How To Recognize the Signs of Depression in Teens

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Thoughtful young woman

Here at Westchester Health Pediatrics, we see a lot of teenagers, which also means that we see our fair share of teenage depression. Teenagers face a host of pressures, from the physical and emotional changes of puberty to questions about who they are and where they fit in.

With all this turmoil and uncertainty, it’s not easy (for teens or parents) to differentiate between depression and normal teenage growing pains. To help teens, parents, teachers, coaches and anyone else involved with teenagers recognize the signs of depression and how to get help, we offer this blog.

Teen depression goes beyond moodiness

Mason Gomberg-001R WEB72

Mason Gomberg, MD

Depression is a serious health problem that impacts every aspect of a teen’s life. Fortunately, it is treatable.

Unlike adults with depression who can seek out help on their own, teenagers rely on parents, teachers, coaches or other caregivers to recognize their condition and get them the help they need. If you have an adolescent, it’s important to learn what teen depression looks like and what to do if you spot the warning signs.

Similar to adults with depression, there is a strong family  history associated with depression.

Signs and symptoms of depression in teens

Recognizing teen depression can be difficult because the signs aren’t always obvious. For instance, teens with depression don’t necessarily appear sad. Irritability, anger and agitation may be the most prominent symptoms.

Here are the most common symptoms:

  1. Sadness or hopelessness
  2. Irritability, anger or hostility
  3. Increased drug use (illegal or legal drugs)
  4. Absence form school
  5. Frequent crying
  6. Withdrawal from friends and family
  7. Loss of interest in activities
  8. Poor school performance
  9. Changes in eating and sleeping habits
  10. Feelings of worthlessness and guilt
  11. Lack of enthusiasm and motivation
  12. Fatigue or lack of energy
  13. Difficulty concentrating
  14. Unexplained aches and pains
  15. Thoughts of death or suicide

Is it depression or teenage “growing pains”?

A certain amount of moodiness and acting out is normal with teenagers as they try to establish their own identity and place in the world. But persistent changes in personality, mood or behavior are red flags of a deeper problem.

If you’re not sure if your child is depressed or just “being a teenager,” try to measure how long the symptoms have been going on, how severe they are and how different your child is acting from his or her usual self. Hormones and stress can explain the occasional spike in teenage angst, but not continuous and unrelenting unhappiness, lethargy or irritability.

Don’t ignore the problem

Depression is very damaging when left untreated, and waiting and hoping that the symptoms will go away often just makes the situation worse. If you suspect that your child is depressed, voice your concerns in a loving, non-judgmental way. Let your teen know the specific signs of depression you’ve noticed and why they worry you. Then ask your child to share what he or she is going through—and be willing to truly listen. Refrain from asking a lot of questions but make it clear that you’re ready and willing to provide whatever support he/she needs.

10 ways to help a depressed teen

  1. Focus on listening, not lecturing. Resist the urge to criticize or pass judgment once your teenager begins to talk. The important thing is that your child is communicating. Simply letting your teen know that you’re there for them, completely and unconditionally, is huge.
  2. Be gentle but persistent. Don’t give up if they shut you out at first. Talking about their depression can be very tough for teens. Even if they want to, they may have a hard time expressing what they’re feeling. Be respectful of your child’s comfort level while still emphasizing your concern and willingness to listen.
  3. Acknowledge their feelings. Don’t try to talk your teen out of depression, even if his/her feelings or concerns appear silly or irrational to you. Your well-meaning attempts to explain why “things aren’t that bad” can often come across as not taking their emotions seriously. To make your teen feel understood and supported, simply acknowledging the pain and sadness they are experiencing.
  4. Trust your gut. If your teen claims nothing is wrong but has no explanation for what is causing the depressed behavior, you should trust your instincts. If your teen won’t open up to you, consider turning to a trusted third party: a school counselor, favorite teacher or coach, or mental health professional. The important thing is for them to start talking to someone.
  5. Encourage social connection. Depressed teens tend to withdraw from their friends and the activities they used to enjoy. However, isolation only makes depression worse, so do what you can to help your teen connect to others. Encourage him/her to go out with friends or invite friends over. Participate in activities that involve other families and give your child an opportunity to meet and connect with other kids. Suggest activities—such as sports, after-school clubs, or an art, dance, or music class—that take advantage of your teen’s interests and talents.
  6. Set aside time each day to talk. The simple act of connecting face to face where you’re focused totally on your teen (no distractions or multi-tasking) can play a big role in reducing his/her depression.
  7. Promote volunteerism. Doing things for others is a powerful antidepressant and self-esteem booster. Help your teen find a cause they’re interested in and that gives them a sense of purpose. If you volunteer with them, it can also be a good bonding experience.
  8. Make physical health a priority. Physical and mental health are definitely connected. In our experience as pediatricians, we’ve seen that depression is exacerbated by inactivity, inadequate sleep and poor nutrition. As a parent, you can combat these behaviors by establishing a healthy, supportive home environment.
  9. Set limits on screen time. Teens often go online to escape their problems, but excessive computer use only increases their isolation, making them more depressed. When screen time increases, physical activity and face time with friends goes down. Both are a recipe for worsening the symptoms of depression.
  10. Encourage plenty of sleep. Teens need more sleep than adults to function optimally—up to 9-10 hours per night. Make sure your teen isn’t staying up until all hours at the expense of much-need, mood-supporting rest.

