Teenage Depression: Causes, Symptoms And Solutions
sagari gongala 
Sandra came home feeling exhausted and sad. She had a good day at school. She scored the highest on the math test, but for some reason she was sad. She went to her room and crashed on the bed. Soon, tears started flowing, without her permission. She tried to stop but couldn’t. “Why do I feel this way?” she thought angrily.
She’d been asking herself that question a lot lately. Like many teenagers, Sandra was depressed but didn’t know it. Teen depression is an illness like any other and is treatable when addressed in time. Here, MomJunction gives you information on depression in teens, how to identify it, and ways to treat it.
In This Article
Understanding Depression
Often confused with mood swings and ‘normal teen behavior’, depression is more than just a momentary feeling of sadness. There is a difference between ‘feeling depressed’ and suffering from ‘clinical depression’.
Disappointment, frustration, anger, and loss can lead to a feeling of depression, which is temporary. Clinical depression is a major depressive disorder that leads to prolonged episodes of sadness, despondency, and hopelessness, and it affects thoughts and actions. The feeling of sadness is so severe that the person loses interest in things that she or he usually enjoys (1).
Depression is also different from bereavement, which is a feeling that one experiences after the death of a loved one or when ending a significant relationship. The grieving process might take weeks or even months, but it is a natural response to a negative situation in life. However, depression results in a set of fixed negative emotions, and leaves the person feeling stuck. The teen may have little or no control over his feelings and may even feel incapable of experiencing pleasure as he did earlier.
Most importantly, clinical depression can surface even when the circumstances are ideal, often making the person wonder why they feel the way they do. Severe depression affects the teen’s everyday life, studies, and social life negatively, and should be addressed early, as it is an actual problem.
Depression Is A Real Illness, Not Just A State of Mind
“Snap out of it!”“Watch a comedy movie or show.”
“Just sleep it off.” “You should go out more often to feel better.”
These are just some of the annoying things that people fighting depression have to hear. The fact is that depression is not just something you can shake off. Teen depression is real and not something you decide to turn on or off. In this section, MomJunction helps you bust the myths about depression among adolescents.
[Read: Teen Peer Pressure]
#1 Myth: Depression is not a real medical problem.
Fact:
Depression is a real illness and a serious one too. Clinical depression is no different from any other illness such as diabetes, and has symptoms that can make life difficult for the person, both physically and emotionally. Most importantly, depression can be caused due to physiological as well as psychological factors. In fact, latest technology is becoming an important tool to diagnose depression through the MRI of brains (2).
#2 Myth: You can “snap out” of depression by thinking positively.
Fact:
Clinical depression is not a choice. Just as a person having diabetes or heart disease cannot “snap out” of it by thinking happy thoughts, a person with depression cannot snap out of it by thinking positively. Depression may not always be due to a chemical imbalance in the brain. But it does affect the structure or functioning of the brain, making it difficult for the person to control how he feels when depressed (3). This is an important myth to break since it causes guilt and worsens depression.
#3 Myth: Depression will go away by itself.
Fact:
Not necessarily. In some cases a depressed person may feel better and come out of it without any intervention. But in most cases, treatment is necessary. In fact, lack of treatment or intervention can worsen the symptoms of depression in teens and make the condition worse (4).
#4 Myth: Talking about depression makes it worse.
Fact:
Talking can be cathartic, especially when the person is dealing with severe depression. Expressing how you feel is not easy when you are depressed, but talking about the troublesome feelings makes the person feel better, not worse. A lot of people refrain from talking about their feelings because of the stigma attached to depression in society. Talking can make depression worse only when the person is mocked at or called weak for their condition.
#5 Myth: Antidepressants are addictive.
Fact:
Antidepressants are drugs that modify the chemistry of the brain to rectify the hormonal imbalance that causes depression. They are not addictive in the same way as alcohol or narcotics such as heroin, are, which means you will not crave for the drug. However, individuals do experience withdrawal-like symptoms on missing certain doses or stopping the drug. That said antidepressants are not for everyone and certainly not for life. In mild-to-moderate depression, a psychotherapy process, specially cognitive-behavioral therapy, could be sufficient.
