossed into something that needs real support.

We walk through depression on a continuum, from natural differences in temperament to mood difficulties to diagnosable depressive disorders that interfere with daily functioning. You’ll hear specific depression symptoms in teenagers to watch for, including shifts in sleep, appetite, energy, concentration, and self-worth, plus why “tired” has become such a common baseline for kids today. Dr. Montminy also explains the brain science in plain language, including how depression can dampen reward and motivation systems and why adolescent brain development can make coping feel harder in the moment.

Most importantly, we focus on what helps: creating a safe, supportive environment; having many small check-ins; listening without judgment; and using “reflect and redirect” to validate feelings while guiding toward doable next steps. We dig into evidence-based strategies like behavioral activation, especially movement, and how pairing it with social connection, music, or time in nature can boost the impact. We also cover when to seek professional help, how to talk about therapy or medication without shame, and how to offer realistic hope that doesn’t dismiss pain.

If this conversation supports you, subscribe, share it with a caregiver or educator, and leave a review so more families can find these mental health tools. What’s one sign or strategy you want to remember for the next hard day?

If you or someone you know is in crisis, call or text 988 for immediate support. 

This podcast is brought to you by Jana Marie Foundation and A Mindful Village. 

Jana Marie Foundation is a 501(c)(3) nonprofit organization located in State College, Pennsylvania which harnesses the power of creative expression and dialogue to spark conversations build connections, and promote mental health and wellbeing among young people and their communities. Learn more at Jana Marie Foundation.

A Mindful Village is Dr. Peter Montminy's private consulting practice dedicated to improving the mental health of kids and their caregivers. Learn more at A Mindful Village | Holistic Mental Health Care for Kids.

Music created by Ken Baxter. 

(c) 2025. Jana Marie Foundation. All Rights Reserved.

This podcast was developed in part under a grant number SM090046 from the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS). The views, policies, and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA, HHS or the Pennsylvania Department of Human Services.

Transcript

Marisa Vicere, Jana Marie Foundation 0:17

Hello and welcome to Ripples of Resilience, a podcast from the Jana Marie Foundation, where we explore ideas, tools, and conversations that support mental health, resilience, and well-being for young people and the adults who care about them. I'm your host, Marisa Vicere and today we're talking about an important and often misunderstood topic, depression. Many people think of depression as simply feeling sad, but it's much more complex than that. Understanding what depression is and what it isn't can help us better support ourselves and the young people in our lives. To guide us through today's conversation is Dr. Peter Montminy, our resident expert. Dr. Montminy, thank you so much for being here today.

Dr. Peter Montminy 1:04

Yeah, thanks, Marisa. I'm really looking forward to this. Depression is something that many people experience, and gaining a better understanding, hopefully, today will help make a difference for some.

Sadness Versus Clinical Depression

Marisa Vicere, Jana Marie Foundation 1:15

We really appreciate you being here and sharing all of your experience and expertise with us. So let's get started with the basics. When we say depression, what are we really talking about?

Dr. Peter Montminy 1:28

Yeah, well, that's a great question. First, it's important to understand that feeling sad is a normal human emotion, right? Just like anxiety or anger or any of these other things. We'll all have periodic bouts of sadness, of lethargy, of feeling down or depressed. It's quite common. But clinical or major depression, however, goes beyond these temporary sadnesses or ups and downs, usually related to something specific popping up in your life that was challenging. But what goes beyond that is then we have more persistent low moods, low energy, loss of interest or pleasure in doing what you used to really enjoy. And maybe you can't even pinpoint what an exact reason for it is. This gets to the more deeper general malaise or depressive moods that can kind of just put a real blanket of fog on our energy, our focus, our thinking, and our feelings. So, yeah, and depression, like any other mental health condition or emotional condition, we can remember, think of it on that continuum from differences to difficulties to disorders.

The Continuum From Differences To Disorder

Marisa Vicere, Jana Marie Foundation 2:35

And I think that's such an important part coming back to that continuum. I know we've mentioned that in past episodes as well. But it's so important to remember that we're always moving along this continuum. And so can you talk to us a little bit more about what that looks like?

