The Difference with Teen Depression
Unfortunately, depression often goes undetected in teenagers. Parents sometimes don’t recognize the symptoms because depression in teenagers looks quite different from depression in adults. As a result, many teens unnecessarily suffer in silence.
Depression can affect all teens regardless of their gender, popularity, academic success, or athletic abilities. It's essential to familiarize yourself with the common symptoms of depression in teens so you can provide support and seek help when necessary.
What is depression?
Teen depression is a serious mental health condition that causes persistent feelings of sadness and loss of interest in activities. It affects how a teen thinks and behaves and can negatively impact school, family, and social functioning.
According to the National Institute of Mental Health, approximately 3 million American adolescents aged 12 to 17 had at least one major depressive episode in 2015. This number represented 12.5% of the adolescent population.
What are the symptoms?
While depressed adults often talk about emotional pain, depressed teens tend to report physical aches and pains. They may report headaches, stomach problems, or say they just don’t feel well. In the case of depression, physical exams won’t reveal any findings.
When should you be concerned?
If you notice one or more of the following...
Adults usually describe feeling sad when depressed, but teenagers often become increasingly irritable. They may behave disrespectfully or may have less patience than usual. They also may become defiant.
While mood swings can be expected during the teenage years, an unusual amount of irritability should be considered a warning sign of possible depression.
b) Academic Changes
Teens may experience a sharp decline in their grades when depression strikes. But, that's not always the case. Some teens maintain a high-grade point average (GPA) even in the midst of emotional turmoil.
In fact, sometimes, the pressure to maintain good grades becomes a factor in depression. A teen who feels the need to get accepted into an Ivy League college, or one who insists a disappointing SAT score could ruin their life, may remain driven to achieve despite being depressed.
c) Sensitivity to CriticismDepression can lead to an intense sensitivity to criticism. Sometimes teens deal with this increased sensitivity by avoiding activities where they fear failure. A teen may refuse to try out for the soccer team or may refuse to invite a date to a school dance in an attempt to avoid rejection.
At other times, teens may deal with this fear by becoming overachievers. A depressed teen may become a perfectionist to avoid the risk of being rejected. It's important to monitor how your teen responds to risk, criticism, and failure, as changes in your teen's behavior could signal your teen is depressed.
- Social Withdrawal
Social isolation is a common problem for someone with depression. Still, teens don't necessarily withdraw from everyone when they become depressed. Sometimes they simply change peer groups.
A teen may begin to hang out with the wrong crowd or stop talking to certain friends or family members.
At other times, teens withdraw from real-life activities and focus their attention on the online world when they feel depressed. A depressed teen may create an online persona and may engage in online chats or play role-playing games for hours to escape life's realities.
Probable causes:Research shows the most decisive risk factors for depression in adolescence are a family history of depression and exposure to psychosocial stress. Other factors to conside include developmental factors, hormonal changes, and psychosocial adversity.
Other factors that can trigger teen depression include:
- Bullying and other peer issues
- Academic pressure or problems
- Chronic disease
- Alcohol or drug use
- Family discord
- Sleep deprivation
- Confusion about sexual orientation
- Other mental health disorders
- Learning disabilities and ADHD
- Low self-esteem
- History of violence (witness to or victim of)
Complications caused by depressionUntreated depression can result in emotional, behavioral, and health problems that affect every area of your teenager's life. Complications related to teen depression may include, for example:
- Alcohol and drug misuse
- Academic problems
- Family conflicts and relationship difficulties
- Involvement with the juvenile justice system
- Suicide attempts or suicide
Suicide preventionIf you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know has thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can call 800-799-4889.
Types of depression
- Anxious distress
- Major Depression
- Psychotic Depression
- Peripartum (Postpartum) Depression
- 'Situational' Depression
- Atypical Depression
Disorders that can cause depression
- Persistent Depressive Disorder
- Bipolar Disorder
- Seasonal Affective Disorder (SAD)
- Premenstrual Dysphoric Disorder (PMDD)
Diagnosis, treatment and prevention
Common antidepressant medicationsThere are several different categories of antidepressant medications. Each works to change how the brain processes the neurotransmitters that affect moods and emotions. Serotonin, dopamine, and norepinephrine are a few brain chemicals that regulate our emotions and energy levels.
