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My Teen Looks Depressed. Signs and Symptoms to Look For


As a child makes the transition from adolescence to teenager, it comes with many emotional changes. While it's not unusual for hormonal changes during puberty to lead to mood changes and irritability, parents must understand their child's emotional changes could signify depression. Let's take a closer look at understanding depression and some signs your child may be experiencing this mental health condition.

What is depression?

Major depressive disorder (MDD) or depression is one of the world's most common mental health conditions. People with depression feel continuous negative emotions such as hopelessness, despair, pessimism, worthlessness, and despondency.

Causes of depression

The exact causes of depression are unknown. However, there is a combination of elements such as genetics, biologics, and environmental factors that may lead to depression.

Neurotransmitters such as serotonin, glutamate, acetylcholine, dopamine, norepinephrine, and epinephrine are believed to be major contributing factors to depression.

Environmental factors leading to depression:
  • Bullying
  • School performance
  • Social media
  • Drug/alcohol abuse
  • Low self-esteem
  • Mental/physical condition

Who suffers from depression?

Approximately 280 million people worldwide suffer from depression. Over 700,000 people die due to suicide yearly, with suicide being the fourth leading cause of death in ages 15 to 29. Depression can affect individuals of all ages, from children, and teenagers, to adults.

Teenage depression

There has been a significant increase in the number of teenagers with depression or who have experienced depression. The 2017 National Survey on Drug Use and Health revealed that the total number of teenagers who have experienced depression increased by approximately 59% between 2007 and 2017. From 2018 to 2019, it was reported that 15.1% of adolescents had a major depressive episode (MDE). A shocking estimate of approximately 500,000 teenagers attempts suicide every year, with 5,000 teens succeeding.

The CDC also released disheartening statistics in 2018-2019 concerning teen depression:

  • 15.1% had a major depressive episode.
  • 36.7% had persistent feelings of sadness or hopelessness.
  • 4.1% had a substance use disorder.
  • 1.6% had an alcohol use disorder.
  • 3.2% had an illicit drug use disorder.
  • 18.8% seriously considered attempting suicide.
  • 15.7% made a suicide plan.
  • 8.9% attempted suicide.
  • 2.5% made a suicide attempt requiring medical treatment.

What are the signs and symptoms of depression?

It may be challenging to recognize the signs and symptoms of depression in a teenager compared to typical teenage angst. The DSM-5 criteria list shows the signs and symptoms of depression:

  • Depressed/negative mood. Persistent negative emotions often result in tears and anguish. Teenagers with depression may not always display their depression as sadness but instead anger, irritability, or animosity. Also, look out for abnormal violent, or aggressive behaviors. Depressed/negative mood is required for a depression diagnosis.
  • Increased/decreased sleep. Sleep patterns may vary from person to person; however, it is common to see depressed teenagers spend more time in bed than usual or experience insomnia.
  • Diminished interest/pleasure. Loss of interest in hobbies or activities that usually brings amusement or enjoyment could be a sign of depression. Diminished interest/pleasure is required for a depression diagnosis.
  • Feelings of guilt/worthlessness. Delusional feelings of guilt or believing that one's self is insignificant and that no one else cares about their wellbeing.
  • Decreased energy. Consistent fatigue, lethargy, and weakness.
  • Decreased concentration. Some people experiencing depression have an impaired ability to concentrate or make routine daily decisions.
  • Increased/decreased appetite. Look for significant or excessive weight loss or weight gain. Consequential weight loss can affect a teenager's growth and development.
  • Psychomotor agitation/retardation. Psychomotor agitation is a symptom that may present as fidgeting, pacing, restlessness, emotional distress, tapping or racing thoughts. Psychomotor retardation is a symptom that causes the slowing down of mental and physical activities. Psychomotor retardation may present as slowed speech, facial expression, and body movements. Slumped or poor posture may also be a sign of psychomotor retardation.
  • Suicidal ideation. Threatening to kill one's self, recurrent thoughts of death or suicide attempts are commonly linked to depression.

Depression diagnosis and treatment

To be diagnosed with depression, a person must have five depressive symptoms (must include depressed/negative mood and diminished interest/pleasure) for at least two weeks.