Dr. Peter Montminy 2:50

Yeah, sure. So at the, you know, there's differences in how people are wired or have tendencies to be more emotionally exuberant, exuberant or enthusiastic, or more kind of maybe down, maybe not all the way to Eeyore and winning the poo, but kind of have more of a kind of low-key disposition, right? So people naturally vary in their moods and in their emotional sensitivity. And some individuals may feel things more deeply or take longer to bounce back from disappointment. So we have that natural kind of human differences level. And we need to respect that and notice that for different people, they run on different kind of energy levels at times, right? Now that becomes an emotional mood difficulty when someone experiences more frequent or intense low moods that begin to affect their motivation to get up and do things, their energy, their daily functioning, or it's just so acute. So we can have increases in frequency of it, or increases in and or increases in intensity of how sad, down, unmotivated, maybe even all the way to hopeless at times you may feel. And when we start getting to that deeper end of frequency and or intensity, it becomes more persistent and it starts interfering with everyday life. Again, that's when we really get to diagnosable disorders, is when you're having it so often or so intensely that you're having trouble in the case of depression, perhaps getting out of bed or getting to school in the morning or getting through your daily schoolwork, keeping up with your assignments, your chores, your social activities. When those low moods are persistent enough to impair your daily functioning, then we have a disorder and you might need some professional help.

Marisa Vicere, Jana Marie Foundation 4:36

Thank you so much for taking the time to walk us through that. And I want to come back to one of the things you had mentioned before about feeling sadness. Like oftentimes we think of depression in this idea of sadness. And just want to see my understanding is if we know one person with depression, we know one person with depression because it all looks differently or could be manifested in different ways.

Dr. Peter Montminy 5:01

Right.

Marisa Vicere, Jana Marie Foundation 5:02

And so can you talk a little bit about what we might see in a teenager?

Dr. Peter Montminy 5:06

Sure. Especially with kids and teens, it's not always sadness, is not always the lead thing we may see. We get a lot of irritability that may come out. And so you when kids can be irritable, you know, and reactive and kind of pissy for lots of different reasons. So, but that it might be a marker to try to look underneath more if they're having some more chronic kind of mood difficulties. Also, a common one, of course, is lack of interest in activities, especially that they used to enjoy or feel. So they just kind of don't want to get up and go or go out or connect or do things they used to want to do is a common marker. Significant changes, or really be on alert for any changes in sleep or appetite. So kids might start sleeping, or teens, this also applies to adults, sleeping less over a considerable period of time might be a marker, sleeping more, needing to sleep or nap more. Same with appetite, overeating more than they used to or under-eating. Well, what's overeating or oversleeping or undereating or undersleeping? Compared to what their baseline, their typical had been. So if you see a significant change in their habits, you want to get that checked out. Of course, we've mentioned before low energy or fatigue. Now, in the modern constant, stressful world that we live in, we talk a lot about wearing down the nervous system, fatigue is a very common thing. In fact, I've been saying for years when I do workshops, what's the what you know, when I see kids clinically in my office, and you know, how are you feeling? How are you doing? How are you feeling? What do you think is the number one thing that kids say to me? Tired. Tired. How sad is that? At the you know, the peak of adolescent youth and vitality and energy, and kids today are tired. So we want to really take a look at that kind of chronic effect. Another one is difficulty concentrating, right? They can't concentrate enough to get through things. This could be, you know, attention problems, it could be anxiety problems, it absolutely could be depression problems as well. So you want to take a look at that. Feelings of hopelessness and worthlessness. Again, on the deeper end of things, the inner critic that we all carry with us gets louder and louder from self-doubts to self-loathing to maybe even self-hatred. So we're also looking at their sense of self and related to that may start feeling hopeless or worthless, like what's the point? And of course, that may also then coincide with self-harming behaviors, perhaps with suicidal intentions or not. And so you have this full range or spectrum of science we want to pay attention to.

Causes And The Depressive Thinking Trap

Marisa Vicere, Jana Marie Foundation 7:39

Thank you so much. And some so many of those go back to really looking for changes in somebody's thoughts, feelings, actions, or appearances. So if we can't remember them all, if we're noticing any kind of shift, especially those bigger ones, starting those conversations is really important. And we'll talk more about that in just a couple of minutes. But first, you know, what are some of the factors that can contribute to depression?

Dr. Peter Montminy 8:04

Yeah. So as usual, right, it's a combination of factors, particularly nature and nurture, both biological, innate, as we said, tendencies or our temperament might lean us towards a more depressive kind of view or energy level in the world. Excuse me.

Marisa Vicere, Jana Marie Foundation 8:26

You're good.

