Bullying is a term used to describe a wide range of aggressive actions intended to intimidate, manipulate, demean or socially stigmatize others. While these actions were once viewed as simply part of \u201cgrowing up,\u201d mental health professionals now understand that they can have a seriously negative short- and\/or long-term impact on the mental, emotional or physical well-being of affected individuals. In the past, researchers have linked exposure to bullying with increased risks for major depression in teenage boys and girls. According to the results of a large-scale study published in 2011 in the journal Prevention Science, teenage girls who develop bullying-related depression also have increased risks for involvement in substance use. Bullying Basics Bullying is based on perceived or actual imbalances in physical or social power, the U.S. Department of Health and Human Services explains. Typically, a person or group in a position of greater power uses that power to aggressively attack the less powerful in some way. Identified forms of bullying include physical bullying, verbal bullying, and relational or social bullying. Common examples of physical bullying include destroying or taking someone\u2019s belongings or engaging in such acts as punching, tripping, kicking, shoving, or spitting on someone. Common examples of verbal bullying include taunting or teasing, making violent threats, using sexually explicit language to demean others, and calling anyone by an intentionally derogatory name. Common examples of social bullying include intentionally spreading false rumors, intentionally embarrassing or shaming others, excluding others from social activities, and using social power to restrict a given person\u2019s access to friendships or relationships. Bullying can occur in a wide range of physical or virtual environments. Common physical environments for bullying behaviors include school classrooms, other locations on school grounds, school buses, and children\u2019s individual neighborhoods. Common virtual environments for these behaviors include the Internet and various Internet- or cell phone-based forms of communication such as texting, tweeting, videos, and e-mails. According to figures compiled in 2011 by the Centers for Disease Control and Prevention, roughly 20 percent of all high school-age teenagers are exposed to bullying. Figures compiled in 2009 by the National Center for Education Statistics indicate a 28-percent bullying rate for all children enrolled in high school or middle school. Bullying and Depression A number of studies have identified a strong link between exposure to bullying and increased risks for major depression. For example, a study published in 2007 by the Journal of the American Academy of Child and Adolescent Psychiatry identified frequent exposure to bullying as a significant risk factor for depression, as well as for suicidal thinking and active suicide attempts. The authors of another study, published in 2013 in the Journal of the American Medical Association: Psychiatry, concluded that increased risks for depression and suicide in bullied children don\u2019t stop when adolescence ends. Instead, those risks remain elevated throughout at least the first decade of adulthood. Connection to Substance Use In the study published in Prevention Science, a multi-institution research team used the results of a nationwide survey of almost 1,500 10th-graders to examine the links between bullying, depression and substance use. This survey, called the U.S. Health Behavior in School-Age Children or HBSC survey, asked a number of questions designed to gauge the prevalence of depression symptoms, as well as a number of questions designed to determine the frequency with which the participating teens did such things as drink alcohol, get drunk, smoke cigarettes, or smoke marijuana. After reviewing the results of the HBSC survey, the researchers reaffirmed the conclusion that all forms of bullying\u2014including virtual bullying or cyber-bullying\u2014increase the risks for depression symptoms in both teenage boys and teenage girls. They also concluded that the effects of bullying-related depression appear to spark an increase in substance use among teenage girls. Interestingly, bullying-related depression in teenage boys apparently does not increase involvement in substance use. Significance The study published in Prevention Science is the first to demonstrate a connection between bullying, depression and increased substance use in teenage girls. The authors of the study believe that their findings indicate a particular need to identify bullying in adolescent girls and to address that bullying before it has a chance to contribute to depression and substance use risks. They also acknowledge the continuing need to address bullying in adolescent boys before it has a chance to contribute to depression risks. Further research is needed to uncover the reason for the varying gender-related substance use risks in bullied teen girls and bullied teen boys.