Teen Depression Symptoms

By PSYCH CENTRAL STAFF and Jane Framingham Ph.D

Teen Depression Symptoms

Teenagers experience depression in a manner very similar to adults, but they may experience their emotions more intensely and with greater volatility. Feeling down about a relationship issue or an upcoming exam is normal. Feeling down for months at a time for no particular reason, however, may be a sign of undiagnosed depression.

Teen depression is a serious issue, but can be helped when you know the symptoms. Though the term “depression” can describe a normal human emotion, it also can refer to a mental disorder. Depressive illness in teenagers is defined when the feelings of depression persist and interfere with the teen’s ability to function.

Depression is fairly common in teens and younger children. About 5 percent of children and adolescents in the general population suffer from depression at any given point in time. Teens under stress, who experience loss, or who have attentional, learning, conduct or anxiety disorders are at a higher risk for depression. Teenage girls are at especially high risk, as are minority youth.

Depressed youth often have problems at home. In many cases, the parents are depressed, as depression tends to run in families. Over the past 50 years, depression has become more common and is now recognized at increasingly younger ages. As the rate of depression rises, so does the teen suicide rate.

It is important to remember that the behavior of depressed children and teenagers may differ from the behavior of depressed adults. The characteristics vary, with most children and teens having additional psychiatric disorders, such as behavior disorders or substance abuse problems.

The following are some of the most common symptoms of teenage depression. These symptoms don’t directly correspond to symptoms of major depression, but they’re similar. A teenager who meets some of the following will often qualify for a diagnosis of major depression.

  • Frequent sadness, tearfulness, crying
    Teens may show their pervasive sadness by wearing black clothes, writing poetry with morbid themes, or having a preoccupation with music that has nihilistic themes. They may cry for no apparent reason.
  • Hopelessness
    Teens may feel that life is not worth living or worth the effort to even maintain their appearance or hygiene. They may believe that a negative situation will never change and be pessimistic about their future.
  • Decreased interest in activities; or inability to enjoy previously favorite activities
    Teens may become apathetic and drop out of clubs, sports, and other activities they once enjoyed. Not much seems fun anymore to the depressed teen.
  • Persistent boredom; low energy
    Lack of motivation and lowered energy level is reflected by missed classes or not going to school. A drop in grade averages can be equated with loss of concentration and slowed thinking.
  • Social isolation, poor communication
    There is a lack of connection with friends and family. Teens may avoid family gatherings and events. Teens who used to spend a lot of time with friends may now spend most of their time alone and without interests. Teens may not share their feelings with others, believing that they are alone in the world and no one is listening to them or even cares about them.
  • Low self esteem and guilt
    Teens may assume blame for negative events or circumstances. They may feel like a failure and have negative views about their competence and self-worth. They feel as if they are not “good enough.”
  • Extreme sensitivity to rejection or failure
    Believing that they are unworthy, depressed teens become even more depressed with every supposed rejection or perceived lack of success.
  • Increased irritability, anger, or hostility
    Depressed teens are often irritable, taking out most of their anger on their family. They may attack others by being critical, sarcastic, or abusive. They may feel they must reject their family before their family rejects them.
  • Difficulty with relationships
    Teens may suddenly have no interest in maintaining friendships. They’ll stop calling and visiting their friends.
  • Frequent complaints of physical illnesses, such as headaches and stomachaches
    Teens may complain about lightheadedness or dizziness, being nauseous, and back pain. Other common complaints include headaches, stomachaches, vomiting, and menstrual problems.
  • Frequent absences from school or poor performance in school
    Children and teens who cause trouble at home or at school may actually be depressed but not know it. Because the child may not always seem sad, parents and teachers may not realize that the behavior problem is a sign of depression.
  • Poor concentration
    Teens may have trouble concentrating on schoolwork, following a conversation, or even watching television.
  • A major change in eating or sleeping patterns
    Sleep disturbance may show up as all-night television watching, difficulty in getting up for school, or sleeping during the day. Loss of appetite may become anorexia or bulimia. Eating too much may result in weight gain and obesity.
  • Talk of or efforts to run away from home
    Running away is usually a cry for help. This may be the first time the parents realize that their child has a problem and needs help.
  • Thoughts or expressions of suicide or self-destructive behavior
    Teens who are depressed may say they want to be dead or may talk about suicide. Depressed children and teens are at increased risk for committing suicide. If a child or teen says, “I want to kill myself,” or “I’m going to commit suicide,” always take the statement seriously and seek evaluation from a child and adolescent psychiatrist or other mental health professional.

