Table of Contents
You need to watch out for signs of depression in teens nowadays, given the amount of stress and tension living in a modern, competitive world can build. If your teen is suffering from depression, you need to be able to spot the warning signals. If any symptoms of depression are noted, it’s time to take action. Tomorrow may be too late. As symptoms of depression intensify, support is needed to bring your loved one back from the brink. If your teen is in denial about depression, the best help you can give is to be there and be non-judgemental.
Common Symptoms of Teen Depression
Common symptoms of teen depression may include:
- Low self-esteem
- Difficulty in concentration
- Change in sleep habits or eating patterns
- Feelings of hopelessness and helplessness
- Less interest in pleasurable hobbies and recreational activities
- Loss or gain in weight
- Consider thoughts of suicide
- Anger and hostility
- Tears or frequent bouts of crying
- Withdrawing from company
- Complete lack of interest in school or activities
- Increased restlessness and agitation
- Emotions of worthlessness and guilt
- Poor self-image and low self-confidence
- Lack of motivation and energy
- Sudden pain and fatigue
Teens are in a sensitive phase of their lives and they need parents, teachers or caregivers to realize their suffering and get them the help that is required. If you have an adolescent youngster grappling with depression, it is up to you as a parent to find the red flags and give the green signal for therapy or care as per the need of the hour. Teens who are depressed need not appear sad. Irritability, anger, and agitation can be not so obvious symptoms of depression.
A certain degree of moodiness and acting out is not out of place for teenagers. Persistent problems in personality, mood or behavior are warning signs for a deeper issue. Is your child being a teenager and acting out or is he/she getting depressed, considering how long symptoms have been on? The severity of the symptoms, and the difference in your child from his/her usual nature point to a deeper problem.
While changes in stress and hormonal level can explain usual teen emotions, continuous and persistent listlessness or irritation signals depression. Alarming and increasing suicidal thoughts are also something that should be heeded in time. Suicidal thoughts carry a high risk with them and it is the responsibility of the parent to seek treatment for clinical depression. For suicidal teens, depression is a disorder which can exacerbate high-risk actions. Teens who are depressed need to be closely watched for suicidal actions or thoughts.
Warning Signs to Watch Out For
Talking even lightly about committing suicide is a sign of deep depression. Saying things like “there is no way out of the situation” or “I am better off dead than alive” are statements that point to depression which is out of control. Even glorifying or romanticizing death can have serious consequences. Teens may also exhibit a preoccupation with death, dying and suicide. Accidents or injuries or even reckless behavior can be a signal of worsening symptoms of depression. Equally strong are the emotions such as saying goodbye to family or bidding farewell to friends and actively looking for means to do themselves in.
Teens may also exhibit a preoccupation with death, dying, and suicide. Accidents or injuries or even reckless behavior can be a signal of worsening symptoms of depression. Equally strong are the emotions such as saying goodbye to family or bidding farewell to friends and actively looking for means to do themselves in.
Teens are not children– they are making the transition to adulthood in one of the most difficult stages of life. As kids get older, problems can become more complex and parents need to change to a more supportive role if the teen is suffering from depression. Teens suffering from depression need help to get better.
Signs Your Teen Needs Help
Sometimes, it can be tough to know whether teens are suffering from atypical or developmental depression. Here are the red flags that need to be considered:
If teens are prone to self-harm and are hitting, cutting or hurting themselves, there are chances of immense emotional turmoil and psychic imbalance. Self-harming actions can become habitual and escalate across time.
Chronic Substance Abuse
Experimentation with drugs or alcohol may be common in teens, but if the kid is coming home drunk or high, a serious issue is forming. Acting immediately is important, particularly if there is a history of substance abuse. Teens suffering from this depression are likely to develop alcoholism or addiction issues.
Suicide Attempts or Suicidal Thoughts
Parents need to take threats of suicide seriously, as teens may actually attempt the act. With teen suicides on an all-time high, this is a warning signal you must watch out for as a parent.
Parenting Crises and How You Can Cope
When there's a problem with the kids, this can trigger a feeling of shame or failure in parents. But getting help is not a sign of weakness. It is actually a sign of strength. Atypical depression, when left untreated, can alter the entire child's life.
