Today’s teenagers are subject to many pressures that we as parents, will never understand. The teen years are difficult regardless of when you grew up, but teens now experience far more pressure to succeed academically and feel pressured by parents to do more, and be more. Aside from that, the increasing presence of technology in recent decades, specifically the prevalence of social media and texting, has a powerful influence on teens and has caused an increase in teen depression.

Though social media was intended to help connect people, and for older generations, it does, but for teens, social media creates feelings of isolation and depression. With teens spending so much time online and so little time interacting with family and friends face-to-face, they are at serious risk of not developing the authentic relationships that are vital to social development. With all of this, it is no wonder that teen depression is on the rise.

Depression, by definition, is a feeling that extends beyond sadness and general discord and gets to the point of illness that makes it hard for the sufferer to function. Unfortunately, depression affects approximately 20% of adolescents before they reach adulthood. While more females than males have indicated the presence of a depressive episode, the amount of teens between the ages of 12 – 17 dealing with depression has risen as a whole.

Unfortunately, not all cases of depression are well documented across the country, partially because of the sad fact that knowledge of depression and other mental health conditions is not where medical practitioners believe it should be. But, in reviewing the number of calls to the Substance Abuse and Mental Health Services Administration (SAMHSA) hotline, calls have been increasing year over year.

In the first quarter of 2018, the hotline had received an average of 68,683 calls per month, an increase of 1% compared to the number of calls received during the same quarter in 2017. This rise in the rate of teen depression in the United States is both alarming and worrisome, to say the least.

The causes of depression in today’s teens

Unfortunately, depression in teens does not really have a single definitive cause. Teens suffering from depression, however, do have a number of biological, psychological, and environmental risk factors that contribute to its development. Biologically, depression is associated with a reduced level of serotonin in the brain and with a shortcoming of norepinephrine.

Depression is associated with a decrease in the size of some areas of the brain, as well as increased activity in other areas of the brain. It is also believed that there is a partially genetic contribution to the development of depression as children and adolescents with parents that suffer from depression are four times more susceptible to developing depression themselves.

Teens who develop depression are more likely to have experienced other biological challenges, such as low birth weight, insomnia, and being the child of a teenage parent (mother was under age 18 at the time of birth).

The above all said, it is believed that the following psychological factors for depression include:

  • Low self-esteem
  • Poor body image
  • Self-critical behavior
  • Inability or helplessness in dealing with challenging situations

Teen depression, as well as generalized mood disorders, are often associated with the stress of body changes, including the rising and falling hormones of puberty, and teen ambivalence towards increasing independence. Further, teen depression is often linked with changes in their relationships with parents, friends, classmates, and others.

Teenagers who suffer from clinical anxiety, conduct disorder, attention deficit hyperactivity disorder (ADHD), or who have cognitive and learning problems, as well as trouble socializing with or relating to others are at higher risk of also developing depression.

In some cases, depression can be a reaction to environmental stresses, such as verbal, physical, or sexual abuse, the death of a loved one or friend, academic challenges, or being the victim of bullying or cyberbullying, or peer pressure. Gay, bisexual, and transgender teens are at higher risk for depression than heterosexual teens, possibly because of bullying by peers and potential rejection by family members, friends, and classmates. Teens in military families are at risk of experiencing depression, as well.

How to recognize if your teen may be suffering from depression

As a parent, while it might feel natural to let your teen hide out in their room for hours on end, or balk at the idea of hanging out with family because they are just teenagers, there are certain extreme behaviors that need to be taken seriously. Clinical depression, which is often referred to as major depression, is the presence of sadness that lasts for more than one to two days before feelings start to improve.

However, in true depressive situations and illnesses, the symptoms last for more than just a couple of days. In these cases, the sadness can last for weeks, months, or sometimes years if no treatment is received. In most cases, depression can result in the teen being unable to perform their daily activities. Even simple activities like getting out of bed, going to work, running an errand, or hanging out with friends can be simply too much. 

If your teen (or anyone in your family, regardless of age) is demonstrating a depressed or irritable disposition for at least two weeks and shows at least five of the following symptoms, it is critical to seek help:

  • Feeling extremely sad or blue
  • Frequent crying spells
  • Loss of interest in activities that would normally interest them
  • A significant decrease (or increase) in appetite
  • Unexplained and significant weight loss 
  • Failing to gain weight as appropriate, or gaining an excessive amount of weight
  • Change in sleep patterns including insomnia or excessive sleeping
  • Fatigue or loss of energy
  • Quick to anger
  • Excessive irritability
  • Chosen isolation from friends and family
  • Difficulty concentrating on daily activities or school work
  • Feelings of worthlessness or excessive guilt
  • Feelings that they would be better off dead 
  • Attempts at suicide 

For teens, in particular, they might also show poor academic performance (uncharacteristic for them), persistent boredom, complaints of headaches and stomachaches, engaging in self-harm (cutting or burning), and a lack of concern for their own safety.