People often feel uncomfortable talking about death. However, asking whether he or she is depressed or thinking about suicide can be helpful. Rather than “putting thoughts in the child’s head,” such a question will provide assurance that somebody cares and will give the young person the chance to talk about problems.

  • Alcohol and Drug Abuse
    Depressed teens may abuse alcohol or other drugs as a way to feel better.
  • Self-Injury
    Teens who have difficulty talking about their feelings may show their emotional tension, physical discomfort, pain and low self-esteem with self-injurious behaviors, such as cutting.
4 Facts About Teen Depression and How Parents Can Help

By MARGARITA TARTAKOVSKY, M.S. (from PsychCentral.com)

Teens are known for being a moody, rebellious, egocentric and emotional bunch. But while this is normal adolescent behavior, depression is a real disorder that affects one in 20 teens (point prevalence statistic from Essau & Dobson, 1999).

According to Michael Strober, Ph.D, clinical psychologist and senior consultant to the Pediatric Mood Disorders Program at the UCLA Neuropsychiatric Institute and Hospital, depression in teens is “a serious mental health problem” which isn’t necessarily temporary. “Depression can linger for months and a significant number of young people can have a recurrence,” he said.

Here, Dr. Strober along with Alice Rubenstein, Ed.D, a clinical psychologist in private practice who treats teens, dole out the facts about this commonly misunderstood disorder.

  1. Depression goes beyond moodiness.
    Temperamental teens are common. But moodiness doesn’t mean depression, Dr. Rubenstein said. Neither does sleeping a lot, which is typical for teens; they actually require more sleep than adults and have trouble falling asleep early. (See more on sleep in teens here.)So how do you know the difference between normal teenage doldrums and depression? Consider if there’s been “a real change in the functioning of [your] child’s behavior,” Strober said. You also might notice changes in appetite and sleep, poor school performance, an inability to concentrate, lack of interest and withdrawal from regular social activities.“Agitation and irritability in teens may be a sign of depression” as well, according to Rubenstein. However, research hasn’t shown the presence of increased agitation as a distinct symptom, Strober said.In general, look for consistent patterns. “If depression lasts more than two, certainly three weeks, you want to pay attention,” she said.
  2. There’s no quintessential face of depression.
    We tend to create categories and stereotypes around certain mental illnesses. That is, many people assume that teens with depression are troublemakers, loners, nerds or artsy types. But depression does not discriminate, Rubenstein noted. It affects all types of teens. (Depression does seem to affect girls twice as much as boys.)
  3. Comorbidity is common.
    Teens rarely just struggle with depression. “Depressive symptoms are part of a bigger picture,” Rubenstein said. For instance, anxietycommonly co-occurs with depression.In fact, in her private practice, Rubenstein has noticed more teens coming in with symptoms of anxiety largely because of the combination of academic pressures and attempts to balance school with sports (or other extracurricular activities) and social events. In other cases, depression may be the primary problem, but other disorders, like learning difficulties, still exist.
  4. Teen depression is treatable.
    Most people think that depression is difficult to treat, Rubenstein said, but treatments like cognitive-behavioral therapy (CBT) can help. According to Strober, research has found that CBT “should be considered as treatment for mild to moderate depression.” “Between four to six weeks, we can bring some relief,” Rubenstein said.There’s also some evidence that shows certain antidepressants are effective in teen depression. Fluoxetine (Prozac) has shown the most benefit, according to research, Strober said. If the antidepressant is helping, it’s recommended the teen take the medication for a year, he said. Whether medication is necessary “really depends on the seriousness and persistence [of depression].”When treating depression in teens, Rubenstein helps her clients create a toolbox to cope with life. Her first goal is to “actively do something that’s helpful to them…to give the message that I want to help you where it hurts.” She does this by finding out one change that will relieve the teen’s pain. For instance, if a teen is super stressed at school, dropping one class and picking it back up in the summer may be a reasonable option. In addition to empowering the client, she also lets them know that they can improve, that they don’t have to feel this way.

