Teen Depression - Signs, Symptoms and How to Help

Before we get started, here are a few quick facts about Teens and Depression…

  • Depression is a serious disorder that can impact the brain development of teens
  • The prevalence of depression rises at age 14-18
  • 1 in 5 individuals experience a serious depressive episode as an adolescent.
  • Recent studies estimate as many as 8% of adolescents suffer from depression at some point in time during any one calendar year.
  • Depression is episodic or cyclical and relapses are likely
  • Adolescent Girls have twice as many depressive episodes compared to boys
  • Suicide is the 3rd leading cause of death in adolescents, and young adults.

I once had a client share this insight…

Being a teenager isn’t easy all the time and we all know this. There always seems to be an issue with school, friends, or at home. 

In today’s society this is especially true, as our sons and daughters entering preteen – teen territory or adolescence they are no longer entering the adolescence that WE grew up knowing. 

Being a Teenager Has Changed

The world has changed. The culture has changed. The boundaries of social norms have expanded and continue to do so.

Not only is our world different but sometimes these problems can be deeper then just little issues we blow out of proportions.  (Thank you social media) While it is true there are some exciting moments during the adolescent timeframe, it is important to recall that our teen years are frequently a source of stress and distress, especially during the years between ages 15-19.

This age range can of course be broadened due to other life events that anyone, at any age, would find difficult. For example the loss of a loved one, financial problems, poor health or family problems. But let’s look at why our teen years, or adolescence, can be particularly difficult.

As children grow out of their childhood into their preteen and teen years, they are grappling with tremendous changes in virtually all aspects of their lives. 

  • Promote/Graduate from Elementary to Middle or Middle to High Schools. 
  • Puberty begins, effecting not only the physical body, but its biology as well
  • The changes brought about by puberty impact the child/teen’s previous view of self and can, for better or worse, influence how he or she conducts relationships with peers, family, and social communities.
  • Alternatively, the changes of puberty can influence the way in which a child/teen’s peers, family members and social community interact with him or her.

Considering all the compounded change happening all at once, it is understandable how one might feel distressed or stressed during adolescence. 

Causal Factors of Depression

We often don’t realize depression can be a product of many factors: poor sleep habits, stress, pain, disease – it is also a normal, and healthy reaction to events in every day life and not always a pathological disorder.  

Many researchers believe it is caused by chemical changes in the brain. This may be due to a genetic predisposition, or triggered by certain stressful events. More likely, its a combination of both. Some types of depression may run in families, but it can also occur if you have no family history of the illness. 

The following may play a role in depression: 

  • Certain medical conditions, including underactive thyroid, cancer, or long-term pain 
  • Certain medications such as steroids 
  • Alcohol or drug abuse 
  • Sleeping problems 
  • Stressful life events, such as: 
  •  Breaking up with a boyfriend or girlfriend
  •  Failing a class
  •  Death or illness of someone close to you
  •  Divorce
  •  Childhood abuse or neglect
  •  Job loss
  •  Social isolation

The important take away here is not that depression runs rampant no matter what the cause, but that regardless what a teen has going on in his or her own life, depression may too also be present.

Signs and Symptoms of Depression

Depression can be a tangle of multiple signs and symptoms.

  • Tearfulness
  • Concentration Issues
  • Sleeping Issues
  • School Refusal
  • Increased/Loss of Appetite
  • Isolation
  • Irritability
  • Low/No Motivation
  • Body Aches/Pains
  • Self Harm
  • Agression
  • Sexual Acting Out
  • Suicidal Ideation

The intensity and frequency of these signs and symptoms, if present at all, determine the severity of depressive disorders.

Major Depressive Disorder

Major Depressive Disorder is the overarching term given for the experience of frequent Major Depressive Episodes, or in other words you are more often experiencing these symptoms than you are not. 

