I recently received a phone call from a distressed mother, saying that her 15-year-old son, Robert, had stopped going to school, spent most of his time in his room, and had lost nearly 10 pounds in the past month. He had become nasty and sullen with his parents and 12-year-old sister She explained that Robert was until now a B+ student, an avid soccer player, and co-president of the school debate team. He had many good friends with whom he spent time studying and going to the movies. She didn't understand what was going on with Robert and why his behavior had so dramatically changed in the past few months. I asked the mother and Robert to come to my office for an initial evaluation.
Clinical teenage depression isn't just bad moods and occasional melancholy. Depression is a serious problem that impacts every aspect of a teen's life. Left untreated, teen depression can lead to problems at home and school, drug abuse, self-loathing — even irreversible tragedy such as homicidal violence or suicide. Fortunately, teenage depression can be treated, and as a concerned parent, teacher, or friend, there are many things you can do to help. You can start by learning the symptoms of depression and expressing concern when you spot warning signs. Talking about the problem and offering support can go a long way toward getting your teenager back on track.
There are many misconceptions about teen depression as there are about teenagers in general. Yes, the teen years are tough, but most teens balance the requisite angst with good friendships, success in school or outside activities, and the development of a strong sense of self. Occasional bad moods or acting out is to be expected, but depression is something different. Depression can destroy the very essence of a teenager's personality, causing an overwhelming sense of sadness, despair, or anger.
Whether the incident of teen depression is actually increasing, or we're just becoming more aware of it, the fact is that depression strikes teenagers far more often than most people think. And although depression is highly treatable, experts say only 20% of depressed teens ever receive help. Unlike adults, who have the ability to seek assistance on their own, teenagers usually must rely on parents, teachers, or other caregivers to recognize their suffering and get them the treatment they vitally need. So if you have an adolescent in your life, it is important to learn what teen depression looks like and what to do if you spot the warning signs.
These are the symptoms and signs of depression in teens:
- Sadness or hopelessness
- Irritability, anger, hostility
- Tearfulness or frequent crying
- Withdrawal from friends and family
- Loss of interest in activities
- Changes in eating and sleeping habits, e.g. eating or sleeping too little or too much
- Restlessness and agitation
- Unexplained bodily aches and pains
- Feelings of worthlessness and guilt
- Lack of enthusiasm and motivation
- Fatigue or lack of energy
- Difficulty concentrating
- Thoughts of death or suicide
- Excessive sensitivity to criticism
- Excessive school tardiness and absenteeism
- Marked decrease in academic performance, e.g. failure to complete homework assignments, and falling grades
If you're unsure if a teen in your life is depressed or just "being a teenager", consider how long the symptoms have been present, how severe they are, and how different the teen is acting from his or her usual self. While some ""growing pains" are to be expected as teenagers grapple with the challenges of growing up, dramatic, long-lasting changes in personality, mood, or behavior are red flags of a deeper problem.
The first thing you should do if you suspect depression is talk to your teen about it. In a loving and non-judgmental way, share your concerns with your son or daughter. Let him or her know what specific signs of depression you've noticed and why they worry you. Then encourage your child to open up about what he or she is going through. If your child claims nothing is wrong, but has no explanation for what is causing the depressed behavior, you should trust your instincts. Remember that denial is a strong emotion. Teenagers may not believe that what they're experiencing is the result of depression. If you see depression's warning signs, seek professional help from a therapist specifically trained and who specializes in working with adolescents. Expect a discussion with the specialist you've chosen about treatment possibilities for your son or daughter.
There are a number of treatment options for depression in teenagers including individual, family, and group therapy. Talk therapy is often a good initial treatment for mild to moderate cases of depression. Over the course of therapy, your teen's depression may subside or resolve. If it doesn't, medication may be warranted. However, antidepressants should only be used as part of a broader treatment plan.You may also want to consider your own therapy to handle the stresses and uncertainities of your child's illness.
After the initial session with Robert and his mother, I began to see Robert individually. We discussed his hopes and dreams for the future, his self-perceived strengths and weaknesses, and his myriad feelings about his relationships with family members and friends. I also had several sessions with Robert's mother and father, who talked about a family history of clinical depression on the father's side, Robert's childhood development, and the stresses that Robert's depression has placed upon them. After preparing Robert for what he wanted to share with his parents, I facilitated a family session in which Robert expressed his feelings of unworthiness, guilt for acting so irritable, and anger towards his parents for not spending enough meaningful time with him. The parents were able to really listen to Robert, be nonjudgmental, and express their love, care, and concern for Robert.
Robert continues to see me individually once a week and plans to join my coed teen support group in the fall. And, Robert's parents are relieved to see the glimmer of their son's happiness return.