How Parents Can Help a Depressed Teen

Again, “Teens who are suffering from depression can be helped,” Rubenstein said, so it’s important to get them treatment. If you think your teen has depression, seek a psychologist who specializes in treating adolescents. It’s key to see an expert. As Rubenstein said, “you wouldn’t hire a plumber to put on your new roof.” Even if your teen doesn’t want to go to therapy or you haven’t discussed the option yet, an appointment is critical. A psychologist can educate you on depression (also consider checking out sources on your own), how to help and give you the tools you need.

Similarly, if medication is going to be considered as part of a treatment plan, try to find a psychiatrist who treats children and adolescents. Sometimes, psychologists and psychiatrists will work as a team. For instance, Rubenstein has worked with the same psychiatrist for years. A team approach is important. “This way everyone is on the same page,” she said. Also, your family doctor might be able to recommend a psychologist or psychiatrist.

Reference

Essau C., & Dobson K. (1999). Epidemiology of depressive disorders. In: Depressive Disorders in Children and Adolescents: Epidemiology, Course, and Treatment, Essau C, Petermann F, eds. Northvale, N.J.: Jason Aronson.

Children and Depression

By HAROLD COHEN, PH.D.

Not only adults become depressed. Children and teenagers also may have depression, which is a treatable illness. Depression is defined as an illness when the feelings of depression persist and interfere with a child or adolescent’s ability to function.

About 5 percent of children and adolescents in the general population suffer from depression at any given point in time. Children under stress, who experience loss, or who have attentional, learning, conduct or anxiety disorders are at a higher risk for depression. Depression also tends to run in families.

The behavior of depressed children and teenagers may differ from the behavior of depressed adults. Child and adolescent psychiatrists advise parents to be aware of signs of depression in their youngsters.

If one or more of these signs of depression persist, parents should seek help:

  • Frequent sadness, tearfulness, crying
  • Hopelessness
  • Decreased interest in activities; or inability to enjoy previously favorite activities
  • Persistent boredom; low energy
  • Social isolation, poor communication
  • Low self esteem and guilt
  • Extreme sensitivity to rejection or failure
  • Increased irritability, anger, or hostility
  • Difficulty with relationships
  • Frequent complaints of physical illnesses such as headaches and stomachaches
  • Frequent absences from school or poor performance in school
  • Poor concentration
  • A major change in eating and/or sleeping patterns
  • Talk of or efforts to run away from home
  • Thoughts or expressions of suicide or self destructive behavior

A child who used to play often with friends may now spend most of the time alone and without interests. Things that were once fun now bring little joy to the depressed child. Children and adolescents who are depressed may say they want to be dead or may talk about suicide. Depressed children and adolescents are at increased risk for committing suicide. Depressed adolescents may abuse alcohol or other drugs as a way to feel better.

Children and adolescents who cause trouble at home or at school may also be suffering from depression. Because the youngster may not always seem sad, parents and teachers may not realize that troublesome behavior is a sign of depression. When asked directly, these children can sometimes state they are unhappy or sad.

Early diagnosis and treatment are essential for depressed children. Depression is a real illness that requires professional help. Comprehensive treatment often includes both individual and family therapy. For example, cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) are forms of individual therapy shown to be effective in treating depression. Treatment may also include the use of antidepressant medication. For help, parents should ask their physician to refer them to a qualified mental health professional, who can diagnose and treat depression in children and teenagers.

