Many of us think of teen years as moody, turbulent ones. While it is true that most teenagers have emotional ups and downs, recent research suggests that such moodiness isn't necessarily a normal part of the teen years. In fact, teens who seem sad or down for more than a few weeks may actually be experiencing depression. It is estimated that between 11 percent and 14 percent of adolescents are clinically depressed. Don’t ignore behavior changes or write them off as phases of adolescence. If you notice any of the following symptoms, consider the possibility that the teen may be depressed and try to get help.

Signs and Symptoms

Teens' families and friends may be the first to notice the warning signs of depression.

A depressed teenager may:

• Seem very sad or cry frequently.
• Become more angry, irritable, or hostile.
• Begin or increase their use of drugs and alcohol.
• Become obsessed with poetry or music with morbid themes.
• Lose interest in things that were previously enjoyed, become apathetic, or drop out of sports or other activities.
• Feel a sense of hopelessness, that life is not worth living, or that nothing will ever change.
• Miss school frequently or begin to do worse in school.
• Be bored all the time, or seem unable to concentrate on schoolwork, a conversation, or even watching TV.
• Attempt to isolate themselves from friends and family members with whom they used to share their feelings.
• Be supersensitive to criticism or rejection.
• Complain of headaches, stomachaches, or other physical problems frequently.
• Eat or sleep much more or less than usual.
• Talk about or try to run away from home.
• Mention thinking about suicide.

Understanding Depression

• Depression is a serious mental illness, caused by a combination of biological, psychological, and environmental factors.
• Depression is more than just feeling down or sad for a day or two; it is a persistent and deep state of unhappiness, lack of interest in life and activities, and low energy or boredom.
• Depression is a major risk factor for suicide.
• Treatment for depression is very effective, but many teens are not diagnosed and, therefore, suffer treated.
• In Virginia, depression is the leading cause of hospitalization for children ages 10 to 14 and the second leading cause for adolescents ages 15 to 19.
• Suicide is the third leading cause of death for adolescents in the commonwealth.
• Teens under stress, those who experience loss, or who have Attention Deficit/Hyperactivity Disorder (ADHD) or conduct or anxiety disorders are at higher risk. Teenage girls and minorities are also at greater risk.
• Teens questioning their sexual orientation are at particular risk for suicide.
• Teens who live in adoptive families may also be at higher risk for suicide.
• Most teens that have one episode of depression will have more at some point later in life.

What can you do?

Depressed teens seldom recognize their need for treatment. For this reason, parents, friends, educators, and others involved with teens are the best hope depressed teens have of getting help. The risk of suicide associated with depression makes this illness a life-threatening one that demands immediate professional attention. Take a teen's talk of suicide seriously! If you see any of the above symptoms, here's how you can help:

• Pay attention. If you live with, teach, or mentor a teen, you are one of the people who are most likely to notice signs of depression. It's up to you to take appropriate action.
• Talk with the teen. A first step is to talk with the teen, to let him or her know that you've noticed the change in behavior, and to offer to listen. Tell the teen that you're concerned and that you'd like to help.
• Share your information with others. Compare notes with others who are in contact with the teen. Are they seeing the same behavior changes?
• Learn about resources in your area. Let the teen know that there is treatment for depression that works. Find out about the mental health resources available in your area. A professional therapist can recommend the right treatment combination. This could include diet, exercise, and sleep modifications, or medication combined with counseling. Offer to make an appointment and accompany the teen to his or her first visit.
• Stay involved. Stress to the teen that he doesn't have to feel this way, and that he doesn't have to go through it alone. Teens need your involvement and your support.

References

Crowe, M., Ward, N., Dunnachie, B., and Roberts, Morian. 2006. Characteristics of adolescent depression. International Journal of Mental Health Nursing, 15, 10-18.

Hankin, B. 2006. Adolescent depression: Description, causes, and interventions. Epilepsy & Behavior, 8, 102-114.

Hess, S., Cox, T., Gonzales, L., Kastelic, E., Mond, S., Rose, L., and Swartz. K. 2004. A Survey of Adolescents’ Knowledge about Depression. Archives of Psychiatric Nursing, 18 (5), 223-234.

Keenan-Miller, D., Hammen, C., and Brennan, P. 2007. Health outcomes related to early adolescent depression. Journal of Adolescent Health, 41, 256-262.

Resources

The National Institute of Mental Health http://www.nimh.nih.gov/health/topics/depression/depression-in-children-and-adolescents.shtml

The National Alliance for the Mentally Ill (NAMI), 1-800-950-NAMI www.nami.org

The Depression and Related Affective Disorders Association www.med.jhu.edu/drada/

Psychology Information Online www.psychologyinfo.com

Virginia Department of Health (1998). An assessment of child and adolescent hospitalizations in Virginia. Richmond VA.

Original publication by Erin Morgan, Research Associate, Human Development; and Angela Huebner, Assistant Professor and Extension Specialist, Human Development; Virginia Tech.

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• Erin Morgan
• Angela Huebner

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