Dr. Peter Montminy 8:29

And also we may be influenced by environmental factors, including stressors in our lives, major life changes, loss of relationships, challenging uh experiences. So we have this combination of things, you know, biologically wired coming up for us in our tendencies, the environmental influences. And then either or both of those can be contributing to the psychological symptoms or factors we're going to see, such as patterns of negative thinking. And then the negative thinking can also be further cause. So the negative thinking can be cause or effect of these other conditions, but it's often a hallmark where we have intrusive, negative, downer thoughts, and particularly thoughts along the depressive triad that are known, the three Ps of depressive thinking, where you you tend to think negative things more negatively about your life, and you think those negative things are personal, that they're your fault or they're happening to you disproportionately, that they're pervasive, like everything around my life sucks right now, that you know, school and home and my family, and that we start, you know, there starts being spread to it feeling more pervasive, and it feels more permanent. Man, it stinks now, it's always going to stink. What's the point? So we're looking for those, you know, patterns of, man, this sucks. We all have moments like that, but are we taking it overly personal, pervasive, or permanent in our views? That really stacks up and contributes to obviously then more emotional, depressive moods.

What Depression Does To The Brain

Marisa Vicere, Jana Marie Foundation 10:03

Absolutely. And so how does depression affect the brain, especially for our young people?

Dr. Peter Montminy 10:10

Aaron Powell Yeah. Well, depression can really impacts the areas of the brain involved in mood regulation, in motivation, and in reward. So we don't often think about that. But right, the flip side of not being turned on or excited by anything, not being interested in pleasure anymore, is that reward center of getting excited or looking forward to things or feeling good about things is not quite lighting up. Our dopamine centers, our serotonin centers, and our brain in particular. So some activities that used to feel enjoyable may not produce the same sense of reward, which can make it harder for someone to feel motivated to engage and literally get up off the couch and go, right? At the same time, the brain may become more focused on negative thoughts or experiences, as we just mentioned. So you get this negative feedback loop that reinforces a negative kind of cycle of depression. And for adolescents, this is particularly important because their brains are still developing, and as we've say time and time again, right? The downstairs emotional brain, emotionally reactive brain, the limbic system is more fully online and further ahead of being developed than the upper cortex regions, your higher order of thinking, your cognitive controls for how to reason your way through this or think your way through this, they're not fully online yet. So again, anything that affects kids' emotions, their emotions are out in front, they're thinking how to manage it or take care of it is lagging behind. And so there's going to be an extra bump of difficulty for our kids.

Marisa Vicere, Jana Marie Foundation 11:39

Thank you. So what are some ways that we can support the young people who may be experiencing depression?

Dr. Peter Montminy 11:46

Sure. And again, to our listening audience, it won't be a surprise for us to talk about creating a safe, supportive environment with ongoing conversations of support, right? Noticing and meeting kids where they are, not being afraid to bring it up yourself. People, you know, we'll talk about this again across subjects. Adults are often afraid to bring it up with a kid for the fear that they're planting the idea in their head. No, we want to open-ended ask, hey, how are you feeling? When are times when you're feeling down? What do you think is going on for you there? And as we talk about again a lot here, normalizing that. It's normal to have a range of feeling down or not be interested. Let's check in about what that, how that's going on for you right now. So really creating that comfortable space of ongoing small chats, no one big talk, right? But having the little ongoing check-in in and in a way that's that's real. A big part of the way we do that is the core universal parenting tool that I've said, I'd come up with years ago, right? Reflect and redirect, reflect and validate their feelings. Reflect on what is the feeling underneath the behavior I'm seeing right now, and then reflect it back to them like a mirror. I see you're kind of feeling kind of bummed, or it seems like you're feeling kind of bummed, or it seems like you're not interested in doing things like that as much anymore. Or I see you're having trouble getting to your homework these days, or wow, I'm I hear that you're really kind of upset about not sleeping well the last few nights. Reflect and validate, reflect back to them with reflex reflective listening skills. I hear, I understand, or at least I'm trying to understand what your struggle is right now, and then redirect, redirect the behaviors, redirect the behavior choices, which simply in this case means we reflect and validate any kind of depressive thoughts or feelings they may have, and redirect them to how to move through it, to action plans for what to do. So we can talk a little bit more about that, if if I may.

Marisa Vicere, Jana Marie Foundation 13:42

Yeah, that would be great.

