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Depression and Your Teen
Teen years are a time of tremendous physical, emotional and cognitive changes. Depression can be used to describe a feeling of "being down" or "having the blues" which occurs to all of us at times. But depression can also refer to a clinical problem or illness that happens when signs of clinical depression are present on a daily or nearly daily basis for two weeks or more, and begin to interfere with the child's ability to function normally.
About 5% of teens are clinically depressed at any given time. Adolescents under significant stress; those who have experienced losses; or who have attention, learning, conduct, or anxiety disorders are at higher risk of developing clinical depression. Girls are also at higher risk, especially minority girls.
Depressed teens may be having problems at home. Sometimes the parents in the home are also depressed. Depression can run in families.
Teens who are depressed do not always show their depression in the same way that an adult does. They may show more irritability, and many develop additional behavioral disorders or substance abuse problems.
Signs of depression
- Frequent crying and sadness. Teens may cry or get tearful more frequently and describe feeling sadness. Some teens wear all black clothes, write poetry with themes of sadness and death, or are drawn to music that has these themes.
- Hopelessness. Depressed teens often feel that their lives will never get better, and that things will never change. This belief makes it hard to get energized to do any of the usual things in your life. It may feel like it is not even worth the energy to take a shower or get dressed.
- Less active with people and activities that they used to enjoy. Depression takes up a lot of emotional and mental energy. You become very focused on what is going on in your own head, and have less energy and interest in people and things around you. Depressed teens may start skipping after school activities, avoid talking and visiting with friends or family members, and may spend more time alone just "doing nothing".
- Decreased communication. Teens may "shut down" communications with others. The adolescent may feel that no one will understand or just may not have the energy to engage with others. They may begin to think thoughts they know will frighten others so they avoid sharing those thoughts.
- Reduced concentration and attention. Grades may fall as the teen becomes more depressed. The teen finds it increasingly hard to stay focused on reading material and more readily forgets information. Parents get frustrated that the teen "isn't listening". In severe depression, teens can't stay focused enough on school material to participate in classes.
- Changes in sleep. The teen may begin to sleep excessively, and even when awake may have little energy. Or, the teen may have difficulty sleeping. This can take the form of having trouble falling asleep at night, or waking up episodically - particularly in the early morning hours.
- Changes in appetite. Some teens find that they just are not hungry at all and begin to lose weight. Others find they can't stop eating, and gain significant weight. A loss or gain of 8-10 pounds or more due to mood changes is significant.
- Frequent physical complaints. Increased complaints of headaches, stomachaches, body pains, and just "not feeling good" are common in depression.
- Self-injury. The depressed teen may become drawn to self-cutting, inflicting a purposeful cut or deep scratch on their arm, abdomen or other body area. While the teen doing cutting may be suicidal, many teens that cut are not at an immediate risk of suicide. The cutting for these teens is done because it feels like it alleviates pain and stress for a few hours, and makes them feel better.
- Suicidal ideas, plans and attempts. Depression results in people feeling hopeless and worthless, and the future seems like it will always be filled with pain and despair. When people feel trapped and in this kind of emotional anguish, suicide begins to seem like an option. If your teen is talking about suicide to you, a friend, or through a journal or poems, immediate help and assistance is needed.
- Running away. If home problems are part of the stress for a depressed teen, the solution of running away may become appealing. Offering the teen some family intervention and treatment, or even a short-term "break" from the home by living briefly with a trusted relative or friend may help.
- Substance abuse. Teens may try to self-medicate their feelings of depression by using alcohol, pills or other drugs that temporarily help them feel better. This can quickly become a habitual way of trying to deal with their mood and problems.
Getting help
Depression can be treated, and treatment can save lives. The best time to treat depression is before it becomes too severe. In the early stages of depression, parents sometimes think the teen is "just being a teen," meaning that they seem more moody, irritable, self-preoccupied, and non-communicative. Talk with a guidance counselor, family doctor, or mental health organization if you are concerned about your child. These individuals and/or your insurance company, family or friends can help you locate a therapist appropriate for your child.
