One day of high school, I distinctly remember realizing that I had more friends who were taking some form of psychiatric medication than friends who were not. The vast majority of them were on antidepressants. As more and more teenagers are prescribed pills for depression, nearly every student in high school and college has at least one friend or acquaintance who has been diagnosed; the illness is less and less something to be hidden from school friends and more and more something to share and even bond over. For me, and for many other teens and early 20-somethings, depression is just another part of social culture.

Most of my high school and college friends who took or are taking depression meds are not shy about it. I’ve sat through multiple debates over which SSRI is the best, and every time a new friend would start taking medication, several others would pipe up with advice. I’ve had friends drag me to the pharmacy to keep them company in the prescription line, friends warn me that they’re going off their meds for awhile so I should help watch out for them, even friends tell me that I should give antidepressants a try when I was in a bad mood.

High school and college are years of mental turmoil for all of us. With the constant changes in both hormones and life responsibilities, every teenager has periods of deep despair. This near-universal stage of emotional volatility must make it difficult for psychiatrists to draw the line between a healthy level of teenage angst and a diagnosis of depression that requires medical treatment. Judging from the sheer number of people I know who started taking antidepressants at a fairly young age, it’s hard to imagine every single one of them absolutely needed to have their emotions chemically regulated.

But by diagnosing my friends so young and reinforcing those diagnoses with powerful medication, depression became part of who they are, a facet of their still-developing identities. For some of them, depression became a way to explain their commonplace teenage sadness to themselves; for some, it became an excuse for not trying harder to find things in life that would make them happier. While certainly some of them genuinely benefited from the medication and used it responsibly, not allowing it to become an unnecessary crutch, others grew to think of their antidepressants as an essential part of themselves, as something they were not even interested in removing from their lives.

I often think of something one of my close high school friends, whom we’ll call Albert, told me about his own struggles with depression. Albert has had severe emotional troubles his entire life, including many serious depressive episodes untied to traumatic life events. In many ways, he seems like a prime candidate for antidepressants, and many of our friends, seeing him in pain, encouraged him to visit a psychiatrist for a prescription. He always politely refused, until even I, who had no personal experience with depression medications, thought he was being a little ridiculous. He explained to me that even if the drugs made him happier, by messing with his brain in its natural state, they would also make him less himself. In contrast to my other friends, Albert believed that antidepressants would take away his identity.

While Albert is probably a bit overly philosophical about the issue, he has a good point. There is something disconcerting about tinkering with the brain’s chemistry in general, but especially in the case of teens, who are in the midst of their most fundamental personal developments. While there are people who end up needing to remain on antidepressants for their entire lives, it seems dangerous for teenagers to have already decided that depression and its treatments will be a permanent part of themselves. It’s wonderful that teens with serious mental health issues feel less need to hide them, but perhaps some schools have reached a level of too much acceptance.