Teen depression is a serious condition that affects emotions, thought and behaviors. Although teen depression isn't medically different from depression in adults, teenagers often have unique challenges and symptoms. Issues such as peer pressure, academic expectations and changing bodies can bring a lot of ups and downs for teens. But, for some teens, the lows are more than just temporary feelings — they're a sign of depression.
Also called major depression and major depressive disorder, teen depression isn't a weakness or something that can be overcome with willpower. Like depression in adults, teen depression is a medical condition that can have serious consequences. However, for most teens, teen depression symptoms ease with treatment such as medication and psychological counseling.
Teen depression symptoms include:
Teen depression often occurs along with behavior problems and other mental health conditions, such as anxiety or attention-deficit/hyperactivity disorder (ADHD).
What's normal and what's not
Warning signs that your teen could be struggling with depression:
When to see a doctor
If you're a teen and you think you may be depressed — or you have a friend who may be depressed — don't wait to get help. Talk to a health care professional such as your doctor or school nurse. Share your concerns with a parent, a close friend, a faith leader, a teacher or someone else you trust.
When to get emergency help
It's not known exactly what causes depression. As with many mental illnesses, it appears a variety of factors may be involved. These include:
Although the precise cause of depression isn't known, factors that seem to increase the risk of developing or triggering teen depression include:
Untreated depression can result in emotional, behavioral and health problems that affect every area of your teen's life. Complications associated with teen depression can include:
Preparing for your appointment
You're likely to start by taking your teen to see his or her primary care doctor or pediatrician. However, when you call to set up an appointment, you may be referred directly to a psychiatrist or psychologist — mental health professionals who specialize in diagnosing and treating mental health conditions.
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea for you and your teen to be well prepared for the appointment. Here's some information to help you get ready for your teen's appointment, and what to expect from the doctor.
What you can do
Your time with the doctor is limited, so preparing a list of questions ahead of time will help you and your teen make the most of your time. List your questions from most important to least important in case time runs out. For problems related to depression, some basic questions to ask the doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions at any time during your teen's appointment.
What to expect from your teen's doctor
Tests and diagnosis
When a doctor suspects a teen has depression, he or she will generally ask a number of questions and may do medical and psychological tests. These can help rule out other problems that could be causing symptoms, pinpoint a diagnosis and also check for any related complications. These exams and tests generally include:
Diagnostic criteria for depression
For a diagnosis of major depression, your teen must have five or more of the following symptoms over a two-week period. At least one of the symptoms must be either a depressed mood or a loss of interest or pleasure. Symptoms can be based on your teen's feelings or may be based on the observations of someone else. They include:
To be considered major depression:
Other conditions that cause depression symptoms
Make sure that you understand what type of depression your teen has so that you can learn more about his or her specific situation and its treatments.
Treatments and drugs
Numerous treatments are available. Medications and psychological counseling (psychotherapy) are very effective for most teens with depression.
In some cases, a primary care doctor can prescribe medications that relieve depression symptoms. However, many teens need to see a doctor who specializes in diagnosing and treating mental health conditions (psychiatrist or psychologist). Some teens with depression also benefit from seeing other mental health counselors.
If your teen has severe depression or is in danger of hurting himself or herself, he or she may need a hospital stay or may need to participate in an outpatient treatment program until symptoms improve.
Here's a closer look at depression treatment options.
Because studies on the effects of antidepressants in teens are limited, doctors rely mainly on adult research when prescribing medications. The Food and Drug Administration (FDA) has approved two medications for teen depression — fluoxetine (Prozac) and escitalopram (Lexapro). However, as with adults, other medications may be prescribed at the doctor's discretion (off label).
Types of antidepressants include:
Finding the right medication
If antidepressant treatment doesn't seem to be working, your teen's doctor may recommend a blood test to check for specific genes that affect how his or her body processes antidepressants. The cytochrome P450 (CYP450) genotyping test is one example of this type of exam. Genetic testing of this kind can help predict how well the body can or can't process (metabolize) a medication. This may help identify which antidepressant might be a good choice for your teen. These genetic tests aren't widely available, so they're an option only for people who have access to a clinic that offers them.
Antidepressants and pregnancy
Antidepressants and increased suicide risk
While this warning may seem alarming, for most teens the benefits of taking an antidepressant generally outweigh any possible risks. In the long run, antidepressants are likely to reduce suicidal thinking or behavior.
If your teen has suicidal thoughts when taking an antidepressant, immediately contact his or her doctor or get emergency help.
Again, make sure you understand the risks of the various antidepressants. Working together, you and your doctor can explore options to get depression symptoms under control.
Through these regular sessions, your teen can learn about the causes of depression so that he or she can better understand it. He or she will also learn how to identify and make changes in unhealthy behaviors or thoughts, explore relationships and experiences, find better ways to cope and solve problems, and set realistic goals. Psychotherapy can help your teen regain a sense of happiness and control and help ease depression symptoms such as hopelessness and anger. It may also help your teen adjust to a crisis or other current difficulty.
Cognitive behavioral therapy is one of the most commonly used therapies for teen depression. It helps a person identify negative beliefs and behaviors and replace them with healthy, positive ones. It's based on the idea that your own thoughts — not other people or situations — determine how you feel or behave. Even if an unwanted situation doesn't change, you can change the way you think and behave in a positive way. Interpersonal therapy and psychodynamic psychotherapy are other examples of counseling commonly used to treat depression. There are a number of additional types of psychotherapy that can be effective. Many therapists use a combination of approaches.
Hospitalization and residential treatment programs
Lifestyle and home remedies
Depression generally isn't an illness that you can treat on your own. But there are some steps you and your teen can take that may help:
Alternative medicine strategies for depression include supplements and mind-body techniques. Here are some common alternative treatments for depression.
Herbal remedies and supplements
Some supplements — including St. John's wort and SAMe — can interfere with antidepressants.
Mind-body techniques used to improve depression symptoms include:
As with dietary supplements, take care in using these techniques.
Make certain you understand risks as well as possible benefits before pursuing any therapy for your teen. To be safe, talk to your teen's doctor before he or she takes any herbal or dietary supplements — particularly St. John's wort or SAMe. Keep in mind, alternative treatments aren't a replacement for conventional medical treatment or psychotherapy.
Coping and support
Showing interest and the desire to understand your teen's feelings lets him or her know you care. You may not understand why your teen feels that things are hopeless or why he or she has a sense of loss or failure. Listen to your teen without judging and try to put yourself in his or her position. Help build your teen's self-esteem by recognizing small successes and offering praise about his or her competence.
Encourage your teen to:
There's no sure way to prevent depression. However, making sure your teen takes steps to control stress, to increase resilience and to boost low self-esteem can help. Friendship and social support, especially in times of crisis, can help your teen cope. In addition, treatment at the earliest sign of a problem can help prevent depression from worsening. Some teens need to continue taking medications even after symptoms let up, or have regular therapy sessions to help prevent a relapse of depression symptoms.
Last Updated: 2010-07-20
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