When seeking treatment for depression teenagers are often left under-addressed by physicians and other clinicians. Parents often miss the initial warning signs of depression which can lead to more serious consequences, such as eating disorders, self-mutilation, and even depression.

Recognizing the signs

Much of the adolescent and teen years are marked with ups and downs, and mood swings as a result of hormonal fluctuations are common, making the diagnosis of depression problematic in this population.

Warning signs of depression in teenagers include a marked drop in grades or attendance at school; dropping out of sports, clubs, or other activities; avoidance of friends and family; excessive sleeping; a significant change in eating habits; frequent bouts of crying or vomiting; obsession with death and dying; and even substance abuse and criminal behavior can all be indications that your teen is suffering from depression.

Lifelong or prolonged depression that extends into the adult years often begins during the adolescent and teen years. Teen girls are almost twice as likely as teen boys to develop depression, and a family history of the condition can significantly increase the risk in both girls and boys.

Getting help

Parents or caregivers are often the ones most qualified to determine if their teen is displaying any of the signs or symptoms of depression. As soon as these symptoms become evident, parents are advised to seek the aid of the child’s pediatrician or primary care physician. Additional resources include school counselors, as well as a host of psychological counseling agencies that may be available privately or through the public health system. In all cases, getting help quickly is the most effective key in helping a teenager deal effectively with depression. Faced with mounting pressure from peers, school, and other activities as they reach the adult years, teens are often left feeling lack of control over their own lives. Guidance by qualified professionals can help teens identify areas in their lives where they can feel in control, and regain a sense of belonging in society during a tumultuous period of their lives.

Teenagers’ role vis à vis authority figures changes as they age.  No longer children, but not yet adults, this ambiguity invariably leads to tension as teens test their limits with curfews, relationships, perhaps even alcohol, tobacco and drugs.  Teenage responsibilities in school increase as do the stakes of success or failure.   They are expected to make preliminary decisions about career choices – all before they have attained full maturity.  Sometimes these pressures result in the shutting down of manic depression in teenagers.  Unable to cope with daily tasks, the teenager finds him or herself unable to finish things or takes to sleeping excessively.  Signs of depression in teenagers are shown by acting out and engaging in risky behavior.  For others depression may manifest itself in more subtle ways, via memory loss or inability to concentrate.

One of the most difficult issues for parents, friends and teachers is to sort out the normal from the abnormal or pathological.  When is sadness no longer simply sadness, but depression?  The psychological answer is that sadness is a response to an event.   Depression is the result of a psychological event.  Time is the best measurement.  An unfortunate or tragic event will bring sadness, but it should be proportionate to its cause and dissipate over time.  The causes, scope and duration of depression are less regular.

The sources of teenage anxiety and depression are indeed many.  But caring friends and parents need not be confused over sadness versus depression – both should be taken seriously.  The role of families as a support is crucial, teenagers need to feel loved and cared for.  The judgments of parents carry extremely high stakes for children, their happiness and well-being must be paramount.

Though any persistent negative teen behavior is cause for worry, some of the most overt symptoms of depression in teens are:

Persistent sadness or persistent anger

While most depressed adults exhibit signs of sadness, some depressed teens may show more irritability, anger and hostility. Perhaps fueled by hormonal changes or the inexperience in how to handle strong emotions, teens may act out their depression by yelling, screaming, and actually becoming violent toward others. If this behavior is occasional, it’s probably normal; however, if it persists, it’s one of the leading signs of depression.

Physical complaints

While a lot of depressed adults may complain of stress or tiredness, depressed teens tend to complain of actual aches and pains, such as stomachaches or headaches.

Change in sleep patterns

Though teens often overtax themselves and need their required 9 hours of sleep, watch for excessive need for sleep, or a decreased need in sleep. Lack of sleep can increase depression.

Change in peers, amount of peer contact, or activities

 This symptom can be tricky. For example, while depressed adults often isolate themselves from others, depressed teens may withdraw from most peers, but maintain contact with one or two. Or, a teen may withdraw from one circle of old friends and begin to associate with an entirely new circle.

Agitation and restlessness

 Though all teens exhibit signs of restlessness at times, it’s important to note if the restlessness or agitation is ongoing and interfering with normal schedules and the ability to concentrate.

Weight gain or loss

A lot of depressed people will either increase or decrease their eating. Though teens may want to be thin and often diet, lethargy with weight loss or gain should be noted.

Change in appearance

Since most teens are very concerned about their appearance, when a teen no longer cares how they look, it may be a sign of depression.

Teenagers face a variety of pressures, from the changes of puberty to questions about whom they are and where they fit in. The transition from childhood to adulthood can also bring conflict between teens and their parents as teens begin to assert their independence. A common misconception is that the cause of depression in teenagers is just a phase or an occasional occurrence of bad spirits. Teens may experience strong feelings of stress, self-doubt, pressure to succeed, financial concerns, and other confusions and fears while growing up.

Teen depression is often misdiagnosed and mistaken for other disorders such as conduct disorder, mood disorders, or anxiety. One reason for this is that even though adolescents and teens are often depressed, they may not show obvious signs that might be found in adults with depression. Symptoms of depression in teenagers are sometimes difficult to read, partly because many times they are similar to the common changes teens experience while growing up.

Parents should be concerned if they notice their teen becoming consistently irritable, angry, hostile, withdrawn, or show drops in their grades at school. Often teens will begin to lose interest in activities that they once enjoyed or experience feelings of hopelessness or guilt.  Teenagers may have trouble sleeping or show observable changes in eating habits. Social, educational and occupational functioning may also become impaired due to changes in the teen’s mood.

When symptoms exceed those of a “normal” teen, it is critical that the teen see the doctor for an evaluation. Anti-depressant medications are often needed to help teens recover from depression. Combining antidepressant medicine with professional counseling often works best. If the teen has suicidal thoughts in addition to the manic depression in teenagers, more intense treatment may be needed such as hospitalization.

Suicide is the third leading cause of death in young people between the ages 10-25. Suicidal thoughts many times accompany other signs of depression in these young people.