Major Depressive Disorder (MDD) Criteria

  • At least 2 weeks of pervasive change in mood manifest by either depressed or irritable mood and/or loss of interest and pleasure.
  • Other symptoms: changes in appetite, weight, sleep, activity, concentration or indecisiveness, energy, self-esteem (worthless, excessive guilt), motivation, recurrent suicidal ideation or acts.
  • Symptoms represent change from prior functioning and produce impairment
  • Symptoms may be attributable to substance abuse, medications, other psychiatric illness, bereavement, medical illness

-DSM IV-TR, American Psychiatric Association

It is possible to experience these symptoms for a period of time, and not suffer from MDD, but rather simply be experiencing a depressive episode.

There are other types of depression as well:

  • SIMD (Substance-induced mood disorder)
  • Psychotic & postpartum depression.
  • SAD (Seasonal Affective Disorder)
  • Bipolar depression
  • And dysthymia (mild depression which is less severe than major depression, but the symptoms of dysthymia can linger longer)

Need to Recognize Developmental Variations of MDD

I want to point out here the more subtle signs of depressive symptoms as they pertain to children and adolescents.

  • In younger children symptoms of depression may include sadness, irritability, hopelessness and worry
  • Symptoms in adolescents and teens may include anxiety, anger and avoidance of social interaction
  • Changes in thinking and sleep are common signs of depression in teens and adults, but not as common in younger children
  • In children and teens, depression often occurs along with behavior problems and other mental conditions such as anxiety or attention-deficit/hyperactivity disorder (ADHD)
  • School work in children and teens who are depressed changes in quality

Depression Signs and Symptoms can vary in Girls and Boys

Girls:

  • Tearfulness
  • Withdrawn
  • Self Harm
  • Sleep issues 
  • Eating Issues
  • Sexual Acting Out

Boys

  • Anger
  • Irritation
  • Addictive Habits
  • Substance Use
  • School Refusal
  • Social Inhibition

Left untreated, Depression can lead to serious consequences

  • Risk of Suicide
  • Substance Abuse
    • Lack of coping strategies
  • Criminal Tendencies
    • Result of being labeled “troubled” due to anger and irritability
  • Poor Academic Performance
    • Result of Concentration and Sleep Issues
  • Health Problems
    • Eating Issues
      • Ulcers
      • Poor Nutrition
    •  Hypertension
    •  Or again, Depression can be a symptom of an illness itself
  • Failed Relationships
    • Result of Social Withdraw
      • No understanding of how to start and maintain relationships
  • Poor Social and Emotional Development
    • Lack of coping strategies

There is a LOT you can do help a teen suffering with depression

Let’s address how you - the Parents, Teachers and other Caregivers of the world - can help the teen or teens in your life:

  1. Learn more about Depression: Attend talks, read books, articles, join groups!
  2. Build upon/Improve Communication with Teen: Make time to talk with your Teen(s) about a wide variety of issues. A parent/teacher/caregiver’s approachability is important, depressed teens are highly sensitive and easily irritated and therefore easily angered, and easily shut you out!
  3. Actively Listen: When your teen feels safe to talk with you, adopt an Active Listener posture: sit relaxed, steady eye contact and ask open ended questions
  4. Provide Emotional Support: Acknowledge and validatethe feelings your teen shares with you. Teens, or anyone suffering with depression are not CHOOSING to be depressed – comments like snap out of it, or cheer up do no good.
  5. Grant Wishes: Find small things that you can do or provide for your teen to make his or her day a little brighter. This demonstrates care, and acknowledgement that he or she is more than these difficult feelings.
  6. Reassure and Comfort: Teens and others suffering from depression are often feeling completely overwhelmed by their negative thoughts and feelings. Reassure them that no matter what, you will be there to support them and care for them.
  7. Set an Example: Set an example to the person you care about by eating well, avoiding alcohol and drugs and exercising. 
  8. Seek Support of Mental Health Professional: Early diagnosis is key to the proper and effective management of depression and seeking the right professional support is important.
  9.  Your Own Self-Care: Parenting a depressed teen is an emotionally challenging task. Maintaining your Self Care is important because that recharge supports your ability to be present for your struggling teen, rather than reactive to their symptoms.

Content and Statistics influenced by Dan Siegel's Brainstorm