#6 Myth: Only the weak get depressed.
Fact:
Depression does not discriminate. It is a complex mental health disorder that has biological, psychological, and social causes and it can affect anyone. As we mentioned before, no one chooses to be depressed. Also, a person who accepts the condition and works hard to fight it has more resilience than a person who is not depressed. He or she is anything but weak.
With a little clarity on some of the common misconceptions about depression, let’s find out what causes depression in the first place.
Causes Of Teenage Depression
Depression is a common yet severe medical ailment that can be treated. Medically, adult depression is the same as adolescent depression. However, the causes of depression and the triggers vary a little. Depression in teens can be due to one or more of the following reasons:
- The neurotransmitters are brain chemicals that carry messages to and from the brain. When their biological chemistry is impaired, the nerve cell receptors and circuits are adversely affected. Research states that any changes in the nerve cell growth and the nerve circuits functioning can contribute to depression (5).
- Hormonal imbalance, which is a disturbance in the hormonal systems in the body, can affect how the neurotransmitters function, and trigger depression.
- Physical, mental, and sexual abuse, loss of a parent, or other traumatic events that the teen experienced as a child can affect the brain’s chemistry and functioning, making the child vulnerable to depression.
- Genetics, in some cases, can contribute to depression, especially if a teen has a blood relative who had the problem.
- Learned patterns of negative thinking may also lead to depression. If the child has learned to think negatively and feel hopeless rather than feel capable and find solutions, he is vulnerable to the condition.
[ Read: Why Teenagers Quit School ]
A teenager can become depressed due to one of the reasons or a combination of these. Common triggers that could increase the risk of teen depression include:
- Failure in exams
- Peer pressure
- Social rejection
- Familial problems
- Negative self-esteem due to obesity, bullying, etc.
- An act of violence, sexual abuse
- Chronic illness such as cancer
- Existence of other mental health disorders such as bipolar disorder, anxiety disorders, eating disorders, or personality disorders
- Having a behavioral disorder such as attention deficit/hyperactivity disorder (ADHD)
- Alcohol or drug abuse
Teenagers who are gay, lesbian, bisexual, or transgender and have a non-supporting environment at home and school are also at the risk of becoming depressed.
But how do you know if your child is suffering from depression? Are there any signs indicating teen depression?
Yes, there are.
Signs And Symptoms Of Clinical Depression
Sure, teenagers are moody most of the time, and they may feel sad and hopeless too. But these feelings last only until they find a solution to their problem, or until the circumstances are back to being ideal. However, if there is a persistent feeling of sadness that lasts for at least two weeks, it could indicate clinical depression in teens.
Symptoms and signs of depression in teens are as follows.
| Symptoms – Emotional Changes | Signs – Behavioral Changes |
|---|---|
|
|
If your child shows any of these signs, seek medical help as soon as possible. When the symptoms become severe, the risks also get bigger. Teenagers dealing with depression are at the risk of:
[Read: Behavior Problems In Teenagers]
- Getting into trouble at school
- Substance abuse
- Eating disorders
- Internet addiction
- Self-injury
- Reckless behavior, especially if they drive a car
- Violence
- Suicide
If you think that a depressed teen is at the risk of hurting herself or someone else, call emergency services immediately!
If you are not sure if the teenager is just ‘being a teen’ or is depressed, consult a mental health specialist to know.
Diagnosing Teen Depression
Depression is diagnosed by a trained psychotherapist or psychiatrist, who will do a thorough psychological evaluation of the teenager. The evaluation will include a discussion with the teenager about his or her thoughts, feelings, and behavior. The teenager may also be asked to fill in a questionnaire to help pinpoint a significant factor or issue that has triggered the depression.
Psychiatrists usually follow standard diagnostic criteria for depression, and look for the presence of specific symptoms that should last for at least two weeks.
The stigma attached to depression or any other mental health disorder can make it difficult for a parent to accept that their child may be suffering from depression and delay seeking proper attention.
