Teen depression

Do you ever wonder whether your irritable or unhappy adolescent might actually be experiencing teen depression? Of course, most teens feel unhappy at times. And when you add hormone havoc to the many other changes happening in a teen's life, it's easy to see why their moods swing like a pendulum. Yet findings show that one out of every eight adolescents has teen depression. But depression can be treated as well as the serious problems that come with it. So if your teen's unhappiness lasts for more than two weeks and he or she displays other symptoms of depression, it may be time to seek help from a health professional.

Why do adolescents get depression?

There are multiple reasons why a teenager might become depressed. For example, teens can develop feelings of worthlessness and inadequacy over their grades. School performance, social status with peers, sexual orientation, or family life can each have a major effect on how a teen feels. Sometimes, teen depression may result from environmental stress. But whatever the cause, when friends or family -- or things that the teen usually enjoys -- don't help to improve his or her sadness or sense of isolation, there's a good chance that he or she has teen depression.

What are the symptoms of teen depression?

Often, kids with teen depression will have a noticeable change in their thinking and behavior. They may have no motivation and even become withdrawn, closing their bedroom door after school and staying in their room for hours.

Kids with teen depression may sleep excessively, have a change in eating habits, and may even exhibit criminal behaviors such as DUI or shoplifting. Here are more signs of depression in adolescents even though they may or may not show all signs:

  • Apathy
  • Complaints of pains, including headaches, stomachaches, low back pain, or fatigue
  • Difficulty concentrating
  • Difficulty making decisions
  • Excessive or inappropriate guilt
  • Irresponsible behavior -- for example, forgetting obligations, being late for classes, skipping school
  • Loss of interest in food or compulsive overeating that results in rapid weight loss or gain
  • Memory loss
  • Preoccupation with death and dying
  • Rebellious behavior
  • Sadness, anxiety, or a feeling of hopelessness
  • Staying awake at night and sleeping during the day
  • Sudden drop in grades
  • Use of alcohol or drugs and promiscuous sexual activity
  • Withdrawal from friends

For in depth information, see WebMD's Symptoms of Depression.

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Can teen depression run in families?

Yes. Depression, which usually starts between the ages of 15 and 30, sometimes can run in families. In fact, teen depression may be more common among adolescents who have a family history of depression.

How is teen depression diagnosed?

There aren't any specific medical tests that can detect depression. Health care professionals determine if a teen has depression by conducting interviews and psychological tests with the teen and his or her family members, teachers, and peers.

The severity of the teen depression and the risk of suicide are determined based on the assessment of these interviews. Treatment recommendations are also made based on the data collected from the interviews.

The doctor will also look for signs of potentially co-existing psychiatric disorders such as anxiety or substance abuse or screen for complex forms of depression such as bipolar disorder (manic depressive illness) or psychosis. . The doctor will also assess the teen for risks of suicidal or homicidal features. Incidences of attempted suicide and self-mutilation is higher in females than males while completed suicide is higher in males. One of the most vulnerable groups for completed suicide is the 18-24 age group.

How is teen depression treated?

There are a variety of methods used to treat depression, including medications and psychotherapy. Family therapy may be helpful if family conflict is contributing to a teen's depression. The teen will also need support from family or teachers to help with any school or peer problems. Occasionally, hospitalization in a psychiatric unit may be required for teenagers with severe depression.

Your mental health care provider will determine the best course of treatment for your teen.

The FDA warns that antidepressant medications can, rarely, increase the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. Use of antidepressants in younger patients, therefore, requires especially close monitoring and follow-up by the treating doctor. If you have questions or concerns, discuss them with your health care provider.

Does depression medicine work for teen depression?

Yes. A large number of research trials have shown the effectiveness of depression medications in relieving the symptoms of teen depression. One key recent study, funded by the National Institute of Mental Health, reviewed three different approaches to treating adolescents with moderate to severe depression:

  • One approach was using the antidepressant medication Prozac, which is approved by the FDA for use with pediatric patients ages 8-18.
  • The second treatment was using cognitive behavioral therapy, or CBT, to help the teen recognize and change negative patterns of thinking that may increase symptoms of depression.
  • The third approach was a combination of medication and CBT.