- Selective serotonin reuptake inhibitors (SSRIs): When taken as directed and under close medical supervision, SSRIs can help teens manage symptoms of depression with fewer side effects than other medication options. SSRIs elevate mood by raising serotonin.
- Monoamine oxidase inhibitors (MAOIs) were some of the first antidepressants developed. MAOIs increase serotonin by blocking the enzyme that breaks it down. MAOIs are not prescribed as frequently because they can have serious side effects and drug or food interactions.
- Tricyclic antidepressants (TCAs): These antidepressants are not commonly prescribed for teens or younger patients due to side effects unless the patient is unresponsive to SSRIs.
- Atypical antidepressants: These antidepressants (including Wellbutrin, Cymbalta, and Effexor) have fewer side effects and are generally better tolerated by younger patients.
Pros of medicationFor many teens, antidepressants combined with psychotherapy are an effective way to treat depression. Antidepressants can help teens in the following ways:
- Improve mood
- Improve appetite
- Increased focus
- Resolve sleep disturbance associated with depression
- Decrease anxious symptoms that can occur with depression
- Decrease depressive symptoms that can trigger suicidal thoughts
It should be noted that the risk of suicide occurs at all times during a major depressive episode, and teens should be carefully monitored and evaluated during this time.
Antidepressants work best with psychotherapy (including process-oriented or cognitive behavioral therapy). During psychotherapy, teens can learn coping skills to manage depression and deal with psychosocial stressors. They can also explore triggers of depression and how to mitigate those triggers in the future.
Cons of medicationAll medications have side effects. Some antidepressants can cause minor side effects that are annoying but manageable, while others can result in serious side effects. It's important to discuss all potential side effects prior to beginning treatment with an antidepressant and keep a close eye on your teen (including regular appointments with the prescribing physician).
SSRIs, the most commonly prescribed antidepressants, can have the following side effects:
- Gastrointestinal symptoms
- Insomnia or sedation
- Dry mouth
- Weight gain
- Sexual side effects
It's important to note that antidepressants are not a "quick fix" for depression and can take 6-8 weeks to relieve symptoms.
The U.S. FDA issues a “black box” warning for all antidepressants in young people up to the age of 24 because of the risk the drugs might increase suicidal thinking and behavior, particularly during the first one to two months of treatment.
Something else to consider: Recent research shows no clear benefit of treatment with antidepressants for children and adolescents.
The bottom line is that every teen is different. One teen might experience many benefits and few side effects. In contrast, another might experience little relief of depressive symptoms and many side effects. A team approach to treating depression (with or without medication) is the best bet for teens.
The Real Dangers of Conventional Medical Treatment
Recent studies published in leading medical journals have seriously questioned the efficacy of conventional pharmaceutical treatment for people with mild or moderate depression.
In early 2010, major media reported on a significant review of research testing antidepressant medications. What is unique about this review of research is that the researchers evaluated studies that were submitted to the U.S. Food and Drug Administration (FDA), though the researchers discovered that many studies submitted to the FDA were unpublished (they found that the unpublished research consistently showed negative results of antidepressants).
This meta-analysis of antidepressant medications found only modest benefits over placebo treatment in published research, but when unpublished trial data is included, the benefit falls below the accepted criteria for clinical significance.
Perhaps most startling about this research is that the FDA only requires drug manufacturers to provide them with two positive studies on depression to attain FDA-approval status, even if these same drug companies submit many more studies with negative results. Such information forces consumers to question the efficacy of "FDA approved drugs," explaining why so many conventional medications eventually get withdrawn from the marketplace.
At the same time that the above review research was published, another review of research was published in JAMA (Journal of the American Medical Association). They found similar results, "The magnitude of benefit of antidepressant medication compared with placebo increases with the severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms." These researchers did find benefits from the use of antidepressants in the treatment of severe depression. Still, because the majority of people taking antidepressants today do not have "severe depression," it is prudent for many people with depression to talk to their doctors about safer and more effective alternatives.
