Alienated. Helpless. Hopeless. These are some of the sentiments expressed by those who have suffered or are suffering from depression. For some, those sentiments may develop into thoughts of self-harm or, when all seems lost, attempts to take their own lives.
A recent report from the Samaritans of Singapore (SOS) revealed that even though suicide rates last year were the lowest since 2012, the number of suicides by those aged 10 to 19 hit a 15-year high of 27.
Ms Suria Basri, senior counsellor for the Children-At-Risk Empowerment Association Singapore, said the increased financial and social pressure as a result of the weakening economy could have put more stress on parents, which in turn could translate to more stress on children to do well academically.
At the same time, youth who grew up with predominantly digital lifestyles may suffer from social isolation, losing an important outlet of expression and support.
A school counsellor, who wanted to be known only as Mrs Goh, said that with much of their social interactions taking place online, many teenagers may have weakened abilities to express their feelings and needs to other people, and send signals that their friends can pick up.
"Online social networks can never replace face-to-face interaction," she said. "There are physical cues that cannot be sent online, that signal to friends and family that they need help."
The role the family plays in a child's well-being cannot be understated, said Mr Larry Lai, the principal counsellor of Focus on the Family Singapore.
Dr Ong Say How, chief psychiatrist and consultant at the Institute of Mental Health, said: "A warm, nurturing and cohesive family is critical as it allows the child to feel loved, safe and secure, as well as feel a sense of self-worth and self-competence.
"Allow the child to make mistakes in the face of challenges and obstacles as it aids in his developing a sense of responsibility and confidence."
Another finding thrown up by the SOS statistics was that there were more suicides committed by teenage boys than girls - 16 to 11 last year. This has been the case since 2012.
When it comes to calls for help, 1,973 girls called the SOS hotline, compared with just 508 boys in the same age group.
A school counsellor, who wanted to be known only as Mrs Lim, believes this is because girls are more likely to open up or seek help early.
Whether due to expectations imposed by society or by themselves, boys tend to keep to themselves, exacerbating any inner struggles they face. Mrs Lim, who has been counselling students aged 16 to 19 for the past 12 years, said: "Girls may come to us for a variety of problems, but when guys come to us, it usually means their problems have become very serious."
She said that boys may also be more daring when attempting to take their lives, leading to a higher number of suicides.
Yet, many of the problems faced by youth within this age range are common to both genders, including challenges at home and in school, as well as biological changes as they undergo puberty.
Some observers pointed out that depression and suicidal thoughts take place over an extended period, and depressive thoughts could have started from a young age and resulted in self-harm or attempted suicide later in life.
But some people who had suffered depression during their teenage years told The Sunday Times that the stigma surrounding seeking counselling kept them from getting help at a young age, which they regretted when they got older.
•Samaritans of Singapore: 1800-221-4444
•Singapore Association for Mental Health: 1800-283-7019
•Institute of Mental Health's Mobile Crisis Service: 6389-2222
•Care Corner Counselling Centre (Mandarin): 1800-353-5800
A female student who had suffered from depression told The Sunday Times that she tried to keep her depression to herself as she was afraid of being ostracised by peers.
A male student who had depression in junior college said he did not tell anyone as he thought it was a result of the stress from school.
But in hindsight, he wished he had sought help earlier."It's important for young people to know their emotional threshold. The moment you feel you have breached your safety threshold, you should seek help immediately."