Adolescent Depression

Depression (a mood disorder) is one of the most common mental illnesses in America. It is estimated that 20% of adolescents will deal with depression by adulthood, and between 10%-15% will deal with depressive symptoms at any one time. Unfortunately, only 30% of depressed teens are treated for their illness. There are many risk factors that may predispose a teen to depression—these include: a family history of depression, chronic physical illness, another undiagnosed or untreated mental illness, substance abuse, trauma, or abuse. Adolescent females develop depression twice as often as men do, and approximately two-thirds of teens with depression also suffer from another mental illness, such as dysthymia (another mood disorder), anxiety, antisocial behaviors, or substance abuse.


Depression is more than just 'feeling down'. It is a potentially serious mental illness that, if left untreated, can have devastating consequences. Depression is not something to brush aside or take lightly, nor is it a failing of the child. So if your child comes to you with any of the following symptoms, or if you notice your child acting in the following ways, don't dismiss their problems. They need help and understanding, not judgment or dismissal.

Signs and symptoms of depression include a change in a teen's previous behavior or attitude, and these changes can cause significant distress and problems in school, home, and social life. The symptoms can have varying degrees of severity, but any changes in your teen's emotions or behavior should be taken seriously. According to the Mayo Clinic, these symptoms include:

Emotional symptoms

  • Feelings of sadness (sometimes expressed as unexplained crying spells)

  • Feelings of hopelessness or emptiness

  • Irritable or annoyed mood

  • Frustration or anger, even over small things

  • Loss of pleasure or interest in previously enjoyed activities

  • Loss of interest (or conflict) with family and friends

  • Low self-esteem

  • Feeling worthless or guilty

  • Fixation on past failures, exaggerated self-blame or criticism

  • Extreme sensitivity to rejection or failure

  • Need for excessive reassurance

  • Difficulty thinking or concentrating, making decisions, or remembering

  • Feeling as if life is hopeless, future is bleak or grim

  • Frequent thoughts about death, dying, or suicide

Behavioral symptoms

  • Tiredness or loss of energy

  • Sleeping too much or too little

  • Changes in appetite: eating too much or too little

  • Use of drugs or alcohol

  • Agitation or restlessness

  • Slowed thinking, speaking, or body movements

  • Unexplained physical pain, such as body aches or headaches

  • Social isolation

  • Decreased performance in school or school absences

  • Neglected appearance

  • Outbursts of anger, disruptive or risky behavior

  • Self-harm, ex. cutting or burning

  • Suicide plan or suicide attempt

There are a variety of factors that cause depression, and in some cases, these factors may work together to cause depression. An example of this phenomenon can be seen in people who have a family history of depression: these individuals may have a genetic predisposition to depression, and an environmental stressor may 'activate' the genes for depression.

According to the Mayo Clinic, factors leading to depression can include:

Changing biological chemistry: The neurotransmitters in your brain are like finely tuned machinery, and even the slightest change in the chemical balance can cause a variety of different problems.

  • A change in the delicate balance of hormones could also be involved in causing or triggering depression.

  • Family history: Research has found that individuals with a family history (especially close blood relatives) are at a higher risk for depression.

  • Childhood trauma: Early childhood events such as emotional or physical abuse or death of a parent or sibling, may cause changes in the brain that make the individual more susceptible to depression.

  • Learned helplessness: Teenage depression may be linked to learning to feel helpless, rather than feeling capable of finding a solution to life's problems. This is part of the reason why it's so important to foster independent learning in your children.

So what can you do if your teen is depressed? The first, and most important thing, is to get them to a doctor. General practitioners are great, but in this case, locating a psychologist or psychiatrist will be best. You want someone who has specialized training in mental illness treatment, which will (optimally) include both medication* and therapy. Medication, usually antidepressants, are very effective at treating depression, so don't be quick to object to making them part of your teen's treatment. Therapy for depression involves the patient talking about their thoughts and feelings on occurrences in daily life; the therapist will also give the patient mental and emotional tools to cope with their depression. While medication and therapy can be useful separately, they are most effective when used in combination.

After you have secured professional help, it is important to continue helping your teen. On top of school, extracurricular activities, homework, friends, and chores, they are now dealing with an illness that they cannot control (this is why it is important to receive combination therapy). This balance between work, life, and mental illness is difficult for adults, but it can be even harder for still developing adolescent brains. It may be difficult to reach your teen some days: they may be closed off, irritable, unmotivated, sad, inadequate, and they may feel as if their friends and family hate them. What your teen needs now more than ever is your love and understanding, not a lecture.

Encourage your teen to see their friends or engage in social activities. Listen to them and acknowledge their feelings. Provide healthy options for snacking, and ensure they make time for sleep. Realize that your teen will have good days and bad days. Sometimes, all they may feel like doing is laying in bed or on the couch. While this may frustrate you, try to understand that depression isn't something that can be cured by putting on a smile or thinking happy thoughts. It isn't just a bad attitude or 'feeling blue'. Depression is a serious illness that has physical manifestations (insomnia, excessive tiredness, physical pain). It takes time for depression to be cured, and it may take a while before your teen feels like themselves again. Unfortunately, there is no way to tell if the depression will relapse- some people may only experience one depressive episode, while others may experience more than one episode in their lifetime. However, treating depression early and effectively can give your teen the tools and knowledge they need to combat depression, no matter how many times it occurs.

*As with any medication, there are side effects and/or risks with taking antidepressants. Many antidepressants have a 'black box warning' to denote that there have been incidences of increased suicidal thoughts or behaviors, particularly in adolescents. As with any medication, it is important to talk with the prescribing physician about the risks versus the benefits. But do not let this information scare you away from antidepressants; the key is to find the right balance.

Depression is an illness that needs to be taken seriously; left untreated, it can lead to risky behaviors (such as drugs or alcohol addiction), loss of relationships, problems at work, and make it difficult to overcome serious illnesses. Depression is an illness that involves the body, mood, and thoughts. It affects eating and sleeping, how you perceive yourself and those around you, and it invades your thoughts. Depression tells its sufferers lies, and without help, it is difficult to ignore those lies and fight back.

Please take time to read the articles referenced below, as they contain a wealth of useful information.

*SUICIDE WARNING SIGNS* If you notice any of the following signs, get medical attention right away, or call the National Suicide Prevention Lifeline at 1-800-273-TALK.

  • Talking or joking about death

  • Statements such as "I wish I was dead", "I want to be done", "I wish I could disappear forever", "There's no way out".

  • Romanticizing or idealizing death

  • Writing stories and/or poems about dying

  • Engaging in reckless behavior or having frequent accidents that result in injury

  • Giving away prized possessions

  • Saying goodbye to family and friends as if it was the last time

  • Seeking or procuring weapons, pills, or other ways to kill themselves

References:

Depression in Teens

Parent's Guide to Teen Depression

Teen Depression

Why Are So Many Teens Depressed?

Untreated Depression

Depression and Anxiety Disorders Damage Your Brain, Especially When Untreated


Emily Taylor is a graduate of Western Carolina University. She intends to pursue a Ph.D. in clinical psychology and it is her goal to work with individuals who suffer from affective disorders. Emily has worked with children of all ages for over 10 years; she has also tutored college students and served as a mentor.

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