I am often asked by parents of teens I work with, “when do I worry about depression?” or “what does severe depression look like in a teenager?” As with most mental illnesses, depression in a teen is difficult to diagnosis because the definition of going through adolescence means angst. Teenagers are developing rapidly and face a number of pressures, from changing bodies to peer pressure to academic expectations. This all presents in the backdrop of crucial questions around identity, who they are and where they fit in. With so much uncertainty it is not always easy to differentiate between normal teenage growing pains and depression. But for some teens, the ups and downs of adolescence are not just temporary feelings but signs of depression. Understanding what teen depression looks like will help parents better recognize the signs of depression and understand how to support their teen to get back on track with their life.
What is teen depression:
- A serious mental health issue that causes low mood and an ongoing feeling of sadness, despair, irritability and loss of interest in activities
- Affects how a teen thinks, feels, and behaves
- Can cause emotional, functional and physical problems
Causes of teen depression:
- Family history of depression
- Social environment
- Medical conditions
- Negative thought patterns
- Stressful home environment
- Learning disabilities that make academic success difficult
- Hormonal changes affecting mood
- Physical illness
- Drug and alcohol abuse
Signs of depression in teens include a shift in the teen’s attitude and behavior that can cause significant distress and problems at school or home, in social activities, or in other areas of life. These include both emotional and behavioral changes.
Emotional changes include:
- Feelings of sadness, which can include crying spells for no apparent reason
- Frustration or feelings of anger, even over small matters
- Feeling hopeless or empty
- Irritable or annoyed mood
- Loss of interest or pleasure in usual activities
- Loss of interest in, or conflict with, family and friends
- Low self-esteem
- Feelings of worthlessness or guilt
- Fixation on past failures or exaggerated self-blame or self-criticism
- Extreme sensitivity to rejection or failure, and the need for excessive reassurance
- Trouble thinking, concentrating, making decisions and remembering things
- Ongoing sense that life and the future are grim and bleak
- Frequent thoughts of death, dying or suicide
Behavioral changes include:
- Tiredness and loss of energy
- Insomnia or sleeping too much
- Changes in appetite – decreased appetite and weight loss or increased cravings and weight gain.
- Use of alcohol or drugs
- Agitation or restlessness
- Slowed thinking, speaking or body movements
- Frequent complains of unexplained body aches and headaches
- Social isolation
- Poor school performance or frequent absences from school
- Less attention to personal hygiene or appearance
- Angry outbursts, disruptive or risky behavior, or other acting-out behaviors
- Self harm
- Making a suicide plan or a suicide attempt
Something important to note is that although a sign of depression is sadness, many teens do not feel sad but instead experience apathy, boredom, lack of pleasure, irritability, anger or temper tantrums as the pervasive symptom.
Another differentiating factor when looking at signs and symptoms of depression is the pronounced differences that we see in symptoms of depression in teen girls compared to that in teen boys.
Depression in Teen Girls:
- Teen girls experience stronger feelings of guilt, self-blame, failure, and even negative body image.
- Teen girls are more susceptible to health problems as a result of depression than boys.
- Depressed girls tend to withdraw themselves from family and friends, cry frequently, and show changes in sleeping patterns. They might lose or gain weight or develop eating disorders.
- Depressed girls may express their despair by self-mutilating, cutting or burning themselves. They may become promiscuous or repeatedly practice unsafe sex.
- Depressed girls often suffer from low self-esteem, struggle to concentrate on activities, and lack motivation.
- Depression in girls also tends to lead to feelings of hopelessness about the future.
Depression in Teen boys:
- Depression symptoms in teen boys differ as they show higher rates of depressed morning mood and morning fatigue.
- Teen boys may act out, physically and emotionally, instead of withdrawing. Teen boys who experience severe depression may also put themselves in harm’s way
What can parents do:
- Open lines of communication and let your teen know you are concerned
- Talk to your teen in a non-judgmental way, focus on listening.
- Encourage teen to take steps to control stress, increase resilience and boost self-esteem to help handle issues when they arise
- Ensure they have a support system, including friends and family they can talk to
- Do not talk them out of depression as this may shut down the conversation, acknowledge their feelings.
- Let them know you are there for them
- Ask questions but also slow down to give them space to respond
- Seek professional help as depression is treatable (this may be talk therapy, antidepressant medication, or a combination of the two).
A consequence of teen development is moodiness, making it hard for parents to differentiate between what is normal development to what is more worrisome. Teen depression goes beyond the occasional bouts of moodiness and evolves into a more severe and unrelenting unhappiness with pervasive negative mood, thoughts, and behavior. If you are unsure if your teen is depressed or just experiencing normal adolescent moodiness, consider how long the symptoms have been going on, how severe they are, and how different your teen is acting from their usual self. Hormones and stress can explain the occasional bout of teenage angst but not persistent unhappiness, lethargy, or irritability.
If you want to learn how to more about teen therapy to help you recognize how your adolescent may benefit from support to help alleviate symptoms of depression and anxiety, give us a call to set up an appointment. We are here, we understand, and we care.
Daniela Weise, LMFT is a therapist at Marin Wellness Counseling who loves supporting teens and young adults. She is a Licensed Marriage and Family Therapist with a Master’s degree in Counseling Psychology from Dominican University. She has over eight years experience working with and advocating for adolescents and their families. Daniela has worked as a therapist in school settings, outpatient agencies, and private practice. Her experience and training has focused on treating depression, anxiety, substance use, self harm, trauma, grief and loss, and life transitions.