Dating Basics

Relationships exist on a spectrum, from healthy to unhealthy to abusive — and everywhere in between. It can be hard to determine where your relationship falls, especially if you haven’t dated a lot. Explore this section to learn the basics of dating, healthy relationships and drawing the line before abuse starts.

Is My Relationship Healthy?
In a healthy relationship:

  • Your partner respects you and your individuality.
  • You are both open and honest.
  • Your partner supports you and your choices even when they disagree with you.
  • Both of you have equal say and respected boundaries.
  • Your partner understands that you need to study or hang out with friends or family.
  • You can communicate your feelings without being afraid of negative consequences.
  • Both of you feel safe being open and honest.

A good partner is not excessively jealous and does not make you feel guilty when you spend time with family and friends. A good partner also compliments you, encourages you to achieve your goals and does not resent your accomplishments.

My Partner Doesn’t Physically Hurt Me

Just because there is no physical abuse in your relationship doesn’t mean it’s healthy. It’s not healthy if your partner:

  • Is inconsiderate, disrespectful or distrustful.
  • Doesn’t communicate their feelings.
  • Tries to emotionally or financially control you by placing your money in their banking account.
  • Keeps you from getting a job or gets you fired.
  • Humiliates you on Facebook or in front of your friends.
  • Threatens to out you to your family.

So, Is My Relationship Unhealthy?

Everybody deserves to be in a healthy relationship free from violence. Drawing the line between unhealthy and abusive can be hard. If you think your relationship is going in the wrong direction, check out the warning signs of abuse.

Remember, there are many types of abuse and while you may think some of them are normal — they are not. Even though teen and 20-something relationships may be different from adult ones, young people do experience the same types of physical, sexual, verbal and emotional abuse that adults do. You should take violence in your relationship seriously.

If you think are in an abusive relationship, you’re probably feeling confused about what to do. You may fear what your partner will do if you leave or how your friends and family will react when you tell them. If you are financially or physically dependent on your partner, leaving may feel impossible. You may also think that the police and other adults won’t take you seriously.

These are all understandable reasons to feel nervous about leaving your partner, but staying in the abusive relationship isn’t your only option. Learn more about your options for staying safe.

Social Networking Safety

You deserve to be in a safe and healthy relationship, whether in person or online. If your partner is digitally abusive,know their behavior is not acceptable and could be illegal. Check out our tips below for staying safe on social networking sites like Facebook, Twitter, foursquare and others.

  • Only post things you want the public to see or know. Once it’s online, it’s no longer under your control.
  • Be protective of your personal information. Your phone numbers and addresses enable people to contact you directly, and things like your birth date, the schools you attended, your employer and photos with landmarks may make it easier for someone to find where you live, hang out or go to school.
  • Set boundaries and limits. Tell people not to post personal information, negative comments or check-ins about you on social media. Ask people not to post or tag pictures if you’re not comfortable with it.
  • You can keep your passwords private — sharing passwords is not a requirement of being in a relationship.
  • Don’t do or say anything online you wouldn’t in person. It may seem easier to express yourself when you are not face-to-face, but online communication can have real-life negative consequences.

Abuse or Harassment

  • Don’t respond to harassing, abusive or inappropriate comments. It won’t make the person stop and it could get you in trouble or even put you in danger.
  • Keep a record of all harassing messages, posts and comments in case you decide to tell the police or get arestraining order.
  • Always report inappropriate behavior to the site administrators.