The internet also offers a lot of opportunities to consult with pros, such as support groups, crisis hotlines, parenting coaches, classes, blogs, books, articles. Speak with a counselor or therapist if you need help.
Questions to Ask Yourself
One of the most important indications of depression is the symptom of sadness or irritability most days in a week for at least two weeks. Losing interest in activities he/she used to enjoy or change in activity levels are and hopelessness about the future coupled with falling grades are some of the clear signs of depression. When grades drop or there is difficulty in concentration levels, it could be a sign of underlying mental tension and hopelessness characteristic of depression.
Diagnosis of Teen Depression
When teenage depression is suspected, doctors can do a series of exams and tests. These include the following:
1. Psychological Evaluation
This involves a psychiatrist or mental health professional talking with the teen about feelings, actions, and thoughts. It may also include a questionnaire. This pinpoints the diagnosis and checks for related complications.
2. Laboratory Tests
Teens can also be asked for blood tests or complete blood count or thyroid to ensure it functions properly.
3. Physical Examinations
The doctor can perform a physical exam and ask in-depth questions about teen health to determine what may be leading to depression. In specific cases, depression-related symptoms may be linked to underlying medical conditions.
Kinds of Depression
Symptoms caused by depression vary from one individual to another. To clarify the kind of depression your teen is suffering from, one or more specifiers may be used. Depression varies across different types including:
Anxious Distress: This is restless depression where individuals worry about possible loss of control events.
Atypical Features: Depression that includes the capacity to be gladdened by happy events, increased hunger, excessive need for sleep, sensitivity to rejection and heaviness of legs or arms.
Melancholic Features: This is severe depression characterized by loss of pleasure, associated with early morning awakenings, worsened moods in the morning time, massive changes in appetite, and feelings of sluggishness, agitation or guilt.
Disorders associated with depression symptoms also need to be considered. Several disorders come with depression as a key symptom. An accurate diagnosis is important for getting appropriate treatments. Doctors or mental health professionals need to evaluate to determine if the symptom of depression is caused by these conditions:
Bipolar 1 and 2 Disorders: These mood disorders range across mood swings that go from major lows to major highs. It is difficult to distinguish between depression and bipolar disorder.
Disruptive Mood Dysregulation Disorder: This is a mood disorder which occurs in younger children including chronic as well as severe irritability. Anger and frequent temper outbursts are also noticed. This is a depressive disorder or anxiety disorder noted in the teen or adult years.
Cyclothymic Disorder: This disorder involves lows and highs which are milder than that of bipolar disorder.
Premenstrual Dysphoric Disorder: This includes depression symptoms linked with hormonal changes that begin a week prior and end or improve within a few days of onset of menstruation. The symptoms are gone or minimal once the period comes to a close.
Persistent Depressive Disorder: Known as dysthymia also, this a chronic, but less severe form of depression. Though not disabling, persistent depressive disorders can prevent normal functionality from living life to the fullest.
Other Kinds of Depression: This includes depression caused by illegal or recreational drugs, prescribed medications or medical problems.
Developmental or Atypical Depression
Two different kinds of adolescent depression include developmental and atypical depression.
#1 Developmental Depression in Teens
Adolescence is associated with a grieving period triggered by a sudden understanding of life issues. As teens go into developmental depression, one engages in disquieting meditation about death, symbolic loss of innocence and childhood identity. The realization of mortality comes in the way and darkens the outlook. Developmental depression leads to internal problems, signaling a fresh chapter in the teen's existence where a new sense of self emerges. This unrest emerges when teens cannot forge a cohesive sense of self without going through uncertainties and insecurities. Key issues of developmental depression include identity and separate individuation. Teens remain mired in childish behavior forms if these are not resolved.
Adolescence developmental depression triggers mood instability, feelings that are melancholic or sad, loss of interest in pleasurable activities, social anxiety, occasional fatigue, hypersomnia or insomnia, infrequent suicidal or homicidal ideation sans intent.
#2 Atypical Depression in Teens
Conditions exacerbating developmental depression create serious emotional instability resulting in atypical teen depression. Generated by emotional distress, atypical depression is triggered by disruptive forces like undiagnosed disabilities for learning, illness, and injury, social rejection, trauma, parental conflicts, financial hardships, the death of loved ones and changing schools or homes.
