Depression in Teenagers

The teenage years are known to be emotionally challenging. Kids are going through so many transitions and are experiencing so many pressures at this time. Aside from the physical changes of puberty and their effect on body image and personal confidence,  there’s also adjustments to high school and dating and new challenges in the realms of alcohol, drugs, sexuality and the virtual social universe. For the most part, adolescents negotiate all of this without too much trouble. However, a percentage of teenagers will struggle with addictions and mental health challenges. Adolescence is the time when many people first experience panic attacks, eating disorders and mood episodes.

Teenage depression is one mood disorder that is fairly common, affecting around 20% of teenagers. Some forms of depression are comparatively mild while others can be so intense that they are life-threatening. In all cases, adolescent depression must be taken seriously. Parents need to know about depression and what they can do to help their kids.

What is Depression?
Depression is a mood disorder characterized by low mood (which, in teenagers, is most often expressed as irritability or “moodiness,” but can also be expressed as sadness), hopelessness, trouble making decisions, feelings of guilt or worthlessness, weight gain or weight loss and sleeping problems (most commonly, waking up around 2 or 3 a.m. or getting up way too early).  Unlike episodic sadness, depression is stronger and seems harder to manage. A person who is depressed cannot simply “shake the blues away” or decide to cheer up. In fact, they feel flat, like there is nothing that can make them happy or give them pleasure. When this state of mind is so intense that it interferes with a child’s social functioning (i.e. she is withdrawing from her friends) and/or academic functioning (i.e. she can’t concentrate, can’t study, is doing poorly in her schoolwork and grades are slipping) and it has occurred pretty consistently for a two week period, it may be an episode of “Major Depressive Disorder.” When the state of mind is less intense (does not interfere with social or academic functioning) and chronic (lasting for at least 2 years fairly consistently), then it may be a form of depression called “Dysthymia.” Of course, diagnoses of either of these disorders occurs when the mood disorder is NOT being caused by something else (like withdrawal from drugs or use of alcohol or a traumatic experience, etc.). The only real way to know if a child is depressed is to have her assessed by a psychiatrist or clinical psychologist. The child’s symptoms may indicate another disorder entirely or the child may be “normal” – just going through a rough time. However, it’s crucial that parents don’t try to diagnose their child themselves. Clinical depression can lead to suicide in teenagers.

Experts believe that depression has a biological origin. While a family history of depression doesn’t automatically condemn a teen to get the disease, it increases the likelihood of depression when other risks factors are present in the child’s life. Risk factors for teen depression include a history of childhood depression (chronic unhappiness in childhood), instability in the family, troubled or weak relationship with parents, poor emotional management skills (too much anger, moodiness or anxiety), lack of social support (good friends and/or loving relationships) and stressful life events like loss (of a significant relationship) or failure (to make the team, or get desired grades, etc.).

How can Parents Help a Teenager with Depression?
It’s ideal if you can establish an open relationship with your child before depression strikes. This way, she is more likely to come to you for help when what she is feeling becomes too overwhelming to ignore. You can help by listening. In fact, it is more important to listen than to talk. A depressed child does not need a pep talk. She needs professional care. Let her talk about her feelings without offering her advice or easy solutions. Instead, use emotional coaching (name her feelings). For instance, you can say things like, “That sounds really hard,” or “I can see how much that’s bothering you” or “I hear how hopeless you feel.” Follow such remarks with, “I think the best help for these kinds of feelings is professional help. A psychologist who works with teenagers knows all about this stuff and knows how to help kids feel so much better. These are such important issues and they deserve the best help that we can find. How would you feel if I asked Dr. Green (the child’s pediatrician) for a referral to a good psychologist?” If the child doesn’t want to accept help, wait a couple of days and raise the subject again. The best help you can give your child is to get her to a mental health professional. If firmness is required, then use it. Do whatever you would do if you suspected that your child had diabetes. (You would do whatever was necessary to get your child to a doctor; do the same thing for this condition). Your child will thank you once she is experiencing an improved mood!

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