What Is Adolescent Depression?
More commonly referred to as teenage depression, this mental and emotional disorder is no different medically from adult depression. However, symptoms in teens may manifest themselves in different ways than in adults due to the different social and developmental challenges facing teens. These include:
- peer pressure
- changing hormone levels
- developing bodies
Depression is associated with high levels of stress, anxiety, and in the worst possible scenarios, suicide. It can also affect a teen’s:
- personal life
- school life
- work life
- social life
- family life
This can lead to social isolation and other problems.
Depression isn’t a condition people can “snap out of,” or simply “cheer up” from. It’s a real medical condition that can affect a person’s life in every manner if it’s not treated properly.
How to Spot Depression in Your Child
Estimates from a study published in American Family Physician state that up to 15 percent of children and adolescents have some symptoms of depression.
The symptoms of depression can often be difficult for parents to spot. Sometimes, depression is confused with the typical feelings of puberty and teenage adjustment.
However, depression is more than boredom or disinterest in school. According to the American Academy of Child and Adolescent Psychiatry (AACAP), some signs of adolescent depression include:
- appearing sad, irritable, or tearful
- changes in appetite or weight
- a decreased interest in activities your child once found pleasurable
- a decrease in energy
- difficulty concentrating
- feelings of guilt, worthlessness, or helplessness
- major changes in sleeping habits
- regular complaints of boredom
- talk of suicide
- withdrawal from friends or after-school activities
- worsening school performance
Some of these symptoms may not always be signs of depression. If you’ve ever raised a teenager, you know that appetite changes are often normal, namely in times of growth spurts and particularly if your teenager is involved in sports.
Still, looking out for changing signs and behaviors in your teen can help them when they’re in need.
If you think someone is at immediate risk of self-harm or hurting another person:
- Call 911 or your local emergency number.
- Stay with the person until help arrives.
- Remove any guns, knives, medications, or other things that may cause harm.
- Listen, but don’t judge, argue, threaten, or yell.
If you think someone is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.
What Causes Adolescent Depression?
There’s no single known cause of adolescent depression. According to the Mayo Clinic, multiple factors could lead to depression, including:
Differences in the Brain
Research has shown that the brains of adolescents are structurally different than the brains of adults. Teens with depression can also have hormone differences and different levels of neurotransmitters. Neurotransmitters are key chemicals in the brain that affect how brain cells communicate with one another and play an important role in regulating moods and behavior.
Traumatic Early Life Events
Most children don’t have well-developed coping mechanisms. A traumatic event can leave a lasting impression. Loss of a parent or physical, emotional, or sexual abuse can leave lasting effects on a child’s brain that could contribute to depression.
Research shows that depression has a biological component. It can be passed down from parents to their children. Children who have one or more close relatives with depression, especially a parent, are more likely to have depression themselves.
Learned Patterns of Negative Thinking
Teens regularly exposed to pessimistic thinking, especially from their parents, and who learn to feel helpless instead of how to overcome challenges, can also develop depression.
How Is Adolescent Depression Diagnosed?
For proper treatment, it’s recommended that a psychiatrist or psychologist perform a psychological evaluation, asking your child a series of questions about their moods, behaviors, and thoughts.
Your teenager must meet the criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM) to be diagnosed with major depressive disorder, and they must have two or more major depressive episodes for at least two weeks. Their episodes must involve at least five of the following symptoms:
- agitation or psychomotor retardation noticed by others
- a depressed mood most of the day
- a diminished ability to think or concentrate
- a diminished interest in most or all activities
- feelings of worthlessness or excessive guilt
- insomnia or excessive sleeping
- recurring thoughts of death
- significant unintentional weight loss or gain
Your mental health professional may also question you about your child’s behavior and mood. A physical examination may also be used to help rule out other causes of their feelings. Some medical conditions can also contribute to depression.
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Treating Adolescent Depression
Just as depression has no single cause, there’s no single treatment to help everyone who has depression. Often, finding the right treatment is a trial and error process. It can take time to determine which treatment works best.
Numerous classes of medications are designed to alleviate the symptoms of depression. Some of the more common types of depression medications include:
Selective Serotonin Reuptake Inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) are some of the most commonly prescribed antidepressants. They’re a preferred treatment because they tend to have fewer side effects than other medications.
