Depression in Teens

As much as 8% of teens experience depression each year, according to one survey. By the time young adults reach age 21, one study found that nearly 15% have had at least one episode of a mood disorder. Depression can cause problems such as difficulties in school, difficulties with relationships, and decreased enjoyment of life. At its worst, depression can lead to suicide, one of the leading causes of death for teens in the United States.

Depression is an illness with many causes and many forms. It is a disorder of a person’s moods or emotions—not an attitude that someone can “control” or “snap out of.” But it is treatable with psychotherapy and/or medication, which is why it's especially important for parents and caregivers to educate themselves about the disorder.

Symptoms

Adults sometimes don’t recognize symptoms of depression in teens because the disorder can look quite different from that in adults. A teenager with depression might have some or all of these signs of the illness:

• Sad or depressed mood
• Feelings of worthlessness or hopelessness
• Loss of interest in things they used to enjoy
• Withdrawal from friends and family
• Crying
• Inability to sleep or sleeping too much
• Loss of appetite or increased appetite
• Aches and pains that don’t go away, even with treatment
• Irritability
• Feeling tired despite getting enough sleep
• Inability to concentrate
• Thoughts of suicide, talk of suicide, or suicide attempts

Types of Teen Depression

The National Institute of Mental Health states that there are two common forms of depression found in teens: major depressive disorder and dysthymic disorder (now known as persistent depressive disorder).

• Major depressive disorder, also called major depression, is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, study, eat, and enjoy once pleasurable activities. Major depression is disabling and prevents a person from functioning normally. An episode of major depression may occur only once in a person's lifetime, but more often, it recurs throughout a person's life.
• Dysthymic disorder, also called dysthymia, is characterized by long-term (two years or longer) but less severe symptoms that may not disable a person but can prevent one from functioning normally or feeling well. People with dysthymia may also experience one or more episodes of major depression during their lifetimes.

Causes

There are thought to be many causes of depression. There are most likely many factors behind who develops depression and who doesn’t, and these factors are no different for teens.

• Traumatic life event, such as the loss of a loved one or pet, divorce, or remarriage. Any event that causes distress or trauma, or even just a major change in lifestyle, can trigger depression in a vulnerable individual.
• Social situation/family circumstances. Unfortunately, there are teens who live in difficult circumstances. Domestic violence, substance abuse, poverty or other family issues can cause stress and contribute to depression in a teen.
• Genetics/biology. It has been found that depression runs in families and that there is a genetic basis for depression. Keep in mind, though, that teens who have depression in their family will not necessarily get the illness, and teens without a history of depression in their family can still get the disorder.
• Medical conditions. Occasionally, symptoms of depression can be a sign of another medical illness, such as hypothyroidism, or other disorders.
• Medications/illegal drugs. Some legal, prescription medications can have depression as a side effect. Certain illegal drugs (street drugs) can also cause depression.

Diagnosis

Depression in teens is most often diagnosed by a primary care physician.

If teen depression is suspected, a doctor will often start with a physical exam that may include blood tests. Your teen's pediatrician will want to rule out any other medical illnesses that may be causing or contributing to your teen's symptoms.

Your child will also be given a psychological evaluation. This often involves a depression questionnaire as well as a discussion about the severity and duration of their symptoms. 

Treatment

The Guidelines for Adolescent Depression in Primary Care (GLAD-PC) recommend the following in the management of teen depression:

• Educating teens and families about treatment options that are available
• Developing a treatment plan that includes specific treatment goals that address functioning at home and school
• Collaborating with other mental health resources in the community
• Creating a safety plan with steps that should be taken if the teen's symptoms become worse or if they experience suicidal thinking
• Considering active support and monitoring before beginning other treatments
• Consulting a mental health specialist if symptoms are moderate or severe
• Incorporating evidence-based treatments such as cognitive-behavioral therapy, interpersonal therapy, and antidepressants
• Continuing to monitor symptoms and functioning during antidepressant treatment; doctors and family member should watch for signs that symptoms are worsening and for suicidal thinking or behaviors

Coping

Talk to your teen about your concerns. There may be a specific cause for why they are acting a certain way. Opening up the lines of communication lets your teenager know you care and that you are available to talk about the situation and provide support.

Other things that may help your teen manage symptoms of depression include:

• Talking about concerns with family and friends
• Having a healthy support system 
• Using good stress management techniques
• Eating a healthy diet
• Getting regular exercise
• Finding new things to look forward to
• Joining a support group, either offline or online

Also, talk to your pediatrician or family physician if you have concerns about your teen regarding depression. Your provider may be able to discuss the situation with your teen, rule out a medical reason for the behavior, recommend a psychotherapist, or prescribe medication.

Lastly, never ignore the signs or symptoms of depression. Depression is treatable and there is help available for both you and your teen. If left untreated, depression can lead to thoughts of suicide or even the act itself.

If your teen talks about suicide or attempts suicide, get help immediately. The Centers for Disease Control and Prevention (CDC) cites suicide as the third leading cause of death for people between the ages of 10 and 24.