Recognizing Signs of Teen Depression: A Guide for Parents

It is very common for children and adolescents to experience occasional moodiness or periods of sadness. The causes of teen depression are multifaceted, involving biological, environmental, and social factors such as bullying, mental health conditions, stressful life events, and lack of social support. Yet, with depression rates on the rise amongst adolescents and teenagers (approximately 12.5% of youth today have experienced at least one major depressive episode), it is vital to distinguish between “the normal” mood changes and symptoms of depression. Common signs of depression in teens include:

• Loss of interest in activities
• Isolation from friends and/or family
• Irritable mood most days of the week, for more than a couple of weeks
• Changes in sleeping or eating habits
• Loss of energy and increased feelings of lethargy
• Drop in grades
• Suicidal thoughts or self-harming behaviors

Teen Depression Treatment Options

The first step to getting your teen the depression treatment they need is to have them assessed by a medical or mental health professional immediately. Once a formal diagnosis of depression is made, treatment options can be discussed. Although treatment may look slightly different for everyone, a combination of psychotherapy and medication is often the first approach used. In cases of severe depression, understanding the severity is crucial as it may require more intensive treatment options, including the possibility of hospitalization.

Teen Depression Psychotherapy

Psychotherapy (also referred to as counseling or talk therapy) is where a mental health professional sits down with your teenager to talk about their depression. Through the process of psychotherapy, your teen can discover the underlying causes and contributing factors to their depression, as well as:

• Identifying unhealthy behaviors and/or thoughts
• Learning healthier ways to cope with and manage the symptoms of their depression
• Setting realistic short-term goals
• Exploring relationships and experiences with family members

While there are numerous approaches to psychotherapy, when it comes to those best for teen depression help, certain models have shown to be the most effective, including cognitive-behavioral therapy (CBT) and dialectical-behavioral therapy (DBT). CBT can help teens better understand the connection between their thoughts and feelings and how these things influence behavior. Through gaining this awareness, teens are able to then benefit from DBT, where they can learn ways to challenge their thoughts, cope with their feelings in healthier ways, and modify their behavior overall.

Teen Depression Medication

Many depressed teens benefit from taking medication, especially the more severe cases. There are many different categories of antidepressant medication, and each works to modify the way the brain processes the neurotransmitters that affect emotion regulation and mood, such as serotonin, norepinephrine, and dopamine. The five major classes of antidepressants are:

• Selective Serotonin Reuptake Inhibitors (SSRIs) – SSRIs are the category of antidepressants known to have the least side effects while still maintaining their effectiveness in treating the symptoms of depression. SSRIs work by inhibiting the reuptake of serotonin in the brain.
• Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) – this class of antidepressants works in a similar way to SSRIs, except they inhibit the reuptake of both serotonin and norepinephrine. SNRIs have been shown to be particularly effective for depressed individuals who experience psychomotor retardation (the slow, lethargic feeling common to depression).
• Tricyclic Antidepressants (TCAs) – TCAs, while commonly prescribed for adults, are rarely suggested for teens or young adults. TCAs usually are only brought on board for younger people if they are unresponsive to other antidepressants first.
• Monoamine Oxidase Inhibitors (MAOIs) – some of the first antidepressant medications developed, MAOIs work to increase a person’s serotonin, which in turn helps regulate and elevate mood. MAOIs, while effective for many, also tend to have some serious side effects and drug/food interactions.
• Atypical Antidepressants – this category of antidepressant is fairly new compared to the others. Atypical antidepressants affect norepinephrine, serotonin, and dopamine levels in the brain. Some common atypical antidepressants are Wellbutrin and Remeron.

Some parents may feel hesitant to put their teenager on medication for depression. Just like anything, there are pros and cons to using medication to treat depression, and it is important to know what these are prior to making a decision about this treatment approach. For many teens, antidepressants are effective in treating the difficult side effects of depression. Antidepressants have been shown to be effective in various ways, including increased focus and attention, elevated mood, improved appetite and sleep patterns, decreased anxious and/or restless feelings (which often occur with depression), and decreased suicidal thoughts.

But just like most medications, antidepressants can have side effects. The general side effects tend to affect each person differently (in terms of severity, prevalence, etc.). Nonetheless, it is important for you and your teen to discuss the possible effects with a medical or mental health professional prior to starting a course of antidepressants. Some general side effects include:

• Dry mouth
• Gastrointestinal issues (i.e., constipation)
• Dizziness
• Insomnia or sedation
• Headaches
• Sexual problems
• Weight gain

Also important to note is that antidepressants are not a “quick fix.” These medications can take anywhere from 4-8 weeks to begin to relieve symptoms.  Thus, if your teen begins antidepressants, it may be helpful for them to seek additional treatment (such as psychotherapy) while the medication has time to start “working.”

Providing Support at Home

Although depression is a serious mental illness, and treatment should be sought as soon as possible, there are things you can do at home to help support your teenager.

• Listen – while you cannot “fix” your teenager’s depression, you can be an empathetic listener and provide emotional support.
• Accentuate the positive
• Encourage them to stay on track with their treatment plan
• Make time to spend one-on-one with your teen
• Model healthy behavior – exercise, nutrition, rest, and socialization are all important factors in managing depression and achieving an overall sense of wellness. By modeling these behaviors, your teen may feel more encouraged to do the same.

Depression is a serious mental illness and one that, if not treated, could become deadly. If you think your teenager may be suffering from depression, do not wait to get them help.