Leaving an Abusive Relationship

  • If you are leaving an unhealthy relationship, start by blocking your ex on Facebook and other social networking pages. We recommend you don’t check-in on foursquare or other location-based sites or apps — you don’t want your ex or their friends tracking your movements.
  • Adjust your privacy settings to reduce the amount of information that particular people can see on your page. Privacy settings on sites like Facebook allow the user to control how their information is shared and who has access to it. Remember, registering for some apps require you to change your privacy settings.
  • Avoid posting private details on your friend’s pages. They may not have appropriate settings and doing so may allow someone to see your movements and location. The same goes for tagging yourself in pictures.
  • Consider what is called a “super-logoff” — deactivating your Facebook account every time you log off and reactivating it every time you log back on. This way, no one can post on your wall, tag you or see your content when you’re offline, but you still have all of your friends, wall posts, photos, etc. when you log back on.
  • While it is inconvenient and may seem extreme, disabling you social networking page entirely may be your best option to stop continued abuse or harassment.

Your Friends’ Safety

If your friend is in an unhealthy or abusive relationship, be careful what you post about them. Pictures, locations, check-ins — even simple statements can be used to control or hurt them. If you’re unsure of what’s ok to post, get your friend’s permission before you click “Share.”

What Should I Look for in a Boy/Girlfriend?

Relationships require respect, trust and open communication. Whether you’re looking for a relationship or are already in one, make sure you and your partner agree on what makes a relationship healthy. It’s not always easy, but you can build a healthy relationship. Look for someone who will:

  • Treat you with respect.
  • Doesn’t make fun of things you like or want to do.
  • Never puts you down.
  • Doesn’t get angry if you spend time with your friends or family.
  • Listens to your ideas and comprises sometimes.
  • Isn’t excessively negative.
  • Shares some of your interests such as movies, sports, reading, dancing or music.
  • Isn’t afraid to share their thoughts and feelings.
  • Is comfortable around your friends and family.
  • Is proud of your accomplishments and successes.
  • Respects your boundaries and does not abuse technology.
  • Doesn’t require you to “check in” or need to know where you are all the time.
  • Is caring and honest.
  • Doesn’t pressure you to do things that you don’t want to do.
  • Doesn’t constantly accuse you of cheating or being unfaithful.
  • Encourages you to do well in school or at work.
  • Doesn’t threaten you or make you feel scared.
  • Understands the importance of healthy relationships.

Remember that a relationship consists of two people. Both you and your partner should have equal say and should never be afraid to express how you feel. It’s not just about speaking up for yourself — you should also listen and seriously consider what your partner says.

Every relationship has arguments and disagreements sometimes — this is normal. How you choose to deal with your disagreements is what really counts. Both people should work hard to communicate effectively.

Am I a Good Boy/Girlfriend? Text-only Quiz

Are you a good boyfriend or girlfriend? Answer yes or no to the following questions to find out. Make sure to write down your responses. At the end, you’ll find out how to score your answers.

Do I…

  1. Forget to thank my partner when they do something nice for me?
  2. Ignore my partner’s calls if I don’t feel like talking?
  3. Get jealous when my partner makes a new friend?
  4. Have trouble making time to listen to my partner when something is bothering them?
  5. Discourage my partner from trying something new like joining a club?
  6. Call, text or drive by my partner’s house a lot?
  7. Get upset when my partner wants to hang out with their friends or family?
  8. Make fun of my partner or call them names?
  9. Criticize my partner for their taste in music or clothing?
  10. Make fun of my partner’s appearance?
  11. Accuse my partner of flirting or cheating even if I’m not sure that’s what happened?
  12. Take out my frustrations on my partner, like snapping at them or giving them attitude?
  13. Throw things if I’m mad at my partner or do things like hit walls or drive dangerously?
  14. Read my partner’s texts or go through their personal things, like their wallet or purse?
  15. Tell my partner they are the reason for my bad mood even if they aren’t?
  16. Try to make my partner feel guilty about things they have no control over?
  17. Sometimes say things to my partner knowing that they are hurtful?
  18. Make my partner feel bad about something nice they did for me that I didn’t like, even though I know they tried their best?
  19. Talk down to or embarrass my partner in front of others?
  20. Have sex with my partner even if I think they don’t want to go that far?

Scoring – So Are You A Good Boyfriend/Girlfriend?

