Sad, empty, alone, low, miserable, overwhelmed, cold, tired, worthless, hurt, insignificant — these are just a few of the words used to describe the “black cloud” that affects people experiencing depression. When teens or young adults arrive at Evoke, they usually have little insight into the symptoms that affect them. As we dig deeper with family members, a more far-reaching list of symptoms usually includes: isolation, loss of interest in school or hobbies, loss of friends, inattention, impulsivity, threats or attempts of suicide, personal dissatisfaction, empty feelings, little connection to or awareness of self, and feelings of anxiety and shame. Parents report, “He gets home from school, goes to his room, shuts the door and never comes out,” and “She used to love playing sports, she was always out with friends, and now she spends afternoons and weekends sleeping”. They talk about weight gain or loss — “She never eats, and when she does it’s only junk food”. They talk about fights that quickly escalate — “When he is around, we are constantly yelling at each other”. They express worry, frustration, disconnection, and confusion.