Unlike developmental depression, teens experience tolerable levels of mourning and melancholy, atypical depression overwhelms teens with massive despair and psychic tension. Rage, hopelessness, frustration or powerlessness flare up and lead to lows and highs, destructive obsessions and negativity.
Teens experience atypical depression engrossed in psychic battles to ward off insecurities and engage in defenses like denial, projection or even dissociation. While these defenses are necessary and helpful, there is more psychic energy to maintain. During the atypical depression, teens appear fatigued, exhausted and hypervigilant.
Atypical adolescent depression includes predominantly depressed or irritated moods. This disorder is also characterized by a loss of interest in activities once considered enjoyable. Panic attacks and social isolation are also noted. The teen also experiences persistent fatigue, hypersomnia or insomnia. Prolonged feelings of indecision or hopelessness may be coupled with severe mood swings. Teens may also be prone to suicidal or homicidal ideation.
Treatment is based on the type and severity of teen depressive symptoms. A combination of medication and talking therapy can be effective for most teens facing depression. When teens are in severe depression or danger of self-harm, they may need to stay in a hospital or participate in an outpatient treatment program until the symptoms lessen.
What You Can Do
Be Empathetic and Supportive
Try to create empathy and deeper compassion for your teen as he/she struggles through the emotions and support your child to make smart choices. Strengthen your relationship with your child and, building empathy and a keen sense of understanding by placing yourself in his/her shoes. Depression makes even the smallest activities seem like an insurmountable hurdle. So, you need to be especially supportive.
Validate Healthy Emotions
Check regarding your teen’s emotional state and ensure you are clear about what is troubling him/her. Validate healthy emotions and don’t ignore behavioral patterns. Be compassionate and caring without being emotional. It is very tough to remain uninvolved as a parent. Listening to him or she share his/her inner concerns and try to understand the problem rather than trying to fix it. Also, give him/her the right to express words and emotions without being critical. Parents may feel that they are being passive, but it is essential to be accepting and strengthen your relationship with your teen at this crucial time.
Work Through To the Positive Things
Noticing positive things which your teen does is important. This could include holding down a part-time job, carrying out small errands or running chores. It is important to recognize what is good and reinforce it. Appreciating and recognizing a good job done can make your teen feel better.
If your teen comes to you for help, do not hesitate to seek professional therapy either. Finding a therapist who can work out the solutions and help your teen to be able to deal with the issues is essential. Therapy involves management of symptoms more than looking for a single cure. Depression has multiple symptoms which require the skill of a trained therapist. Several different types of therapies are in place including:
- Behavioral therapies
- CBT/Cognitive Behavioral Therapy
- Interpersonal therapy
- Dialectical behavior therapy
- Behavioral activation
- Rational Emotive Therapy
- Cognitive Therapy
- Humanistic/Rogerian therapy
Psychotherapy or psychological counseling is also known as talk therapy. It is a general term for treatment of depression, by talking about depression and related issues with a mental health professional. Different kinds of therapy can work well for treating depression, such as cognitive behavioral or interpersonal therapies.
Psychotherapy needs to be done one-to-one, with family members or a group. Via regular sessions, teens can learn about the causes of depression and how to cope with unhealthy thoughts and behaviors. Exploring relationships and experiences can also be facilitated using the aid of a psychotherapist. Psychiatrists can also help teens to set realistic goals and retain a sense of control. This eases depression symptoms like anger and hopelessness. Adjusting to new crises is also essential.
In some cases, the depression is severe enough for a hospital stay, especially if the teen is harming himself/herself or others. Getting psychiatric treatment at a hospital can help your teen to stay safe and calm until symptoms can be managed better at home. Further, everyday treatment programs may also offer help. These programs offer support and counseling needed to get depression symptoms under control.
You can be your teen's best friend to help him or her succeed. Here are the ways you can augment therapies to help your teen successfully cope with depression:
Adhere to the Treatment Plan:
Your teen needs to attend the doctor's appointments. Additionally, the teen needs to be motivated to stick to the treatment plan. Even if your teenager is feeling well, it is essential to continue taking medicines as prescribed. If your teen leaves medication mid-way, depression symptoms can return. Quitting on medicines suddenly can cause withdrawal symptoms.