At the end of the 12-week study, researchers found that nearly three out of every four patients who received the combination treatment -- depression medication and psychotherapy -- significantly improved. More than 60% of the kids who took Prozac alone improved. But the study confirmed that combination treatment was nearly twice as effective in relieving depression as psychotherapy alone.

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What are the warning signs for teen suicide?

Teen suicide is a serious problem. Adolescent suicide is the second leading cause of death, following accidents, among youth and young adults in the U.S. It is estimated that 500,000 teens attempt suicide every year with 5,000 succeeding. These are epidemic numbers.

Family difficulties, the loss of a loved one, or perceived failures at school or in relationships can all lead to negative feelings and depression. And teen depression often makes problems seem overwhelming and the associated pain unbearable. Suicide is an act of desperation and teen depression is often the root cause.

Warning signs of suicide with teen depression include:

  • Expressing hopelessness for the future
  • Giving up on one's self, talking as if no one else cares
  • Preparing for death, giving away favorite possessions, writing goodbye letters, or making a will
  • Starting to use or abuse drugs or alcohol to aid sleep or for relief from their mental anguish
  • Threatening to kill one's self

If your teenager displays any of these behaviors, you should seek help from a mental healthcare professional immediately. Or you can call a suicide hotline for help.

Depression carries a high risk of suicide. Anybody who expresses suicidal thoughts or intentions should be taken very, very seriously. Do not hesitate to call your local suicide hotline immediately. Call 1-800-SUICIDE (1-800-784-2433) or 1-800-273-TALK (1-800-273-8255).

What can parents do to alleviate teen depression?

Parenting teens can be very challenging. There are, though, some effective parenting and communication techniques you can use to help lower the stress level for your teenager:

  • When disciplining your teen, replace shame and punishment with positive reinforcement for good behavior. Shame and punishment can make an adolescent feel worthless and inadequate.
  • Allow your teenager to make mistakes. Overprotecting or making decisions for teens can be perceived as a lack of faith in their abilities. This can make them feel less confident.
  • Give your teen breathing room. Don't expect teens to do exactly as you say all of the time.
  • Do not force your teen down a path you wanted to follow. Avoid trying to relive your youth through your teen's activities and experiences.
  • If you suspect that your teen is depressed, take the time to listen to his or her concerns. Even if you don't think the problem is of real concern, remember that it may feel very real to someone who is growing up.
  • Keep the lines of communication open, even if your teen seems to want to withdraw.
  • Try to avoid telling your teen what to do. Instead, listen closely and you may discover more about the issues causing the problems.
  • If there is a close friend or family member your teen is close to and comfortable with, you might suggest your teen talk with this person about his or her concerns.

If you feel overwhelmed or unable to reach your teen, or if you continue to be concerned, seek help from a qualified health care professional.

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Can't teen depression go away without medical treatment?

Teen depression tends to come and go in episodes. Once a teenager has one bout of depression, he or she is likely to get depressed again at some point. The consequence of letting teen depression go untreated can be extremely serious and even deadly.

WebMD Medical Reference Reviewed by Amita Shroff, MD on March 22, 2016

Sources

SOURCES:

National Institute of Mental Health: "What is Depression?"

Food and Drug Administration: "The Lowdown on Depression."

Mental Health America: "Factsheet: Depression in Teens."

Medline Plus: "Adolescent Depression."

ParentsMedGuide.org: "The Use of Medication in Treating Childhood and Adolescent Depression: Information for Patients and Families."

SAMHSA: "Major Depression in Children and Adolescents."

Medline Plus: "Teen Mental Health."

American Psychiatric Association, Practice Guideline for the Treatment of Patients with Major Depression, 2000.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR, American Psychiatric Pub, 2000.

Fieve, R. Bipolar II, Rodale Books, 2006.

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