Teenagers are quite sensitive and emotional creatures. They can be heartbroken over getting lower grades, and not getting an invitation to a friend’s birthday party can plunge them into sadness.

If their sadness becomes intense and prolonged, starts interfering with daily activities, and makes your teen feel worthless, do not take it lightly. These might be the symptoms of depression.

Depression is the most common mental health issue in the United States. Here is what you need to know about symptoms, causes, behavior indications, and management of depression in teens.

What is depression?

Depression is characterized by strong and prolonged feelings of sadness and worthlessness, decreased energy levels, and loss of interest in daily activities.

Its symptoms can range from mild to severe. Depression seriously affects a person’s ability to properly carry out their responsibilities. In severe cases, there are consistent feelings of hopelessness and recurrent thoughts of suicide, and the most severe cases can lead to the affected person taking their own life.

What is the difference between sadness and depression?

A teenager can be sad for many reasons—an argument with a friend, poor test grades, or lack of success in obtaining permission for a sleepover at a friend’s place.

The important thing to remember is that there’s a difference between feeling sad and being depressed.

• Sadness is a temporary feeling which subsides with time, while depression lasts for weeks, months, or even longer.
• Sadness has an apparent cause, while a specific reason of depression can’t usually be identified.
• Depression is more intense than sadness and interferes with a person’s activities and abilities, for example, the ability to think, concentrate, or complete a daily task successfully.

Teen depression statistics

How many teens suffer from depression? According to the National Institute of Mental Health (NIMH), depression is the most common mental health disorder in the United States.

The NIMH reports that 3.2 million (13.3%) of US adolescents (12-17 years of age) face depression, the prevalence being 20% in females and 6.8% in males. Depression rates are highest (16.9%) in teens with an inter-racial background. Out of all adolescents affected, almost 71% are at risk of severe impairment. Alarmingly, 60.1% of all US teens with depression didn’t receive any treatment in 2017.

Causes of depression in teens

Why are teens depressed? There can be several causes, split into biological, emotional, and environmental.

The most common risk factors include:

• Family history: Children and teens whose parents and other family members have a history of depression are at a higher risk. Research indicates that there is a difference between the genetic makeup of depressed patients with a family history of the condition and patients affected sporadically.
• Childhood traumatic experiences: Exposure to emotional, physical, or sexual abuse in childhood can make teens more predisposed to depression.
• Social discrimination: Children from interracial, immigrant, or ethnic minority groups are at higher risk of suffering depression in adolescence.
• Broken family: Growing up with one parent due to divorce, losing a parent to illness or an accident, or bitter experiences as a foster kid are all factors that can lead to depression in teens.
• Prolonged illness: Chronic illness such as cancer, asthma, or diabetes can put teen at higher risk of depression.
• A pessimistic frame of mind: If children grow up with parents who have a pessimistic outlook on life, they might learn to look at the gloomy side of things.
• Drug abuse: It puts teens at higher risk of depression.
• Personality type: Teens with confused, emotionally dependent, or introverted personalities, different sexual orientations, or a history of being bullied are among the high-risk population.

How to tell if your teen is depressed

According to the Diagnostic and Statistical Manual of Mental Disorders V (DSM V), the symptoms of depression should either be new (first episode) or significantly worse compared to the pre-episode phase. They should last for at least 2 weeks and significantly impede home and work life.

An important thing to remember is that similar symptoms arising from medical conditions (for example, hypothyroidism) are not accounted for in the diagnosis of depression. Therefore, the possibility of underlying medical conditions needs to be ruled out first.

Symptoms of depression are either subjectively reported or observed by family members. In the case of teens, they might feel reluctant or unwilling to share their emotional challenges and negative feelings.

It becomes very important for the family members, especially parents, to talk to their teens if they observe signs of depression. You should offer reassurance, support, and help in getting medical and psychological assistance for treating depression.

The most common symptoms of depression in teens and adults include:

• Sad, depressed, or irritable mood
• Loss of interest in most or all daily activities, including the person’s favorite activities in the past
• Disturbances in appetite (eating too little or too much) and/or unintentional loss or gain of a significant amount of weight
• Sleep disturbances, for example, insomnia (difficulty in falling asleep and staying asleep) and hypersomnia (excessive daytime sleepiness and prolonged nighttime sleep)
• Loss of energy, fatigue, and inability to complete daily tasks properly
• Feelings of worthlessness or generalized and excessive feelings of guilt (for being of no use to one’s self and others)
• Negative thinking and a greater focus on problems, difficulties, and the gloomy side of things
• Social withdrawal (avoidance of family, friends, and social gatherings)
• Significant decrease in decision-making capability, concentration, and the ability to think
• Recurring suicidal thoughts
• Oversensitivity and irritability
• Lack of motivation to succeed and achieve goals

How to help a teen with depression

If the parents spot any red flags and the depression symptoms last for days or weeks, they should seek professional support. The American Academy of Pediatrics (AAP) has provided guidelines for screening, diagnosis, and treatment of depression in teens.

According to these guidelines:

• Physicians should annually screen every child above the age of 12 for depression to ensure the timely detection of symptoms.
• If an adolescent is deemed at risk, they should be regularly monitored over time.
• If the initial screening of a teen shows a positive result, a doctor should conduct a thorough assessment based on standard diagnostic criteria. It can comprise of interviews with the parents and the teen, observations, and the application of diagnostic instruments.
• If a formal assessment results in a diagnosis of depression, a multidisciplinary team which might include a physician, psychologist, psychiatrist, and case manager should start working with the teen. Don’t hesitate to seek help from a mental health professional with advanced training and a strong background in treating teens.
• Along with treatment, parents and teens should be educated about depression and the best evidence-based treatment approaches. If the adolescent is suicidal, the parents should also receive guidance on making any required adaptations in the home environment and looking closely for the warning signs.
• Ongoing treatment should be closely monitored for improvements across environments (home, school, social gatherings, etc.).
• Treatment plans should be modified based on the effectiveness or ineffectiveness of the therapeutic approaches.

How to prevent depression in teens

The following strategies can help prevent depression in adolescents:

• Ensure a healthy and balanced diet.
• Incorporate physical exercise in your teens’ daily routine.
• Create family routines where all family members spend quality time together.
• Make efforts to improve the resilience and self-esteem in your teens.
• Encourage your teens to help others, do volunteer work, and engage in social welfare activities. It will help them set meaningful goals in life. They will also learn to respect and value themselves.
• Surround your family with optimists and avoid toxic people.

Depression is real

Let me stress that depression doesn’t mean your teen is being lazy, oversensitive, or not trying hard enough to shake it off. Teen depression is real. It’s a mental health disorder with a very high prevalence, but, fortunately, it can be treated.

Your support will enable your teen to fight back and ultimately beat depression.