Movement And Connection As Medicine

Dr. Peter Montminy 13:44

Yeah. So we want to, you know, the things we can do is make sure that the kiddo has the opportunity to kind of connect and hang out more with supportive peers and adults. Just hanging out, being connected, feeling a part of something. Yes, especially when they don't feel like they want to do that. Yeah, I know. And so just come on over. You don't have to say or do a lot, but even just help them kind of be around the family or around some friends is really important. Working on that sleep and eating routine, let's just practical, not rocket science, but practical. How do we fine-tune our sleep hygiene? How do we take care of ourselves to get through the night? How do we take care of make say sure we're eating? Yes, even when, especially when you don't feel like eating more, let's figure out how you're going to eat a little, keep fueling your body to get through this, right? So it's not being stuck when they go, I don't want to get together with friends. I don't want to eat. I don't want Yes, and reflect and redirect. Yes, I understand you feel that way. And what will get you through it so you feel less that way is it when we can do a little bit and a little bit. So let's figure out what you can eat, what you can do to connect, that type of thing. Yeah? Yeah. Yeah. Small manageable activities, even when motivation is low. I was just starting to talk about that. I want to highlight the number one place that that's most important by the research. I just came back from another conference. And the number one thing we can do for all these mental health challenges in youth is get out and move. Get up and move the body. You know, it is the natural remedy for a whole lot of what's wrong in our heads, in our minds, and in our hearts is to move that body. So behavioral activation is the number one curative ingredient for depression in particular. And what will turbocharge that. So again, you're looking for small doable steps. Literally, let's get up and walk around the block. Literally, get up and come on in and help me cook dinner. Little just little movements, right? Yes, sure. Exercise the gym, run a marathon. No, we're not talking about that. We're saying let's get up and move, let's go for a walk. And this the science shows that you'll get the benefits of that movement activity. And yes, it can be yoga, but again, it can just be taking a walk. You'll get extra benefits of that movement activity for depression and for most mental health conditions. If you can make it social, so it can be with another person. That's a turbocharger to the boost in the in the reward centers in the brain. So you want to make it even just a partner, a one-on-one partner, or in a group, wherever you can get some activity movement going in a group, social, with music also as an additive beneficial effect. So get some music going. And outdoors and in nature is also a particular mood and mental health turbo booster. So look to move. If you can add social music or nature, all the better.

Marisa Vicere, Jana Marie Foundation 16:40

I love it. It's so important. And really, you're talking about meeting them where they are. So we understand running a marathon is not going to happen right now, but let's see where you are and what we can do to motivate just a little bit and get that started.

Dr. Peter Montminy 16:55

A little bridging, move one, two steps forward, literally in this case. Exactly right.

Marisa Vicere, Jana Marie Foundation 17:00

Thank you. And I love how you also pointed out it's really about listening without judgment. It's about giving that reassurance and encouraging those self-care strategies that work for the individual that we're working with. And I know that a lot of organizations out there, like Jana Marie Foundation, offer evidence-based courses to learn more about these signs and symptoms and about ways to support young people in our lives. So these are always great things to go to as a parent, as an educator, just to learn a little bit more. And so, you know, that that just helps us create more of these safe environments that you had mentioned at the beginning where young people can feel understood and heard, and even sometimes be willing to have that conversation around that encouragement of professional help.

Dr. Peter Montminy 17:49

Okay, yeah.

When To Seek Professional Help

Marisa Vicere, Jana Marie Foundation 17:50

Yeah. And so kind of moving into that, while we can create these safe environments for young people, we do know that sometimes it goes beyond what we can help with, and that we do need to encourage the professional help. When should we consider seeking some additional help for somebody in our life?

Dr. Peter Montminy 18:09

Yeah. So if the symptoms of depression are really more persistent across time, worsening in terms of frequency and intensity, as we spoke about, and again, another key marker, interfering with their daily functioning or daily life, then it really is important to get to the next level of resources. And it's really important that when we have those talks, doesn't mean you're crazy, stupid, or broken. It means, hey, something's hurting literally, let's get some care for that hurt and suffering and take care of it. Using external resources, professional otherwise, it's not a sign of weakness, it's a sign of strength. When we're having trouble with something, let's go use our external resources to get the help we need. So I really encourage you to think that way and to uh, you know, embody that and talking to your kids that way, hopefully. And so then you can redirect them, you know, certainly to the pediatrician or the school counselor, or often the first two points of entry to maybe get on to a counselor, a therapist, a psychologist, or other mental health provider that can really do then. There's a whole lot of well-documented professional treatments that can help resolve, not necessarily magic wand cure, but really help diminish depressive difficulties, really help increase resilience in the face of depressive moods or life crises or difficulties. So we really want to recognize using those from a range of mindfulness-based cognitive behavioral therapies to, again, behavioral activation, getting up and move, and body-mind activities are really things that can be done with a professional guide, a therapist who can help you. And sometimes medication can be helpful as well, and you want to add that as needed, looking at that obviously with your physician.

