Depression
“I have been hearing about depression in teenagers and am concerned about it. But, we all know that teenagers are often moody and uncommunicative. How can we know whether a teenager is depressed, or just going through a ‘phase’?”
Depression is a serious illness in any age group, including teenagers. It can make family life stressful and interfere with the person’s ability to function and to enjoy his or her life. In the most serious cases, it can lead to suicidal thinking, suicide gestures or attempts, and even completed suicide. So, whenever it is diffi cult to distinguish between clinical depression and the “moodiness” that often affects teenagers, parents ought to err in the direction of caution. It is much better to follow up on concerns that the teen is depressed, even if it turns out not to be a true depression. That’s far better than the opposite: concluding that a teenager’s mood problems are “just a phase” when the teenager is truly depressed. Depression is an illness, and it requires expert evaluation and treatment. It is important to note that it is just not true that all teenagers, even most teenagers, inevitably go through phase of development that looks like depression. Periods of irritability and moodiness aren’t rare in teenagers—or in any of us. But, most teenagers actually get through the teen years without displaying any more than mild and temporary mood symptoms. There is a persistent cultural myth that all teenagers are chronically moody, emotionally disturbed and behaviorally erratic. It’s just not true.
The point of this is that if a teenager acts depressed, seems depressed, and certainly if he or she says he is depressed, parents ought to default to the idea that the teenager is suffering from depression and not “going through a phase.”
In thinking about depression in teens, a key word is “change.” Depression usually involves a noticeable change in thinking and behavior. A decline in motivation and social withdrawal is sometimes seen. One may see changes in sleep and eating, but they can go in either direction—too much sleep, too little sleep, or an increase or a decrease in appetite. Teenagers with depression are often prone to have physical complaints such as headaches, stomach aches and fatigue. They may report trouble concentrating and making decisions. Some will report excessive guilt, sometimes guilt about things they clearly aren’t responsible for. They may be preoccupied with death and dying. They may feel sad or anxious. Some feel helpless and hopeless. Hopelessness, in fact, is a particularly worrisome sign of depression and increases the risk of suicidal behavior. Also, with depression, one may see in increase in rebellious behavior, a decline in grades and in increase in the use of alcohol and drugs. Some depressed teenagers engage in self injury, such as “cutting.”
What should parents do if they are concerned about depression in a teenager?
A first step is to try to have a conversation with the young person about the parent’s concerns. A parent might say, “I have noticed some changes in your mood and behavior, and I am worried that you might be depressed.” I also recommend asking teenagers directly about suicidal thoughts. Any level of suicidal thoughts and feelings ought to lead a parent to seek professional help for the teenager.
Parents who are concerned that their child may be depressed need to consult with a professional. Start with your pediatrician. If the doctor believes an evaluation is appropriate, he or she can help make a referral to a child and adolescent psychologist, psychiatrist or other professional. Depression is serious, but it is treatable and the sooner it is treated, the better the outcome.
Dale Wisely, Ph.D. is Director of Student Services at Mountain Brook Schools and has been a child and adolescent psychologist for nearly 30 years. Dr. Wisely welcomes your questions for future columns; email jennifer@ villagelivingonline.com to submit yours.