Sadly (and strangely), when conventional doctors today do not obtain adequately effective results with one drug, they often simply prescribe more medications in hopes that one of them, or their combination, will be more effective (whether this increased use of drugs is effective or not, there are certain "benefits" that drug companies receive from this strategy). However, advancing research is finding that "polypharmacy" (using multiple drugs concurrently) may lead to worse, not better, results. New research has shown that polypharmacy with psychotropic medications in suicidal adolescent inpatients has been linked to a significantly increased risk for early readmission.
Presented at Ohio State University and Nationwide Children’s Hospital, the researchers found that suicidal adolescent inpatients receiving three or more different classes of psychotropic medications had a 2.6-fold increased risk of being readmitted within 30 days of discharge.
Natural alternatives for depression
In many patients, mild to moderate depression can be successfully treated with various naturopathic and holistic options, such as dietary changes, dietary supplements, exercise, massage, herbs, and sunlight.
Anthroposophical TherapyAnthroposophy is a spiritual science whose practical applications include biodynamic agriculture, anthroposophical medicinal products, and eurhythmy ("movement as visible speech").
Aromatherapy MassageAromatherapy is the use of essential oils to treat a variety of conditions. Naturopathic physicians use aromatherapy to treat depression, anxiety, insomnia, stress-related disorders, and chronic pain.
Various aromatherapy oils, diluted in a carrier oil like almond or olive oil, are massaged into the skin, where they are absorbed into the bloodstream. Below is a list of some of the essential oils used to treat depression and anxiety.
- Clary sage is used for treating insomnia, anxiety, and depression.
- Basil lifts fatigue, anxiety, and depression.
- Rose acts on the nervous system.
- Ylang-ylang is used for anxiety, depression, insomnia, and stress.
- Sandalwood has sedative properties and is suitable for treating depression and tension.
- Lavender is used for depression, headache, hypertension, insomnia, migraine, nervous tension, and other stress-related conditions.
- Jasmine increases the beta waves in the frontal lobe, which can create a more alert and responsive state of mind.
- Rosemary relieves headaches and aids clear thinking.
- Patchouli has an uplifting effect for depression and anxiety.
- Chamomile is very calming; it soothes nerves and helps insomnia.
- Geranium is both sedative and uplifting and thus is used for treating nervous tension, depression, and hormonal and menstrual problems.
Dietary Changes/SupplementsThe first line of naturopathic treatment for almost every disease is improved patient nutrition. Nutrition plays a key role in the onset, severity, and duration of depression, including daily mood swings. Food patterns preceding the onset of depression and during a depressive episode are similar. These patterns may include skipping meals, poor appetite, and a desire for sweets. Depressive symptoms are exacerbated by nutritional imbalances, including
- Frequent consumption of caffeine
- Sucrose consumption
- Deficiencies in vitamins and minerals (biotin, folic acid, and other B vitamins; vitamin C; calcium; copper; iron; magnesium; or potassium)
- Excesses of vanadium
- Imbalances in amino acids
- Food allergies.
Dietary RecommendationsThe main dietary focus in treating depression is to ensure that the patient's diet is rich in foods containing omega-3 fatty acids and those containing magnesium, vitamins B and D, and the antioxidant vitamins A, C, and E. Along with proper nutrition, sufficient water intake plays a vital role in maintaining the proper chemical balance in the body; even mild dehydration can cause fatigue.
PhototherapyPhototherapy is the use of light to treat disease and is a treatment of choice for SAD. Other indications for bright light therapy include nonseasonal depression, bipolar depression, chronic depressive disorder, antepartum and postpartum depression, late luteal phase dysphoric disorder, circadian phase sleep disorders, jet lag, shift work problems, and behavioral disturbance and insomnia in organic dementia.
Energy PsychologyEnergy psychology has been referred to as “acupuncture without needles” in treating mental health disorders. More than two dozen variations of energy psychology can be identified, with the most well-known being Thought Field Therapy (TFT), the Tapas Acupressure Technique (TAT), and the Emotional Freedom Techniques (EFT). Many of these adapt practices and concepts from acupuncture and acupressure; others borrow from yoga, meditation, qigong, and other traditional methods.