Fighting Stigma With Normalizing And Values

Marisa Vicere, Jana Marie Foundation 20:03

Thank you. And you hinted at it, but there's still this stigma around depression and around mental health in general. What can we do as parents or as adults that can really help change that?

Dr. Peter Montminy 20:16

Aaron Powell Yeah. Well, again, I uh it's why I keep going back to this idea of normalizing and talking about a continuum. We all have moments of being anxious and distressed. Is it happening so much it's messing with me, I can't get through my day. We all have moments of feeling down and depressed and like I'm not interested and just leave me alone for a little bit. I need to pull the blanket over my head. And and there's times when, hey, that's happening over and over again, and I can't seem to control it or stop it, and it's messing up with things I want to do. Look at your values in life. Look at what you care about, what's important to you. I want to do this. What does your kid want to achieve? What are things you want for your kid? And then how is this mental health condition? Today we're talking about depressive moods, really major depressive mood disorders who may be blocking your ability. So we go, yes, and recognizing you have that suffering, that is very human, not a personal flaw, that you have a human emotion that you're struggling with. Now, how do we move towards what's really important to you and how it's help you get where you want to go while resolving this difficulty? And we'll see who can help us with that, professional or otherwise.

Marisa Vicere, Jana Marie Foundation 21:28

Thank you so much. So depression is more than just a sad feeling. It is a complex experience that can affect thoughts, feelings, and everyday life. But when we create environments where young people feel seen, heard, and supported, we help build resilience and hope even during difficult times. Thank you, Dr. Mottminy, for sharing your insights today. And thank you, everyone, listening to Ripples of Resilience brought to you by the Janna Murray Foundation. Hold on a moment here. I just messed that up. That's not the right ending. Oh my gosh.

Dr. Peter Montminy 22:10

Yeah. There's one other point I liked I didn't get to say, so I don't know if we can go back in and sort it or not. But go ahead and finish what you were going to finish.

Marisa Vicere, Jana Marie Foundation 22:19

Well, I have to re-record.

Dr. Peter Montminy 22:20

So what if you're going to re-record the closing, then let me come back in here with where I ended.

Marisa Vicere, Jana Marie Foundation 22:26

Do you want me to ask a follow-up question?

Dr. Peter Montminy 22:28

In my last answer. Yeah, go back to my last answer and say anything else you want to add to that before we wrap up. And that yeah.

Marisa Vicere, Jana Marie Foundation 22:35

Okay, perfect. I'm just gonna mark where I'm doing this at.

Dr. Peter Montminy 22:39

Yeah.

Marisa Vicere, Jana Marie Foundation 22:43

All right. Thank you so much, Dr. Montminy. Is there anything else that you would like to add before we wrap up today?

Dr. Peter Montminy 22:50

Yeah, one more thing, I guess, is especially when our kids are struggling with depressive moods and they're not feeling connected to a lot of hope. It's again a pervasive permanent sense of feeling down. We want to be able to offer them hope, not false reassurances or just try to cajole them out of it, but really just remind them of this simple truth. These dark clouds, moon clouds you're experiencing right now are just clouds in the sky. Clouds come and clouds go. And truly, this too shall pass. So I'm not dismissing your pain. I am letting you know I know you and we can and will get through this. This will pass. And you are more than just your depressive moods. That's a part of you. You are more than that. We're gonna get through it. And in that way, convey realistic hope to help pull them forward.

Marisa Vicere, Jana Marie Foundation 23:41

That is amazing and so encouraging to hear. And that reminder that this is something that is very real and we are able to work our way through it, especially with that support around us.

Dr. Peter Montminy 23:56

We can do hard things.

Marisa Vicere, Jana Marie Foundation 23:57

We can. So thank you so much for joining us today. As we wrap up, we want to remind you that depression is more than just a sad feeling. It's a complex experience that can affect thoughts, feelings, and everyday life. But when we create environments where young people feel seen, heard, and supported, we help build resilience and hope, even during difficult times. Thank you, Dr. Montminy, for sharing your insights with us today. And thank you to everyone listening to Ripples of Resilience. This podcast is brought to you by Jana Marie Foundation, where we're dedicated to opening minds and saving lives through conversations that matter. And by a mindful village, where Dr. Peter Montminy provides holistic mental health care for kids and their caregivers. If you found this episode helpful, please consider sharing it with a friend, caregiver, or educator. These conversations matter and they help create meaningful ripples of resilience in our communities. Until next time, take care of yourselves and each other.