Give yourself one point for every “Yes” you answered to questions one through four and five points for all “Yes” answers to numbers 5-20. Don’t give yourself any points for any “No” answers.

Now that you’re finished and have your score, the next step is to find out what it means. Simply take your total score and see which of the categories below apply to you.

  • Score: 0 Points
    If you got zero points, congratulations! You make a good boyfriend/girlfriend! It sounds like you’re very mindful of your actions and respectful of your partner’s feelings — these are the building blocks of a healthy relationship. Keeping things on a good track takes work, so stay with it! As long as you and your partner continue like this, your relationship should grow in a healthy direction.
  • Score: 1-2 Points
    If you scored one or two points, there may be a couple of things in your relationship that could use a little attention. Nobody is perfect, but it is important to be mindful of your actions and try to avoid hurting your partner. Remember, communication is key to building a healthy relationship!
  • Score: 3-4 Points
    If you scored three or four points, it’s possible that some of your actions may hurt your partner and relationship. While the behaviors may not be abusive, they can worsen over time if you don’t change. Read about the differenttypes of abuse, so that you can keep your relationship safe and healthy.
  • Score: 5 Points or More
    If you scored five or more points, some of your actions may be abusive. You may not realize it, but these behaviors are damaging. The first step to improving your relationship is becoming aware of your unhealthy actions and admitting they are wrong. It’s important to take responsibility for the problem and get help to end it. An unhealthy pattern is hard to change, so chat with a peer advocate for more information on how to get help.

Take the Dating Pledge

Take the pledge and promise to have healthy, safe relationships free from violence and free from fear. Then, share it with your partners, friends and family because everyone has the right to a healthy relationship!

I, (fill in name), promise myself, future and current partners to maintain relationships that are based on respect, equality, trust and honest communication. I will value my partner’s boundaries online and behind closed doors. I will never engage in any type of abuse — physical, emotional, sexual, financial or digital.

If one of my friends experiences abuse, I pledge to help them by saying something, modeling healthy communication and connecting them to resources.

I pledge to remember, demonstrate and promote the fact that love is respect.

Sex and Healthy Relationships

In a healthy relationship, both parties are ready and feel comfortable with sexual activity. You shouldn’t have to have sex to keep your boyfriend or girlfriend. You may feel comfortable kissing or holding hands, but not want to go any further. That’s ok.

Deciding whether you want to have sex or when you should is a decision you should make when it feels right for YOU. In a healthy relationship, your boyfriend or girlfriend respects your decisions — even when they don’t like them.

If you are thinking about when to have sex, keep in mind:

  • You should feel comfortable with your decision.
  • Talk with your partner about safe sex practices, like getting tested for STIs and considering birth control options.
  • Be honest with yourself and your partner. If you’re not ready, that’s ok and your partner should respect it.
  • If something scares you or makes you feel uncomfortable, you can say no at any time.
  • You have the right to talk openly and honestly about your fears, worries and feelings.
  • If your partner tries to threaten or pressure you into having sex, it can be a sign of an unhealthy relationship. You deserve better.
  • No matter how long you’ve been with someone or how many times you’ve done something, you have the right to say no at anytime for any reason.
  • If someone won’t take no for an answer and repeatedly pressures you verbally, emotionally or physically it can be a sign of abuse.
  • You have control over your body, and no one else has the right to tell you what to do with it.

Why is It So Complicated?

Having sex can raise the intensity of emotions that people feel for each other — whether you’re in a serious or casual relationship, At times, this elevation is a good and enjoyable thing, but sometimes it makes a hard situation worse. It’s important that you feel ready and confident in your decisions about having sex.

What is Sexual Abuse?

Sexual abuse is any type of unwanted sexual contact. Forcing or pressuring someone to do something they don’t want or don’t consent to is sexual assault. No one should ever take advantage of you sexually when you are asleep, intoxicated or under the influence of drugs. This can be a very serious and dangerous form of abuse. Learn more about sexual abuse and what to do if you experience it.