Recognizing teen depression

Be Aware of the Risk for Teen Depression

Your teen is more at risk for depression if:

• Mood disorders run in your family
• They experience a stressful life event like a death in the family, divorcing parents, bullying, a break up with a boyfriend or girlfriend, or failing in school 
• They have low self-esteem and are very critical of themselves 
• Your teen is a girl. Teen girls are twice as likely as boys to have depression. 
• Your teen has trouble being social 
• Your teen has learning disabilities 
• Your teen has a chronic illness 
• There are family problems or problems with their parents

Know the Symptoms of Depression

If your teen is depressed, you may see some of the following common symptoms of depression. If these symptoms last for 2 weeks or longer, talk to your teen’s doctor. 

• Frequent irritability with sudden bursts of anger 
• More sensitive to criticism 
• Complaints of headaches, stomachaches or other body problems. Your teen may go to the nurse’s office at school a lot. 
• Withdrawal from people like parents or some friends 
• Not enjoying activities they usually like 
• Feeling tired for much of the day 
• Sad or blue feelings most of the time 

Notice changes in your teen’s daily routines that can be a sign of depression. Your teen’s daily routines can change when they are depressed. You may notice that your teen has:

• Trouble sleeping or is sleeping more than normal  
• A change in eating habits, such as not being hungry or eating more than usual 
• A hard time concentrating 
• Problems making decisions

Notice changes in your teen’s behavior that could be a sign of depression. They could be having problems at home or school.

• Drop in school grades, attendance, not doing homework 
• High-risk behaviors, such as reckless driving, unsafe sex, or shoplifting 
• Pulling away from family and friends and spends more time alone 
• Drinking or using drugs

Teens with depression may also have:

• Anxiety disorders
• Attention deficit hyperactivity disorder (ADHD)
• Bipolar disorder
• Eating disorders (such as bulimia or anorexia)

Bring Your Teen to a Health Care Provider

If you are worried that your teen is depressed, see a health care provider. The health care provider may perform a physical exam and order blood tests to make sure your teen doesn’t have a medical problem.

The health care provider should talk to your teen about:

• Their sadness, irritability, or loss of interest in normal activities 
• Signs of other mental health problems, such as anxiety, mania, or schizophrenia
• Risk of suicide or other violence -- whether your teen is a danger to him or herself or others

The health care provider should ask about drug or alcohol abuse. Depressed teens are at risk for:

• Heavy drinking
• Regular marijuana (pot) smoking
• Other drug use

The health care provider may speak with other family members or your teen’s teachers. These people can often help identify signs of depression in teenagers. 

Be alert to any signs of suicide plans. Notice if your teen is:

• Giving possessions to others
• Saying good bye to family and friends
• Talking about dying or committing suicide
• Writing about dying or suicide
• Having a personality change
• Taking big risks
• Withdrawing and wanting to be alone

Call your health care provider or a suicide hotline right away if you are worried that your teen is thinking about suicide. Never ignore a suicide threat or attempt.

Call 1-800-SUICIDE or 1-800-999-9999. You can call 24/7 anywhere in the United States.

Call Your Health Care Provider

If you notice: 

• Depression is not improving or is getting worse 
• Nervousness, irritability, moodiness, or sleeplessness that is new or getting worse 
• Side effects of medications

Identify Your Teen’s Depression Early

Most teenagers feel down sometimes. Having support and good coping skills helps teens through down periods.

Talk with your teen frequently to check in with them. Ask them about their feelings. Talking about depression will not make the situation worse, and may help them to get help sooner.

Get your teen professional help to deal with low moods. Treating depression early may help them feel better sooner, and may prevent or delay future episodes.

References

US Preventive Services Task Force. Screening and treatment for major depressive disorder in children and adolescents: US Preventive Services Task Force Recommendation Statement. Pediatrics. 2009;123:1223-1228.

Zuckerbrot RA, Cheung AH, Jenson PS, Stein REK. Identification, assessment, and initial management guidelines for adolescent depression in primary care. Pediatrics. 2007;120:e1299-e1312.

Cheung AH, Zuckerbrot RA, Jenson PS, Ghalib K. Treatment and ongoing management guidelines for adolescent depression in primary care. Pediatrics. 2007;120:e1313-e1326.

Bostic JQ, Prince JB. Child and adolescent psychiatric disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier;2008:chap 69.

Antidepressant Medications for Children and Adolescents: Information for Parents and Caregivers. National Institute of Mental Health (NIMH). January 13, 2010. Accessed March 25, 2012.  

Update Date: 10/24/2012

Updated by: David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.