Homeopathic Treatment of DepressionNumerous studies have shown benefits in using the herb St. John's wort to treat mild to moderate depression. However, homeopaths generally find that it is preferable to prescribe individualized homeopathic remedies to each patient to attain better long-term sustained results without taking continual doses of any medicine (natural or otherwise). In fact, a recent study published in a medical journal published by Oxford University Press found that individualized homeopathic treatment is as effective and is safer than Prozac in treating people with moderate or severe depression.
- SAM-e - S-adenosylmethionine (SAM-e) naturally occurs in the body.
- John’s Wort - St. John’s wort derives from a yellow flower that people have used in herbal medicine for centuries.
- Omega-3 fatty acids
- 5-HTP - 5-hydroxytryptophan may change serotonin levels in the brain, much like some antidepressants.
- DHEA - 5-Dehydroepiandrosterone is a steroid hormone that the adrenal glands produce.
- NAC (N-acetylcysteine) - NAC is a precursor to the amino acids L-cysteine and glutathione.
- Rhodiola (Rhodiola rosea)
- Vitamin D
- B vitamins
If a person thinks they have symptoms of depression, they should speak to a doctor before trying any natural antidepressants.
Your physical activity, lifestyle, and even your way of thinking are all natural depression treatments.
These tips can help you feel better, starting right now.
- Get in a routine. If you’re depressed, you need a routine
- Set goals. When you're depressed, you may feel like you can't accomplish anything. That makes you feel worse about yourself. To push back, set daily goals for yourself.
- Exercise. It temporarily boosts feel-good chemicals called endorphins. It may also have long-term benefits for people with depression. Regular exercise seems to encourage the brain to rewire itself in positive ways.
- Eat healthy. There is no magic diet that fixes depression. It's a good idea to watch what you eat, though. If depression tends to make you overeat, getting in control of your eating will help you feel better.
- Get enough sleep. Depression can make it hard to get enough shut-eye, and too little sleep can make depression worse. What can you do? Start by making some changes to your lifestyle. Go to bed and get up at the same time every day. Try not to nap. Take all the distractions out of your bedroom, no computer and no TV. In time, you may find your sleep improves.
- Take on responsibilities. When you're depressed, you may want to pull back from life and give up your home and work responsibilities. Don't. Staying involved and having daily responsibilities can help you maintain a lifestyle that can help counter depression. They ground you and give you a sense of accomplishment.
- Challenge negative thoughts. In your fight against depression, much of the work is mental, changing how you think. When you're depressed, you leap to the worst possible conclusions.
- Check with your doctor before using supplements. There's promising evidence for certain supplements for depression.
- Do something new. When you're depressed, you're in a rut. Push yourself to do something different. Go to a museum. Pick up a used book and read it on a park bench. Volunteer, take a language class and do what you love.
- Try to have fun. If you’re depressed, make time for things you enjoy. What if nothing seems fun anymore? That's just a symptom of depression. You have to keep trying anyway.
All the things you can do daily to protect yourself from depression or make it sustainable and even better are:
Take Care of Your Body
- Exercising is a great positive activity to keep your mind and body occupied.
- Ensuring you are eating right and getting the right nutrients into your body is also essential to feeling well emotionally.
- Make sure you are getting enough sleep.
Seasonal Affective Disorder
- Make sure you are getting enough sunlight.
- Getting the right nutrition is essential to maintaining mental and emotional health.
Find Healthy Outlets
The important thing to remember if you are having symptoms of depression is that you are not alone, and there are resources available to help you.
Teen depression is different and very disruptive, but it is an illness. Punishment doesn't help; treatment and understanding do.
So, don’t hesitate to ask for help!
Suppose you are experiencing severe depression that inhibits your daily living. In that case, it is important to get help from a counselor who specializes in working with teens. Everyone needs help sometimes, and working with a counselor could be the jump start you need to get back on the right track.