Learn More About Depression
Education can empower teens and motivate teenagers to stick to a treatment plan. It can also benefit caregivers, as well as the teen patient, is to learn about depression and understand it is a treatable condition.
Boost Communication With Teens
Talking to teens about changes observed and stressing your empathy and continued unconditional support ensures you provide your teen with the care needed. Create an environment where teens share concerns and you provide a listening ear to their problems.
Listen to Warning Signs
Paying attention to warning signs is essential, and working with the doctor or therapist is critical to learning more about the trigger to depression symptoms. Check how to proceed if symptoms worsen and ask family or friends to also watch for the warning signals.
Encourage Your Teen To Follow Healthy Habits
Regular exercise, especially light physical activities can help to lower the extent of depression. A healthy amount of sleep is also critical for teens, especially those with depression. If teens are facing problems with sleep, the doctor needs to be approached. Your teen should also safeguard against addiction to alcohol and other drugs. These healthy habits can limit the severity of depression.
Eliminate the Possibility of Self Harm
Eliminating or limiting access to items teens could use for self-harm is important. This includes keeping guns under lock and key, removing sharp items, risky medicines or alcohol at home especially if your teen has depression.
Turning to Therapy
Adolescence is a time when one is prone to depression. Additionally, risk factors are driven by social environmental changes, biological and cognitive factors, when it comes to development. More than 50 percent of adolescents report depressed moods and 8 to 10 percent of these experience clinical symptoms. Depression impacts different areas of development, including academic, cognitive, family functioning and social factors. If left untreated, depression can have terrible consequences.
Moreover, depression in teens is strongly correlated to recurrent depression in adulthood as well as long term impairment of functionalities. It further confers a ten-fold increase in suicidal behavior. Clearly, depression can have long-lasting consequences and your teen needs effective intervention to manage the symptoms effectively.
There is strong empirical evidence for successful care of adolescent mental health disorders like depression. Therapy for depression is as effective as medication and is considered the first line of treatment for mild or moderate symptoms of depression in youth. Here are the most common and effective therapies for countering teen depression.
CBT/ Cognitive Behavioral Therapy
CBT or Cognitive Behavioral Therapy is an evidence-linked approach associated with treating a wide range of teen mental health issues, including ADHD, impulse control disorders, eating disorders, anxiety and oppositional deficient disorder. CBT is time-limited, directive, problem-focused, structured and goal-linked. Weekly session structures begin with the establishment of collaborative agenda setting and review and end with the consolidation of fresh skills. CBT also involves “homework” whereby the teen client carries out certain health-promoting actions and thinks positively to counter the depression.
Treatment is anywhere from 4 to 20 sessions. It is based on program setting and choice. However, treating comorbidity or severe symptoms can take a longer time to tackle. Clinical psychiatrists use various combinations of CBT techniques or adhere to specific therapeutic programs. Common CBT interventions range across psychoeducation or helping patients and parents understand the link between affect, behavior, and cognition. Other techniques include mood monitoring. For this, keeping a mood diary is essential, as is linking emotions to pleasant thoughts and activities. Behavior activation techniques that teens enjoy can range across joining sports teams, going for nightly walks or more. Cognitive restructuring involves identifying distorted thinking and replacing negative ways of thinking with more positive ones. Social communications, conflict resolution, and problem-solving skills are frequent components of CBT programs as well.
Cognitive behavioral therapy has an extensive body of research backing it up. It also has a long history against interpersonal or dialectical behavior therapy. The approach has been traditionally considered the golden standard for treating teen depression. CBT has been compared with pharmacological treatments like Selective Serotonin Reuptake Inhibitors. The Treatment of Adolescent Depression Study, for example, has found that when Prozac is combined with CBT, it works better than fluoxetine alone or CBT and placebos.
Combination of drugs and therapy work better for depressed youths because CBT acts as a buffer against suicide and negative life stress. This is something pharmacological aids alone cannot address. Later studies like TORDIA or Treatment of SSRI-Resistant Depression In Adolescents provides support for combined medicine and CBT psychotherapy. Practice Parameters of American Academy AACAP for the child and teen psychiatric help has suggested mild cases of depression can respond to CBT alone. Moderate or severe depression may require CBT plus other psychotherapies along with antidepressants.