Teenagers must receive help and treatment as soon as possible to prevent long-term complications. In 2019, 43.4% of adolescents with major depressive episodes were treated for their condition. According to the Office of Disease Prevention and Health Promotion, the target goal for adolescents with depression to be treated is 46.4%. Although the recent statistics are not far from the target percentage, the overall goal is to continue increasing the number of treated adolescents with depression.

Currently, numerous treatment options are available to treat teenage depression:

  • Speaking to a healthcare professional (psychiatrist, psychologist, etc.). Seeking professional assistance is a typical first step in treating depression. They can help identify any underlying causes and create a customized treatment plan.
  • Medication (SSRI, SNRI, bupropion, mirtazapine, etc.). Many antidepressants have a danger warning indicating that they are associated with an increased risk of suicidal ideation in children, teenagers, and young adults. When initiating antidepressants, teenagers must be monitored for suicidal ideation.
  • Medication treatment will not work immediately. Patients on antidepressants may not feel the full effects of the medication until four to eight weeks.
  • Cognitive behavioral therapy (CBT). Cognitive behavioral therapy is the gold standard of therapy for treating children and adolescents with depression.
  • Dialectical behavioral therapy (DBT). Dialectical behavioral therapy for adolescents includes parent and child therapy sessions.
  • Interpersonal psychotherapy (IPT). Interpersonal psychotherapy is used to address teen relationships with friends, peers, parents, and romantic partners.
  • Mindfulness-based cognitive therapy (MBCT). Combines CBT with mindfulness to treat recurrent depressive episodes.

Prior to drug treatment

Before initiating antidepressants, it is essential to review the person's drug profile to ensure that their depression is not caused by or worsened by select medications. Drugs that can cause or worsen depression include:

AtomoxetineCyclosporineIndomethacinMethlydopa
Anabolic steroidsEfavirenzIsotretinoinMethylphenidate/stimulants
ClonidineHormonal contraceptivesProcainamideVarenicline

It is also important to rule out bipolar disorder before initiating antidepressants as antidepressants can worsen bipolar disorder and induce mania.

Get help

If you suspect a teenager or anybody is suicidal, it is important to take action immediately.

Listed below are 24-hour suicide prevention hotlines and sites:

  • 988 Suicide & Crisis Lifeline (call/text 988 or 988lifeline.org)
  • National Suicide Prevention Lifeline (1-800-723-8255)
  • Crisis Text Line (text 741741 or crisistextline.org)
  • TrevorLifeline (text 678678 or TheTrevorProject.org)
  • Teen Hopeline (call/text 877-870-4673 or Teenhopeline.com)
  • Teen Line (text 839863 or teenlineonline.org)

Conclusion

Approximately 280 million people worldwide suffer from depression. Over 700,000 people die due to suicide yearly, with suicide being the fourth leading cause of death in ages 15 to 29. If you suspect a teenager or anybody is suicidal, it is important to take action immediately.

Key takeaways

The exact causes of depression are unknown. However, there is a combination of elements such as genetics, biologics, and environmental factors that may lead to depression.

The 2017 National Survey on Drug Use and Health revealed that the total number of teenagers who have experienced depression increased by approximately 59% between 2007 and 2017.

To be diagnosed with depression, a person must have five depressive symptoms for at least two weeks.

A combination of psychotherapy and medication is used to treat depression.

If you suspect a teenager or anybody is suicidal, it is important to take action immediately.

References:

World Health Organization. Depression.

Geiger, A.W., Davis, L. (2019). A growing number of American teenagers – particularly girls – are facing depression. Pew Research Center.

Bruce, D.F. Teen depression: Causes, symptoms, heredity, and treatments. WebMD.

Centers for Disease Control and Prevention. Data and statistics on Children's Mental Health.

National Library of Medicine. Table 9, DSM-IV to DSM-5 major depressive episode/disorder comparison.

Buyukdura, J.S., McClintock, S.M., Croarkin, P.E. (2011). Psychomotor retardation in depression: Biological underpinnings, Measurement, and treatment. Progress in neuro-psychopharmacology and biological psychiatry.

Healthy People 2030. Increase the proportion of adolescents with depression who get treatment.

Child Mind Institute. Treatment for depression.

Shapirof, K., Bombatch, C., Garrett, S.D., Veverka, A. (2021). Chapter 63/Depression . In: RxPrep Course Book: 2021 Naplex Course Book. El Segundo, CA: RxPrep, Inc.

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