What to Know: Helping a Depressed Teenager | BrainsWay

Teenagers and Depression

Approximately 4.1 million teenagers had at least one episode of depression in 2020, representing 12% of the U.S. population 12 to 17 years old. Unfortunately, depression is not evenly spread among youth in this age group. Physical changes in puberty, inequalities, and social pressures contribute to more identified depression among females (25.2%) and those with a mixed racial background (29%).

Depressed teenagers also display symptoms that adults may easily misinterpret. Poor grades, an irritable mood, and staying up late into the night may look like signs of rebellion or misbehavior. However, these are hallmark signs of depression in teenagers, and missing these symptoms could result in undiagnosed cases.

Read on to review the signs and causes of depression in teenagers. Then examine essential differences between adult and teenage depression. Finally, understand how depression treatment for teenagers can help.Teenagers and Depression

Understanding Depression in Teenagers

While this developmental stage is known for its emotional ups and downs, experiencing the overwhelming pains of an official major depressive disorder as a teenager is not a normal part of growing up.

Teenagers are prone to quick mood changes, a sign they are transitioning from childhood to new dimensions of emotional maturity. However, true depression is sometimes mistaken for typical moodiness, and adults who notice the differences can recognize teenagers who need help.

What Are the Signs of Depression in Teenagers?

To be diagnosed with depression, teenagers must first meet two essential symptom criteria occurring for the past two weeks:

  • Pervasive low mood OR irritable mood.
  • Loss of interest in pleasurable activities, inability to feel pleasure.

Additionally, they must report at least three other symptoms, such as:

  • Cognitive Symptoms: Trouble concentrating, making decisions, remembering things, thoughts of suicide, and thoughts of death.
  • Emotional Symptoms: Hopelessness, sadness, irritability, emptiness, and worthlessness.
  • Behavioral Symptoms: Tearfulness, fatigue, slow speaking, or body movements, insomnia, appetite and weight changes, unexplained back aches, or headaches.

Depression symptoms must be significant enough to interfere with daily functioning, such as poor grades and attendance at school, ignoring home responsibilities, problems at work, or withdrawing from social interactions.

What Causes Depression in Teenagers?

The exact causes of depression are uncertain, but many risk factors may increase the chance of developing it for some teenagers, including:

  • Personal attributes more closely linked with a risk of depression, such as introversion, underdeveloped social skills, early puberty, or a rebellious attitude.
  • Family history of depression. Additionally, family history and loss of energy occurring together may be correlated with a genetic risk for depression.
  • Stressful childhood events. Experiencing trauma during childhood, such as abuse or neglect, can create changes in the brain that make depression more likely.
  • Genetic and environmental effects. One study indicates that during adolescence, the influence of genetics and environment are similar. As teenagers mature into adults, genetic factors play a more prominent role.

How Depression in Teenagers Differs from Adult Depression

While major depression in teens is essentially the same disorder as adults, perhaps considered an early onset of adult depression, there are notable differences in symptom presentation.

The American Psychiatric Association’s (APA’s) Diagnostic and Statistical Manual of Mental Health Disorders, 5th Edition (DSM-V) allows for irritability to present as a core symptom instead of a low mood. Interestingly, there is no consensus about irritability being a base symptom of depression among teenagers. In fact, one study found that irritability was no more common for teens than for adults. This difference in observation reveals the importance of a greater awareness of the spectrum of depression symptoms rather than relying on core symptoms alone.

All symptoms of depression can occur in both adults and adolescents, but symptom presentation does not look the same for all individuals or age groups. Some symptoms appear more commonly in teenage depression than in adult depression. Also, some symptoms may be correlated with more severe cases of teenage depression.

Symptoms Common to Adults and Adolescents

Some symptoms of depression appear about as often for adults as they do for adolescents, such as feelings of worthlessness and a low mood. And although an irritable mood can be considered a core symptom for adolescents, one study found that low mood is almost always present, with or without irritability.

Somatic Symptoms More Common Among Teenagers

The same resource mentioned above found that several somatic or physical symptoms were most frequently observed in adolescents with depression. Insomnia was highly indicative of depression, as well as appetite and weight changes, and fatigue. These are sometimes known as vegetative symptoms of depression.

In contrast, symptoms such as lack of concentration, excessive sleeping, and anhedonia (lack of feeling pleasure) were less prominent for adolescents and more often associated with adult depression.

teenage depression

Symptomatology and Overall Depression Severity

Researchers have found correlations between symptomatology and overall depression severity. While the reasons behind this are unclear, it brings to light the value of understanding the nuances of depression presentation. Some of the key findings include these associations:

  • Sleep problems with more prominent emotional and cognitive symptoms: Less severe depression.
  • Weight and appetite changes, psychomotor symptoms, suicidality: More severe depression.

The main takeaway from these observations is that when watching for potential teenage depression, a low mood is not the only key indicator. Vegetative symptoms (weight/appetite changes, low energy, insomnia) are significantly linked with teenage depression, and overlooking these symptoms may result in untreated disorders.

How to Help Depressed Teenagers

Adolescents who get help and support with their depression can learn to manage their symptoms and recover. Here are several ways to help teenagers rebound from depression.

Maintaining Healthy Daily Routines

Teenagers coping with depression may have difficulty with insomnia and appetite changes. Still, parents and other adults can support healthy routines at home and school to encourage recovery. As teenagers’ symptoms improve over time, routines promote opportunities for adequate rest, physical activity, and regular meals.

Therapy for Teenage Depression

Cognitive Behavioral Therapy (CBT) is a talk therapy that addresses the interaction of emotions, thoughts, and behaviors and is effective for depression in teenagers. Results for long-term improvement are better when CBT involves behavioral activation components, the intentional use of behaviors and activities to influence mood.

Interpersonal Therapy (IPT) focuses on how depression symptoms impact relationships, understanding that attachment and effective communication are linked with healthy psychological functioning. One research review found that adolescents experienced significant improvements in depression symptoms and general functioning from interpersonal therapy.

Medication

While new studies on antidepressants for adolescents are few in number, a large research review from 2020 thoroughly addressed safety and efficacy findings. This study indicated that selective-serotonin reuptake inhibitors (SSRIs) are effective and better tolerated in adolescents than selective-norepinephrine reuptake inhibitors (SNRIs). While suicidality is likely driven by multiple factors, its association with SNRIs means that SSRIs are recommended as the primary antidepressant choice.

Peer Support Groups

As teenagers mature, they shift away from the family unit and lean on their peers more often. Learning to give and receive support from peers can be especially meaningful for teenagers with depression. While few studies have adequately explored the benefits in detail, in-person and online peer support is a popular option and may support better mental health outcomes.

Reaching Out: Helping Teenagers with Depression

Teenage depression is disruptive and painful, but may not always appear like a sad mood, as it often does with adults. Learning key differences between adult and teenage depression can make it easier to reach out and help young individuals in need.