Many CBT programs for treating depression were developed in a group-delivery modality for research expediency. These programs can further be tailored to individuals and applied in a variety of clinical settings including inpatient, outpatient, school and partial hospitalization programs. CBT manuals are focused on varying levels of directedness, from taking action to principle-based manuals guiding therapy flexibly. Level of parental involvement is an important component of CBT therapies.
Interpersonal psychotherapy is a time-limited, structured therapy developed for the treatment of non-bipolar, non-psychotic major adult depressions. The original model has been adapted for adolescents in a therapy format known as IPT-A. This defines the symptoms of depression and focuses on treatment through an interpersonal lens, solving problems pertaining to the teen patient's relationships and social environment. This therapy also improves communication as well as problem-solving skills to enhance interpersonal effectiveness in teens. Focus on interpersonal relationships is paramount at the time of adolescence. This is a period in which intimate peer and dating relationships are fostered and parent-child relationships undergo transformation based on the development of autonomy.
IPT-A further identifies interpersonal problem areas to focus on treatment of grief, role transition, role dispute, and interpersonal deficits. Through the means of an interpersonal interview, the therapist and the patient identify key areas on which to focus.
Treatment is structured over 12 to 16 weeks in sixty-minute sessions. The framework comprises phases to which therapy is aimed:
- Identifying specific interpersonal problem areas involves examining the patterns in present significant relationships.
- Developing problem-solving and communication strategies to address specific interpersonal problem areas.
- Practicing the skills in session and transitioning these into a social environment, providing patients with a sense of support for maintaining social competence and independence.
The effectiveness of psychological therapies shows that numerous therapies can work at the treatment endpoint. A range of therapies produces gains during treatment which is maintained at follow-ups when minimal treatment comparison groups are included. Accelerated resolution of depression is an important achievement for social, emotional and cognitive well-being of teens.
Treatments that have follow-up sessions can be useful in maintaining treatment gains. These findings argue for the maintenance of treatments to help those who do not respond well to first or second-line treatments. Studies have shown CBT to be more effective than relaxation, non-directive supportive therapy, or even systemic family behavioral therapy. These studies show that CBT is likely to reduce the duration of depressive episodes compared with these therapies.
Some studies also show group CBT is effective for treating teens and increasing chances of remission as well as reducing depressive symptoms. Evidence also points to the efficacy of family therapy. Guided self-help can also work wonders for specific cases depending on the coping resources of the teen.
Alternative or complementary therapies need to be studied carefully, and your teen's suitability for these judged, before pursuing these courses of treatment as compared to traditional medical treatment or psychotherapy with alternative medication. When it comes to depression remember that alternative forms of therapy have their plus and minus points and may be less effective than medical care.
Examples of alternative medicine techniques that can help include deep breathing, relaxation techniques, acupuncture, yoga, tai chi, guided imagery, meditation, message or music or art therapy, and other forms of alternative treatment. Relying on these methods is not enough, though.
Help Your Teen Cope With Low Self Esteem
Showing the interest and the desire to understand teen feelings is essential. As a parent, you may not understand why teens feel hopeless or there's a sense of loss or failure. Listening without judging is the key as is putting yourself in your teen's position. Help to build your teen's self-esteem by recognizing and praising positive coping skills.
Encouraging your teen to maintain and keep healthy friendships is essential. Positive relationships can boost teen confidence and help individuals to stay connected with others. Encouraging teens to avoid relationships with individuals whose attitudes and behaviors make depression worsen is also another positive step you can take as a parent.
Help your teen to stay active. Participating in sports, job or school activities can help keep your teen focused on what is positive rather than following negative behaviors or feelings. When life seems overwhelming, encourage your teen to talk and share. Many teenagers are not able to become nonjudgemental when they cannot live up to unrealistic standards. Let your teen know it's okay not be perfect.
Encourage your teen to choose commitments carefully and set reasonable goals. Structuring time is an effective way to help teens plan activities by making lists or using organization planners. Sticking to relevant routines can help in improving the mood. Another positive step your teen can take is to maintain a private everyday journal. Making journal entries can improve the teen's mood by permitting individuals to work through negative emotions like pain, anger, and fear.
