Teenage Depression: Signs, Causes, and How to Help

Cases of teenage depression have almost doubled in the U.S., increasing from 8.1% in 2009 to 15.8% in 2020. This makes it important for those of us with adolescents in our lives—whether our own kids, teenaged family members, children of friends, or kids in the neighborhood—to know how to help a teenager with depression.

Getting help begins with recognizing depression symptoms and understanding some of the potential causes of this mental health condition. The next step is knowing when to seek help and who to reach out to. We'll cover all of this here.

Is It Teenage Depression?

Teens with depression can experience significant emotional pain, sometimes even feeling pain physically. Yet, they may not know how to make it better or find the help they need.

Only a physician or mental health professional can diagnose teen depression, assessing the symptoms and their severity to develop an effective treatment plan. That said, parents are usually in the best position to start the process, which begins with recognizing that depression may exist.

Symptoms of Depression in Teens

Depression can show up differently in teens than it does in adults. It can also be hard to differentiate this mental health condition from the normal mood swings experienced during puberty or typical teen angst.

In addition to sadness, symptoms of teenage depression can include:

• Anger and irritability
• Difficulty concentrating
• Fatigue
• Feelings of worthlessness or guilt
• Loss of interest in activities
• Restlessness
• Sleeping too much or not enough
• Talk of death or suicide

Even though it's one of the most common mental health disorders for kids in this age group, teenage depression often goes undetected. Its symptoms are sometimes ignored until something serious happens, such as a suicide attempt or engaging in high-risk behaviors.

Causes of Teenage Depression

The teen years are often a period of physical, emotional, and social upheaval. This alone can cause mood swings and depressed moods. But what causes clinical depression in teens?

Several factors can play a role in the development of depression in adolescents, including:

• Biochemical imbalances
• Bullying
• Childhood abuse
• Childhood trauma
• Genetic predisposition to depression
• High levels of stress

Sometimes the teen can help shine a light on what could be contributing to their depression. Even if they don't know, talking to them will help keep the lines of communication open while they are working through their depression.

When to Seek Help for Teen Depression

It's important to seek help if teenage depression is suspected because it typically doesn't go away on its own. This mental health condition can last for several months if untreated, potentially causing the teen to miss certain developmental milestones.

Untreated teenage depression can also lead to other serious issues, such as those related to substance use, behavior problems, and even medical problems. Getting the teen evaluated by a qualified professional can help them receive an appropriate diagnosis and put them on a path to treatment.

The child's pediatrician can also check for other medical conditions that might be contributing to the teen's symptoms. Children who are diagnosed with depression often have co-occurring chronic physical and mental health conditions, as well as having unmet mental and medical services needs.

It may not be depression, but any long-term changes in the teen's functioning suggest a serious problem that must be identified and addressed. It’s always best to err on the side of caution when the possibility of teen depression exists because this condition can worsen, possibly leading to a suicide attempt.

The Process for Evaluating Teenage Depression

A thorough evaluation by a professional is required to determine if the teen has depression. This evaluation involves an assessment of the severity of the condition, along with weighing the best treatment options.

To begin the evaluation process, the teen's parent or guardian can schedule an assessment with a medical doctor or mental health professional. Ideally, this professional should specialize in working with teenagers. The teen's pediatrician can be a good first step.

What Evaluation Might Look Like

A professional can evaluate the teen's health, make a diagnosis, recommend treatments, and refer them to another professional, if necessary. How they do this can vary.

• A medical doctor can order blood tests, review family history, and evaluate current medications, sleep patterns, and diet to determine if there is a physical cause for depression. 
• A psychological evaluation (testing by a psychologist) can provide extensive information about the severity and nature of the symptoms, contributing factors, and the possible presence of suicidal ideation. This option is best suited for cases in which the diagnosis is unclear. 

A therapist who specializes in treating teens evaluates the symptoms based on talks with the teen and family members. They then come up with specific recommendations that are the most likely to help the teen.

The evaluation process can take time. Help the teen understand that determining effective therapies and medications can be a trial-and-error process, and it might take several tries to find the best treatment plan for them.

How to Help a Teenager With Depression

People who are experiencing depression often don't want to seek help; they might beg, get upset, or become violent when getting help is suggested. Even if they provide resistance, working with a mental health professional or physician is crucial. There are also a few things we can do to help.

Learn About Depression

If a teen that we care about is diagnosed with depression, it's important to educate ourselves about this condition. This enables us to better understand what they may be going through. It also puts us in a better position to help them navigate teenage mental illness.

