When to worry about someone who is isolating

One of the legacies of the COVID-19 pandemic is that we are isolating a lot more than we used to. We became accustomed to social distancing, staying home and not going to school or work in person. Five years later, most people have readjusted to their pre-COVID lives, but we also became more comfortable with being alone.

You can be alone without being lonely. If someone is comfortable being alone, their isolation could be situational. We all have a bad day from time to time. On these days, we may choose to hunker down for a mental health day to recharge. If someone is otherwise functioning, going to school, hanging out with friends, participating in family events, this kind of isolation is perfectly healthy.

But there may come a time when isolation is a cause for concern because it could be a sign of clinical depression. Is the behavior their normal baseline, or are there behaviors that should be assessed by a physician, therapist or psychiatrist?

If you notice in your adolescent or young adult child that they are isolating more than they used to and there are changes in appetite, energy or interests, it may be a symptom of depression. If someone reports feeling lonely or choosing to isolate when they're surrounded by friends or loved ones, this can be a cause for concern.

Isolation caused by clinical depression is a chemical reaction in the brain telling you that you can’t get out of bed, don’t want to socialize with people and aren't willing to see that your life could and should be better. Often, young people don’t know how to articulate what they’re feeling.

How do you start addressing your concerns?

With an adolescent or teen, check with their teachers or school social workers to see if they've noticed anything. They could be struggling with a social situation or with schoolwork.

Try asking questions, but not prying. Keep questions specific to elicit a response other than “fine.” Ask, with interest rather than concern, about what they learned today, who they sat with at lunch and if they’re looking forward to an after-school activity.

If symptoms persist, it’s time for a physical evaluation. Always start by going to the primary care doctor to rule out possible health conditions that could be causing these changes in behaviors, because continual discomfort can cause depression.

It could be that your child is getting headaches because they need glasses. Maybe they’re having stomach aches because of undiagnosed gastrointestinal issues, hormonal issues or physical maturation. Some recreational substances like marijuana and alcohol can also cause these behaviors. A blood or urine screen may be ordered by the physician to rule those out.

Lastly, reach out to a mental health provider in your area. A therapist can parse out what your adolescent or young adult is struggling with. Depression could accompany life changes, such as friends moving away, or going to a new school. It could be academic challenges or college applications. So many things need to be factored in.

If you’re not able to speak with the doctor or therapist directly because of patient privacy rules, or if your loved one is having trouble expressing themselves, you can write down your observations and provide it to the practitioner. That way, they can say, “This is what your parent is noticing.”

A therapist may recommend medication. I always recommend to parents that a psychiatrist, who is medically trained to diagnose and treat mental illnesses, be the one to prescribe any antidepressants.

Self-isolation can be a symptom of clinical depression, but there’s usually a lot more to the story. Take time to tease out the real causes.

• Bonnie Lane, M.S., is principal consultant with Family Support Services in Northbrook, specializing in supporting families whose loved ones suffer from severe mental illness or substance addiction. Daily Herald readers can contact her at (847) 651-1554 or bonnielane@thefamilysupportservices.com.