Connecting with other teens facing depression is also beneficial for your teenager. This can include local as well as online support groups such as the Depression and Bipolar support alliance or National Alliance on Mental Illness. Encourage your teenager to also follow healthy habits and remain emotionally resilient.
Medication May Be Needed
Many teens suffering from depression benefit from medication. This includes antidepressants. Therapy alone is effective with mild or moderate depression. A combination of medication and therapy is a must for severe symptoms. A board-certified adolescent psychiatrist can also benefit consultation. Therapy requires trust and commitment to work. If you lay the groundwork for positive therapeutic benefits, your teen may turn to you for support when he/she is ready to. Teens are known to be egocentric and rebellious but depression is a disorder that affects 1 in 20 teenagers (Essau and Dobson, 1999). Depression is a serious mental health problem and it goes beyond moodiness, necessitating medication depending on the severity of the symptoms. Comorbidity with more than one disorder or medical condition is common enough in depression. Anxiety and depression frequently go hand in hand.
Teen depression is treatable. Treatments like CBT coupled with antidepressants can help. Research has found that 4-6 weeks of CBT can serve as a good treatment for mild to moderate depression. Fluoxetine or Prozac has been found to be effective in treating depression. Medication depends on the seriousness of the condition.
US-FDA has approved two drugs for teen depression namely fluoxetine or Prozac and escitalopram or Lexapro. Medication options and possible side effects must be considered including risks and benefits. While most antidepressants are safe, FDA requires antidepressants to carry warnings. Teens and young adults may have suicidal thoughts or behaviors while taking antidepressants, more so in the first few weeks after the dose is started or changed.
Those taking antidepressants need to be watched for worsening depression or unusual behavior especially when there is a new medication or change in dosage. If teens have suicidal thoughts while taking the medicine, contacting the doctor or getting emergency help is essential. For many teens, the benefits of taking antidepressants outweigh the risks. Keeping antidepressants in place is likely to reduce suicide risk by working on cognition and mood levels.
As everyone differs, finding the right medicine or dosage for your teen takes time, effort and may involve trial and error. Certain medications may take weeks or longer to take complete effect and adjust to side effects. As a parent, you need to encourage your teen not to give up.
Further, genetic traits play a role in how antidepressants impact individuals. In some cases, results of genetic testing through cheek swabs or blood tests may offer insights about how the body may respond to particular antidepressants. Other variables than genetics can impact medication response.
Carefully monitor the teen's usage of medication. For working properly, antidepressants need to be taken at the dose prescribed consistently. Overdosage can be a risk for teens with depression, so small quantities of the medicine may be prescribed or medication is administered by the parent. Ideally, your teen should not have a large number of medicinal pills available at home.
For teens facing side effects, antidepressants should not be stopped without considering the doctor's advice first. Remember that some medicines may cause withdrawal symptoms until the dose is gradually tapered off. This can cause depression to worsen.
Learn About Depression
Make sure you learn all about depression. Parent education can empower your teen as well. Adhere to the treatment plan and even if the teen stops taking medications, depression symptoms may return. Communicate well with your teen and pay attention to warning signs. Work with the doctor and therapist to identify triggers of depression and how you can cope. Help your teen to stay off alcohol and drugs by talking with him/her and involving the therapist in a communicative therapeutic relationship.
Encourage Your Teen
Help your teen to maintain and keep healthy relationships. Positive friendships can boost the confidence of the teen and help him/her to stay connected with others. The teen should avoid relationships with people whose behavior or attitude could worsen depression. Help your teen to stay active, be realistic about challenges and ask for help. Encourage your teen to open up and choose goals he/she feels committed to.
Join a Support Group
Depression is a serious condition and a life-threatening disorder. Your teen, as well as you, need help and this is why the support group for teens and their parents can really work well. Choose the best psychiatric care and a friendly support group to act as a buffer when things get tough.
Depression is a difficult disorder to cope with if you do not make the effort to understand your teen’s emotions. Clinical depression carries a lot of behavioral, affective and cognitive symptoms with it. From pioneering research done by Martin Seligman on causes to research by cognitive thinker Aaron Beck regarding the effectiveness of treatment, depression has been studied for decades. While there are no easy answers, asking the right questions can help your teen to cope with this mental health disorder.