SSRIs work on the neurotransmitter serotonin. Research shows that people with depression may have abnormal levels of neurotransmitters associated with mood regulation. SSRIs prevent their body from absorbing serotonin so it can be more effectively used in the brain.
Current SSRIs approved by the U.S. Food and Drug Administration (FDA) include:
- citalopram (Celexa)
- escitalopram (Lexapro)
- fluoxetine (Prozac)
- fluvoxamine (Luvox)
- paroxetine (Paxil, Pexeva)
- sertraline (Zoloft)
The most common side effects reported with SSRIs include:
- sexual problems
Talk to your doctor if the side effects are interfering with your child’s quality of life.
Selective Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)
Selective serotonin and norepinephrine reuptake inhibitors (SNRIs) prevent the reabsorption of the neurotransmitters serotonin and norepinephrine, which help regulate mood. The side effects of SNRIs include:
The most common SNRIs are duloxetine (Cymbalta) and venlafaxine (Effexor).
Tricyclic Antidepressants (TCAs)
Like SSRIs and SNRIs, tricyclic antidepressants (TCAs) block the reuptake of certain neurotransmitters. Unlike the others, TCAs work on serotonin, norepinephrine, and dopamine.
TCAs may produce more side effects than other antidepressants, including:
- blurred vision
- dry mouth
- sexual dysfunction
- weight gain
TCAs aren’t prescribed for people with an enlarged prostate, glaucoma, or heart disease, as this can create serious problems.
Commonly prescribed TCAs include:
- clomipramine (Anafranil), which is used for obsessive-compulsive disorder
- desipramine (Norpramin)
- doxepin (Sinequan)
- imipramine (Tofranil)
- nortriptyline (Pamelor)
- protriptyline (Vivactil)
- trimipramine (Surmontil)
Monoamine Oxidase Inhibitors (MAOIs)
Monoamine oxidase inhibitors (MAOIs) were the first class of antidepressants on the market and are now the least prescribed. This is because of the complications, restrictions, and side effects they may cause.
MAOIs block serotonin, dopamine, and norepinephrine, but also affect other chemicals in the body. This can cause:
- low blood pressure
- dry mouth
People taking MAOIs must avoid certain foods and beverages, including:
- most cheeses
- pickled foods
- certain meats
- beer, wine, and alcohol-free or reduced-alcohol beer and wine
Common MAOIs include:
You should be aware that the FDA required the manufacturers of antidepressant medications to include a “black box warning,” which is offset inside a black box. The warning says that the use of antidepressant medications in young adults aged 18 to 24 have been associated with an increased risk of suicidal thinking and behavior, known as suicidality.
It’s recommended that your child see a qualified mental health professional before or at the same time as starting medication therapy. Many different types of therapy are available:
- Talk therapy is the most common type of therapy and includes regular sessions with a psychologist.
- Cognitive-behavioral therapy is guided to replace negative thoughts and emotions with good ones.
- Psychodynamic therapy focuses on delving into a person’s psyche to help alleviate internal struggles, such as stress or conflict.
- Problem-solving therapy helps a person find an optimistic route through specific life experiences, such as the loss of a loved one or another transitional period.
Research shows that regular exercise stimulates the production of “feel good” chemicals in the brain that elevate mood. Enroll your child in a sport they’re interested in, or come up with games to encourage physical activity.
Sleep is important to your teen’s mood. Make sure they get enough sleep each night and follow a regular bedtime routine.
It takes the body extra energy to process foods high in fat and sugar. These foods can make you feel sluggish. Pack school lunches for your child that are full of a variety of nutritious foods.
Avoid Excess Caffeine
Caffeine can momentarily boost mood. However, regular use can your teen to “crash,” feeling tired or down.
Abstain from Alcohol
Drinking, especially for teens, can create more problems. People with depression should avoid alcohol.
Living with Adolescent Depression
Depression can have a profound impact on your child’s life and can only compound the difficulties associated with teenage years. Adolescent depression isn’t always the easiest condition to spot. However, with proper treatment your child can get the help they need.