Let your child know that you are worried about them, and that you want them to go and talk with someone. Trusted family friends or peers may be able to talk with your child if your child will not listen to you.
When you select a therapist, ask that person about their degree and license. In general, you may prefer a licensed psychologist or social worker that has experience in working with adolescents. Your child may prefer a male or female counselor, or a young or older one. If these preferences exist and can be met, try to do so to ease your child in getting started with counseling.
Teens often believe the same stigma that parents do about mental illness. The teen may say, "I'm not crazy", "I don't need this", etc. Reassure your teen that everyone gets depressed at one time or another in their life, and sometimes people get stuck in that mood of depression and it turns into a medical issue that needs treatment. Use the example that if you don't take care of a cold it can turn into bronchitis, and if you don't treat that it can turn into pneumonia. You want to get treatment early.
Treatment for depression
Treatment for mild depression may consist of counseling alone. Treatment for moderate depression may well include medication and counseling. Treatment for severe depression will include both.
Counseling may involve individual counseling where just the counselor meets with your teen. Frequently it also includes parent or family counseling. This doesn't mean that your family is bad, or crazy, or the cause of all of your child's problems. It means that your child lives within a family, and their problems affect your life. Family members have a great ability to be healing forces in life of a teen, and may help fix stress and problems that allow teens to recover faster.
Medication may be recommended for your child. Approach the use of medication with care and caution, but recognize that some carefully done studies have shown that medication and counseling used together have the best result in lifting depression. Talk first with your family doctor, and see if a psychiatrist is available in your area. Be certain to ask about the side effects and risks of medication, and insist that your child be seen frequently by the physician providing the medication. Generally, a physician will want to see your child the most during the first few weeks to be certain that the medication and dose are working without undue side effects. Once it is clear that your child is improving and tolerating the medicine, appointments will probably not be as often. Unlike an antibiotic, which begins to work immediately and can be ended after seven to ten days, antidepressants can take up to a few weeks to see the full benefit and may be used for several months before stopping them.
Suicidal crisis
If your teen is talking about suicide, contact your family doctor, the crisis hotline, or the current counselor for your child immediately. Don't show panic or anger towards your teen. Instead say, "I'm sorry that you feel like this, and I want to help." Have someone stay with your teen if you need to go and make phone calls. But don't do it in a way that makes your teen feel that you are trying to trap them, or think they are crazy. You can say, "Look, you are feeling so bad that I'd like Aunt Jane to just sit with you a while so that I can give the doctor a call and find out how we can help today." If your child appears at a very high risk for a suicidal attempt, or you just aren't sure, don't leave them in a situation where they can get at a weapon or medication, or where they can leave the home unsupervised, before you can get help.
In Erie County, you can call Crisis at 456-2014 and if you are in an emergency situation they may quickly send a counselor to the home. If you are in an immediately dangerous state, such as your child has a loaded gun or has hurt themselves and won't go with you to the hospital, call the police. If your child says they have swallowed some medication, even though it may sound minimal, call the emergency room. Teens sometimes minimize what they tell their parents, and it is best to get immediate medical care.
"Feeling suicidal" can range from having one or two thoughts of "I wish I were dead but I would never do something to myself" to being so preoccupied with a plan to kill oneself that the teen can't be safely left alone. Have a mental health professional help sort out with you and your teen what needs done.
Supporting treatment at home
You can support treatment at home by asking the mental health and medical professionals how you can assist, and what (if anything) needs done to make the home a safe environment for your child. Keep household routines structured and normal, praise your child's progress, and set reasonable expectations for what daily activities they can be expected to do. Encourage your child to keep regular appointments with the counselor and physician. Don't stop care without first talking to these professionals.
Be certain to take care of yourself as well. Talk with the counselor about the stress of having a child who is depressed. Let trusted family members help support you. You may want to call the local chapter of NAMI, an organization of family members many of whom have children or teens with mental health difficulties.
Remember, depression can be successfully treated.
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