Feeling sad can be normal for teens, and can sometimes be ruled out as typical teen angst. However, for teens with depression it can become difficult to function.
Depression is formally known as Major Depressive Disorder (MDD). It causes persistent low mood and a number of other symptoms that can make it difficult to perform daily tasks.
Depression and anxiety are one of the most common mental health problems diagnosed in teens. Research shows up to 10% of teens in the United States are diagnosed with depression.
Diagnosing Teen Depression
Depression is diagnosed by a psychiatrist or pediatrician. Assessment may consist of a physical health exam and psychiatric evaluation
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), clinical depression is diagnosed when an individual experiences five or more of the following symptoms over a two-week period:
- Persistent feelings of sadness
- Loss of interest or pleasure in activities once enjoyed
- Angry outbursts, irritability
- Significant changes in appetite or weight
- Sleep disturbances
- Fatigue or lack of energy
- Anxiety
- Slowed thinking, speaking or body movements
- Feelings of worthlessness
- Difficulty concentrating or making decisions
- Unexplained physical problems, such as back pain or headaches
- Thoughts of death or suicide, suicide attempts or self-harm
Types of Teen Depression
MDD has a number of subtypes. These often present with their own symptoms in addition to the classic low mood. The other subtypes of MDD include:
- Melancholic presents with a low mood (more severe than normal MDD). It causes a lack of appetite, slows down thoughts, speech and movement, and can be worse in the mornings
- Seasonal affective disorder presents with classic symptoms of depression but only during the fall or winter months. When there are shorter days and lack of sunlight chemical changes in the brain can cause low mood and symptoms of depression
- Atypical depression has symptoms that differ than typical depression such as increased appetite, excessive sleepiness, and a temporary improvement of mood when exposed to positive events
- Psychotic depression also includes symptoms of psychosis (delusions, hallucinations and distorted thinking)
What Causes Teen Depression?
Depression does not have one direct cause. There are a variety of influences that can come together to cause depression in teens. Understanding why teens feel depressed can help provide them with the proper support and services.
- Biological factors play a large role in depression. During teenage development, the brain is going through rapid changes, especially in key regions related to emotional regulation and decision making. Changes in brain chemicals such as serotonin and dopamine can predispose teens to depression
- Psychological factors such as temperament, personality traits, stress tolerance and trauma can make teens more prone to developing depression
- Social factors also play a large role, especially for teens who are exploring their identities, forming new relationships and finding their place in the world. It is normal for teens to seek validation or acceptance from their peers
- Environmental influences from parental pressure, academics or sports can also increase the risk of developing depression. Studies show that high academic pressure is one of the top external influences that causes mental health problems in teens.
Available Treatment for Teen Depression
Supporting your teen with depression takes time, patience and compassion. If you think your teen is suffering from MDD or any of its subtypes, reaching out for professional help can be life-saving.
Some common treatments used to help manage depression in teens:
- Cognitive behavioral therapy to help identify negative thought patterns, build healthy coping strategies and develop realistic goals
- Antidepressants or mood stabilizers to treat chemical imbalances and manage symptoms
- Group therapy to connect with other teens who are struggling with the same problems can decrease feelings of loneliness or isolation
- Self-management tools may be taught in therapy sessions to manage symptoms of low mood at home. This could include journaling, meditation, movement, art, getting outside
How to Support A Depressed Teen
Sometimes parents can say the wrong things too and make their teens shut them out. This is usually not with bad intentions, but depressed teens can be extra sensitive. Below are a few tips on the dos and don’ts of supporting your teen with depression.
Dos and Don’ts
Creating a safe home environment where teens feel comfortable to talk about their feelings goes a long way, especially when paired with professional treatment. Parents may invite their teens to talk about how they are feeling, while also modeling this in their own life. Some things parents can do to support their teens include:
- Let your teen know it’s okay to be depressed
- Have open conversations related to mental health in the home
- Educate yourself on depression and understanding that it’s a brain disease
- Help your teen build a self-care routine and support them so they stick to it
- Encourage them to get involved socially
- Find an activity you and your teen can enjoy together and carve out a period for quality time (riding bikes, cooking a meal, watching a movie)
Although the intention isn’t meant to be hurtful, some parents with no experience of depression may freak out or provide unhelpful responses that further stigmatize depression.
Some things parents should not do or say include:
- Don’t freak out or yell at your teen for being depressed
- Don’t punish them for self-harm behaviors
- Don’t say:
- “Be more grateful”
- “Everyone gets sad or depressed”
- “Just focus on the positive”
- “You don’t have any reason to be depressed”
Depression is not black and white, and sometimes parents may not understand why their teen is depressed.
Sources
- Anxiety and depression in children: Get the Facts. 2023. Center for Disease Control.
- Drevets, W. C., Price, J. L., & Furey, M. L. (2008). Brain structural and functional abnormalities in mood disorders: implications for neurocircuitry models of depression. Brain structure & function, 213(1-2), 93–118.