The teens themselves can also be a good source of information. Be available to listen to how they feel and what they are experiencing. Encourage the teen to talk about anything that's bothering them.

Help the Teen Understand Depression

Explaining what is known about depression can help a teen better understand their symptoms and grasp the importance of treatment. Sharing how common it is can also help them not feel alone or abnormal if they have this condition.

If the teen has trouble understanding depression, comparing it to a physical malady such as diabetes is one way to help them see it as a disorder. This puts it into context as a condition that affects their health, thereby requiring treatment.

An example of what to say: "Depression is a mental illness. It's like the flu and other illnesses in that it can make you feel tired or have a headache. It can also affect your moods and feelings, potentially making you feel sad, lonely, frustrated, angry, or scared."

Let Them Know What to Expect

Teenagers are more likely to comply with treatment if they know what to expect, and if their expectations are positive. The unknown can be scary. So, it's helpful to give them some idea of what their treatment plan may look like, as well as why it's important for them to do their part.

An example of what to say: "Taking your medicine every day and going to therapy once a week is important to helping you feel better. You can talk privately to your therapist about how you are feeling. Your medicine may make you feel tired or dizzy, but it should go away soon. That's why you'll see the doctor once a month. They will ask how the medicine is making you feel and will make sure that it's helping you."

Give Them Some Control

Teenagers may also be more likely to comply with treatment if they have a say in their treatment. Giving them a sense of control aids in their development while also teaching them how to make healthy decisions.

Of course, allowing a teen to plan their own treatment isn't practical. But letting them make small decisions can help them feel like they have more control over their lives.

An example of what to say: "Your therapist wants to see you every week. What day of the week would be best for you? Would you rather go right after school or after dinner?"

Encourage Supportive Relationships

Supportive relationships are essential for people of all ages. But they are especially important for teenagers with depression. Depression can cause teens to withdraw from friends and family, increasing their feelings of sadness, loneliness, and isolation.

Having just one friend or supportive adult to talk with can be of significant benefit to the teen. We can be this person by declaring our support and availability, along with encouraging the teen to connect or re-connect with friends and share their feelings.

An example of what to say: "I am always here to talk to you about anything. Talking to your friends can help, too. Having supportive and encouraging people to lean on is important. Talking about your feelings can make a difficult time a little bit easier. Which of your friends do you think you might be able to talk to?"

Address Myths

Teens may be familiar with the social stigma of mental illness or have heard others say derogatory things about people will a mental health condition. Consider addressing this with them so that they don't feel like they must hide or be ashamed of their depression diagnosis.

Remind the teen that people might not understand or be misinformed, but that is no reason to feel embarrassed or ashamed. Teenagers with depression should also know that telling people about their diagnosis is up to them, but it's not something they need to hide.

Treatments for Teenage Depression

Teen depression is often treatable with medication, psychotherapy, or a combination of the two. Their care provider will help decide the best individual treatment plan for them. If suicide is a concern, the teen may need to be hospitalized to get the level of care needed to resolve this type of urge. 

Medication

Antidepressant medications can be effective in the treatment of teenage depression. They also provide a certain level of convenience, enabling adolescents to obtain relief by taking a tablet or pill.

It's important to know that all antidepressants carry a black box warning of an increased risk of suicidal thinking in children and adults under the age of 25. Because of this, their use in teens should be carefully monitored by care providers, parents, and other concerned adults, particularly during the first few weeks of treatment. 

Psychotherapy

There are two therapeutic approaches often used to treat teenage depression:

• Cognitive-behavioral therapy (CBT) focuses on the relationship between thoughts, feelings, and behaviors. During these therapy sessions, teens learn to identify negative thought patterns and replace them with more positive, helpful ones.
• Interpersonal therapy (IPT) is focused on social relationships and communication issues that can contribute to feelings of depression. It can help teens learn to interact with others in new ways and improve the quality of their social relationships.

Lifestyle Changes

In addition to professional treatment, certain lifestyle modifications can also help teenagers with depression feel better. Ones to consider helping them implement include:

• Developing a healthy sleep schedule
• Eating a nutritious diet
• Getting regular physical exercise

Teen Depression and Suicide Risk

Adults sometimes mistakenly believe that talking about suicide can plant the idea in the teen's mind. However, talking about suicide won't give the teen ideas. Instead, addressing the topic can help them recognize when an issue exists, also helping them know what to do if they have suicidal thoughts or behaviors.