But depression is nothing to be ashamed of or embarrassed about. It is a medical condition, and not a flaw in the child. Remember that neglecting depression symptoms in teens due to fear of ridicule or criticism will do more harm to the child. Getting the child the right treatment will put them on the path of recovery and help in living a normal life.
Treating Depression In Teenagers
A person suffering from depression may lose all hope and feel that there is no way out. But that’s not true. Depression in teenagers can be treated with the help of therapy and medication in some cases.
As is with most mental health disorders, there is no one-size-fits-all treatment. More often than not, a trial and error method (while ensuring the patient’s safety and welfare) is used to determine the right treatment option for the patient.
[Read: How To Handle Out Of Control Teenager]
1. Psychotherapy/ Counseling
Most cases of depression are treated with the help of psychotherapy or counseling, which involves scheduled and timely sessions with a qualified psychologist or psychotherapist at a set frequency. In case of severe depression, the teen may need to go for counseling at least thrice a week. The type of therapy used could also vary depending on the core issues that have triggered the illness.
- The most common option is talk therapy, where the teenager will get to talk about their thoughts, feelings, and actions in a safe environment. Talk therapy allows teens to look at the problem in an objective way, and resolve them without getting overwhelmed. If the talk therapy isn’t working, depending on the age, you may also try art therapy, clay field therapy, sand tray therapy and play therapy.
- Cognitive-behavior therapy is another form of therapy that focuses on replacing negative thought patterns with positive thoughts and good emotions. This type of therapy helps in dealing with unhealthy thoughts that may eventually lead to thoughts of violence or self-harm.
- Psychodynamic therapy can also help in treating depression by focusing on what’s going on in the person’s psyche to deal with internal struggles such as stress, anxiety, and fear.
- Problem-solving therapy helps the teenager find better ways to deal with stressful situations. It also helps in finding ways to cope with the loss of a loved one, separation of parents, or other transitional periods.
How counseling helps
- Identify causes of depression
- Change unhealthy thoughts to healthy thoughts
- Set realistic goals
- Examine relationships and experiences
- Find better ways to cope with problems
- Regain sense of control and happiness
- Learn to adjust during a crisis or difficult situation
Not everyone may be comfortable with psychotherapy for this form of therapy warrants opening up about vulnerable topics that trigger a variety of emotions. In some cases, psychotherapy alone may not be enough to treat depression. A combination of therapy and medications can help beat depression.
[Read: Tips To Manage Stress In Teens]
2. Medication
Medication is required if the teenager is severely depressed because of modified brain chemistry or hormonal imbalance. Medications prescribed include:
I. Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs work by increasing the levels of serotonin in the brain. They are the most commonly prescribed medications to treat depression in teenagers and have fewer side-effects. While there is a controversy surrounding the idea that low levels of serotonin can cause depression (5), it is believed that release of these chemicals can make a person feel good (6). Hence, SSRIs are the first choice of medication for someone fighting depression.
Approved SSRIs for teenagers include (7)
- Escitalopram (Lexapro, Nexito)
- Paroxetine (Paxil, Leparox)
- Fluoxetine (Prozac, Prodep, Trizac)
- Sertraline (Aderta, Zoloft)
- Citalopram (Celexa, Celica)
- Fluvoxamine (Luvox, Fluvoxin)
Common side-effects of SSRIs include diarrhea, nausea, headaches, and sexual problems.
Selective Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)
SNRIs work by preventing the reabsorption of serotonin and norepinephrine neurotransmitters that regulate good mood. Approved SNRIs include:
- Duloxetine (Cymbalta, Combac)
- Venlafaxine (Venlor XR, Effexor)
Common side-effects of SNRIs include insomnia, nausea and vomiting, constipation, headaches, and anxiety.
II. Tricyclic Antidepressants (TCAs)
One of the first antidepressants, TCAs have been in use for treating depression since the 1950s. These work like SSRIs and SNRIs by preventing reuptake of the hormones serotonin, norepinephrine, and dopamine. However, TCAs are avoided owing to their several side-effects including constipation, headaches, blurred vision, dry mouth, dry eyes, disorientation, dizziness, fatigue, and seizures among others.
