An important aspect of teenage-hood is the flux of highs and lows, due to shifting beliefs about self, seeking independence, navigating peer relationships, and, of course, hormones. While experiencing heightened emotions and mood swings is considered “normal” for teens, it is important to be able to recognize when a teen is experiencing depression versus a bout of sadness. Some parents might pick up on signs right away, while others might not notice the shift in mood immediately. This post is meant to review some key indicators of depression in teens as well as steps to help parents support and advocate for their teens.
The most commonly diagnosed form of depression is Major Depressive Disorder, frequently referred to as depression. This depressive disorder is more than a rough patch; it is a mental health condition that requires understanding and intervention. Depression results from a complex interaction of social, psychological, and biological factors. Symptoms may vary from person to person, but for most teens, depression will change how they function day-to-day and will typically last more than two weeks.
Depression rates in teenagers rose rapidly around 2012, and now are reported in 22% of adolescents, which is double the rate in adults (Ghaemi, 2020). As in adults, girls are more likely to experience depression than boys. Research also shows higher rates of depression in minority populations (ie. Race/gender/sexual orientation/neurodiversity) In the last decade, you might have noticed more and more mental health screenings included in your children’s well-visits at pediatrician offices. These screenings typically include anxiety scales and depression scales that the child and parent will both report on.
Sadness in teens is a natural reaction to a loss or setback (think a high school breakup, losing a big game, not getting a role in a show, etc.), and this usually passes in little time. Depression is more enduring than typical highs and lows, and includes the following:
Sad mood most of the day, every day, both felt by the teen and observed by other(s)
Diminished interest or pleasure in activities that previously were enjoyed
Significant change in appetite (either not eating or eating more than normal)
Change in sleeping habits (ie. Sleeping way more or not sleeping as much)
Changes in motor functioning observable by others (ie. Appears restless all the time, or appears
to be “slowed down” all the time)
Lack of focus or concentration (typically reported by teen and reflected in academic
performance)
Recurrent thoughts of death, dying, or not being “here”
Whereas teens tend to be better reporters of their internal experiences, such as their moods and thoughts, parents tend to be better reporters of overt behaviors, like disruptive behavior in the home/classroom, defiance, motor functioning or tearful appearance. Again, a clinical diagnosis would be any combination of these symptoms every day for two weeks or longer and must include overwhelming sadness or loss of interest in most usual activities. Depressed teens are likely to be irritable, sulky, or get into trouble at school beyond that of your average angsty teenager.
Parents might ask themselves, "Why is my child experiencing depression?". Although there are some theories about it, no one knows exactly what causes depression in teens (or anyone else, for that matter), but we can accept that it is not caused by bad parenting - therefore won’t be cured by good parenting. So, it is not the fault of the parent(s)- nor is it the fault of the depressed teenager.
Humans are complex creatures. Researchers suspect there are actually many different causes of depression, and that it is not always preventable. Factors that can contribute to depression include:
Genetics
Brain chemistry
Certain medical conditions
Stress
Poor nutrition
Grief and Loss
History of Trauma
I recommend shifting the focus from the “Why” toward “Okay, what now?” when a teen is diagnosed with depression. Let's say your teen was screened at their annual checkup and the pediatrician shares results that show depression in your child. What now? First, have a conversation with your teen about what they are experiencing, and explore areas in which you can offer support in and out of the home. This could be individual therapy, support groups, rearranging schedules, or more intensive interventions based on your child’s needs. Conversations about depression will not make your teen’s depression worse - it will actually open up a line of communication that de-stigmatizes their experience and validates what they are feeling.
I also recommend seeking professional help for your teen, as depression symptoms likely will not get better on their own. Depression could also get worse, or lead to other problems, if left untreated. You can get involved in their therapy, and learn which copings skills are helping to incorporate into your daily lives. Ask them about their symptoms daily, and listen without judgement; resilience is all about “we” as all of us grow and adapt when we have a caring support system that is consistent and reliable.
Encourage your teens to be physically active and consume nutritional meals - this could look like taking walks together or having a picnic together. The other big recommendation I make to parents (much to the chagrin of teens) is to set limits on screen time, especially social media. In several large studies, heavy users of technology are twice as likely as light users to be depressed or have low well-being (Twenge, 2020). There will be pushback, but coming up with limitations together with your teen will ease some of this discomfort.
On a final note, I will add encouragement to be patient and kind to yourself. It is not easy to parent a depressed teenager - often, it will feel like a day to day challenge. If you are feeling like “I can’t do anything right,” that does not mean you are doing anything wrong. You will get through this, and you have found information to support yourself and your child by reading this blog, so give yourself a real pat on the back. Thank you.
Additional Resources for Parents & Teens
Crisis numbers - 988 Suicide & Crisis Hotline
Safety Plan Template
Safety Check Agreement
Suicide Warning Signs Fact Sheet
References
Mojtabai R, Olfson M, Han B. National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics. 2016;138(6). doi:10.1542/peds.2016-1878
Jean M Twenge, Why increases in adolescent depression may be linked to the technological environment, Current Opinion in Psychology, Volume 32, 2020,Pages 89-94,ISSN 2352-250X, https://doi.org/10.1016/j.copsyc.2019.06.036
S.N. Ghaemi, Digital depression: a new disease of the millennium? First published: 18 January 2020 https://doi.org/10.1111/acps.13151
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