Know when to seek professional help

If your teen’s depression is severe, we urge you to seek professional help from a mental health professional with advanced training and a strong background treating teens. Remember: no one therapist is a miracle worker, and no one treatment works for everyone. If your child feels uncomfortable or is just not “connecting” with a certain psychologist or psychiatrist, seek out a better fit.

Unless your child is behaving dangerously or is at risk for suicide, he/she may be able to avoid prescription antidepressants which are designed and tested on adults (so their impact on young, developing brains is not fully understood). Some researchers are concerned that exposure to drugs such as Prozac may interfere with normal brain development, particularly the way the brain manages stress and regulates emotion. They are also known to increase the risk of suicidal thinking and behavior in some teenagers and young adults.

Red flags to watch for if your teen is taking antidepressants

Call a doctor immediately if you notice:

  1. New or more thoughts of suicide
  2. Suicidal gestures or attempts
  3. New or worse depression
  4. New or worse anxiety
  5. Agitation or restlessness
  6. Panic attacks
  7. Difficulty sleeping (insomnia)
  8. New or worse irritability
  9. Aggressive, angry or violent behavior
  10. Acting on dangerous impulses
  11. Hyperactive speech or behavior (mania)
  12. Other unusual changes in behavior

Don’t forget to take care of yourself and the rest of your family

As a parent dealing with teen depression, you may find yourself focusing most (or all) of your energy and attention on your depressed child. Consequently, you may be neglecting your own needs and the needs of other family members. However, it’s extremely important that you continue to take care of yourself during this difficult time.

At Westchester Health Pediatrics, we urge you to reach out for much needed support. Having your own support system in place will help you stay healthy and positive as you work to help your teen.

Suicide and teens

Seriously depressed teens often think about, speak of, or make “attention-getting” attempts at suicide. However, since an alarming and increasing number of teenage suicide attempts are successful, suicidal thoughts, behavior or comments should always be taken very seriously.

For the overwhelming majority of suicidal teens, depression or another psychological disorder plays a primary role. In depressed teens who also abuse alcohol or drugs, the risk of suicide is even greater. Because of the very real danger of suicide, teenagers who are depressed should be watched closely for any signs of suicidal thoughts or behavior.

Suicide warning signs to watch for

  1. Talking or joking about committing suicide.
  2. Saying things like, “I’d be better off dead,” “I wish I could disappear forever” “There’s no way out,” or “I just want the pain to stop.”
  3. Speaking positively about death or romanticizing dying.
  4. Writing stories and poems about death, dying or suicide.
  5. Engaging in reckless behavior or having accidents resulting in injury.
  6. Giving away prized possessions.
  7. Saying goodbye to friends, family and pets as if for the last time.
  8. Seeking out weapons, pills or other suicide facilitators.

How to get help for a suicidal teen

  1. If you suspect that your teenager (or someone you know) is suicidal, do not delay—TAKE IMMEDIATE ACTION. For 24-hour suicide prevention and support in the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK.
  2. To find a suicide helpline outside the U.S., visit the International Association for Suicide Prevention website or Suicide.org.
  3. To learn more about suicide risk factors, warning signs, and what to do in a crisis, read this article on Suicide Prevention by HelpGuide.org.

Valuable resources

If you think your child might be suffering from depression, please come see us.

If your teenager is showing signs of depression, please make an appointment with Westchester Health Pediatrics to come in and talk to one of our pediatricians. We will meet with you and your child and perform screening tests for signs of depression. We’ll then evaluate his/her condition, and together, try to determine the cause and severity of the problem. If we feel it is needed, we will refer your child to a mental health specialist.

Rest assured, we will do everything we can to help your child become healthy and happy, physically and emotionally.

Make an appt

By Mason Gomberg, MD, a Westchester Health Pediatrics pediatrician.

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About the Author: ML Ball