Commonly prescribed TCAs include:
- Desipramine (Norpramin)
- Amoxapine (Demolox)
- Imipramine (Depsonil, Tofranil)
- Amitriptyline (Amitone, Amitrol)
- Nortriptyline (Pamelor, Notri, Primox)
- Protriptyline (Vivactil)
- Maprotiline (Deprilept)
- Doxepin (Doxin)
- Trimipramine (Surmontil)
[ Read: Why Do Teens Runaway ]
III. Monoamine Oxidase Inhibitors (MAOIs)
The first class of antidepressants created, MAOIs are the least prescribed owing to the complications, risks of negative drug interactions, and the food restriction linked to them. MAOIs increase the levels of serotonin, norepinephrine, and dopamine by breaking down an enzyme known as monoamine oxide.
Side-effects of this drug include weakness, drop in blood pressure, fatigue, headache, weight gain, and impotence. MAOIs prescribed could include:
- Isocarboxazid (Marplan)
- Rasagiline (Azilect)
- Tranylcypromine (Parnate)
- Phenelzine (Nardil)
- Selegiline (Eldepryl, Zelapar)
Note: MAOIs also contain boxed warnings (warnings inside a black box) that they can increase suicidal thoughts and tendencies in children, teenagers, and young adults.
Note that antidepressants are prescription medicines that should be taken under the guidance of a qualified psychiatrist. Make sure that the teenager takes the prescribed dosages of these medications for the recommended period.
IV. Exercise and rest
A daily routine of exercises and proper rest can aid in treating depression quicker. Research says that regular exercise can trigger the release of endorphins, which are the ‘good’ or ‘happy’ chemicals in the brain that elevate the mood (8). Proper sleep hygiene can also help regulate the teenager’s mood and keep crankiness and irritation at bay.
If the child is at risk of self-harm or harm to others, he may have to be hospitalized and kept under observation until the risk mitigates.
Treatment needs to be supported with your care, and the determination of the child to come out of the condition.
[Read: Meditation Techniques For Teens]
Coping With Depression
Watching your teenaged child suffer from depression is not easy. While you cannot make them feel better overnight, you can make their life bearable by teaching them a few coping techniques. The first step is to not judge the kid for their behavior and outlook. Depression is not your teen’s fault.
Encourage your teen to:
- make friends and maintain healthy relationships at home and school. The best way to teach them this is to be a good role model.
- exercise regularly and stay active. Encourage them to participate in school sports or any activities that keep them physically active.
- talk to you if something is bothering them. Teenagers hesitate to talk about their emotions, but bottling up their emotions can be overwhelming and worsen the condition.
- have realistic goals and expectations. It is easier to give up hope when things don’t get better soon. At such times, offer them the support they need to keep going.
- stay better organized and structure their time. They will start to feel better when they complete things.
- simplify life, by choosing their responsibilities and obligations carefully.
- have a private journal in which they can write about their thoughts and the emotions that tag along with such thoughts. This will help them understand their thinking patterns better.
- connect with teens who have dealt with or are fighting depression for support. They can also join a support group if there is any in your community.
Seeing your child in depression could be heart-wrenching for you. You would feel guilty that you haven’t tried to prevent the situation. But…
Can Depression Be Prevented?
It is not entirely possible to prevent depression, considering that sometimes, there are biological factors at play. However, you can minimize the risk by ensuring that the child grows up in a healthy environment, has a balanced diet, and leads a healthy lifestyle. A happy childhood, however, does not bring down the risk of depression entirely.
Depression is a serious issue that can impact your teenager’s life in a significant way. How you handle the medical condition will have a direct impact on how quickly your child can get out of it and lead a healthy life. Do not take depression for granted, for it not only affects the teen’s outlook on life but may also put him at risk of some extreme reaction.
Being a parent to a depressed teen is not easy. Don’t hesitate to talk to your child therapist for answers and join a support group to help your child better.
Remember that there is help if you need it.
[ Read: Benefits Of Regular Exercise For Teenagers ]
Have any suggestions or tips on how to deal with teenage depression? Share them in our comments section.
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