Conversation | Teen Depression | Hillcrest ATC

Treatment for teen depression

If your teen is exhibiting the behaviors as outlined above, it is important to schedule an appointment for your teen with their physician, as soon as possible. At the appointment, your physician will most likely conduct the following tests:

  • The doctor may do a physical exam and ask pretty deep questions about your teen’s health to actuate what may be causing the depression. In some cases, depression may be tied to an underlying physical health problem, and your doctor will want to identify that possibility as soon as possible so that treatment can be undertaken.
  • Your teen’s doctor may do a blood test called a complete blood count or may test your teen’s thyroid to make sure it’s functioning as it should.
  • A doctor or mental health professional will conduct a psychological evaluation, by talking to your teen about their thoughts, feelings, and behaviors. They will likely ask your teen a series of questions, and the answers will help identify a diagnosis so that the doctor can check for related complications.

The specific treatment or course of action will depend on the type of depression, and the severity of your teen’s symptoms. In most cases, treatment will include a combination of psychotherapy (talk therapy) and medication. In extreme cases and in situations where your team is at risk of suicide or has engaged in self-harm, the doctor may suggest a hospital stay or participation in an outpatient treatment program until symptoms improve.

Understanding the types of depression

After your teen receives a diagnosis, you may have trouble trying to understand the type of depression your teen has. Because symptoms of depression vary from person to person, your doctor may provide a diagnosis of depression with the presence of one of several specifiers. Examples of these specifiers may include anxious distress, melancholic features, and atypical features, among others. However, the main types of depression are outlined below:

  • Major depressive disorder (MDD) – If your teen experiences most of the symptoms listed earlier in this article, for more than two weeks, they will most often be determined to have MDD.
  • Persistent depressive disorder – Dysthymia, more modernly referred to as persistent depressive disorder, is a category of chronic depression that occurs for the majority of days for two or more years. It can be mild, moderate, or severe.
  • Bipolar disorder – This is a mood disorder that is associated with abnormally elevated moods (mania) combined with depressed mood and diminished interest in activities. The manic periods can sometimes be quite extreme which can cause the need for hospitalization. Physical and emotional symptoms of those with bipolar disorder include fatigue, insomnia, and lethargy, unexplained aches and pains, hopelessness and low or no self-esteem, anxiety and irritability, and indecision and disorganization.
  • Postpartum depression – While this is far less likely for teens unless they have recently given birth, postpartum depression can begin during pregnancy, but usually presents itself shortly after birth.
  • Premenstrual dysphoric disorder (PMDD) – PMDD produces similar symptoms to PMS, but those related to mood are more pronounced. Symptoms include extreme fatigue, feeling sad or hopeless, severe feelings of stress or anxiety, mood swings, irritability, inability to concentrate, and food cravings. 
  • Seasonal affective disorder (SAD) – While SAD is more common in the northern or far southern regions of the planet and can often be treated with light therapy to offset the seasonal loss the daylight, teens can be quite susceptible, especially if they do not spend much time socializing outdoors. SAD is triggered by a disturbance in the normal circadian rhythm of the body. The light coming in through the eyes impacts this rhythm, and any seasonal disparity in night and day patterns can cause an interruption leading to depression.

How can parents support their teens through depression

If your teen is battling depression, you as a parent may feel confused, worried, and unsure how to help. It is not unnatural to question your parenting as part of the process. But it is important to understand that sometimes, despite the best intentions of parents, children are more prone to depression than are others. The biggest thing that you can do as a parent is to support your teen through their treatment and recovery.

  • Be supportive – Take this time of treatment and recovery to strengthen your relationship with your teen. Build empathy and understanding by taking a moment to put yourself in their shoes, and try to see the world the way they see it. This will help your teen to associate with you more, as will validating their emotions. 
  • Focus on the positive – Be sure to notice the great things that your teen is doing, and focus on those, versus verbally calling out the areas of opportunity. If your teen is getting up on time, going to school, holding a part-time job, or any combination of the above, these activities and occurrences should be celebrated. Accept these behaviors for what they are, and avoid falling into the trap of thinking that these behaviors are what they should have been exhibiting all along. Everyone and anyone can benefit from the appreciation of a job well done, even if it was expected of them.

Supporting your teen through their depression, treatment, and recovery, will not be easy. It is important for parents too to seek help, and many parents find that therapy and counseling that they partake in on a parallel path to their teen’s treatment, can be especially helpful. Understand both for you and your teen that depression is not who your teen is overall, and that they do have the ability to get well. You as a parent, have the ability to love and support them through it, free of guilt and judgment.

When teens feel that they are not heard, or if they feel that their parental figures do not understand or respect what they are going through, their treatment can be severely hindered. Teens will be far more successful when they know that their parents are rooting for their success from the sidelines.

If your teen is struggling with teen depression, reach out to a facility like Hillcrest ATC for a consultation.