Written By: Lynne Cole – Therapist | Last Updated: August 2023
Raising a teenager is tough work, and it’s especially tough when a teen starts experiencing issues with their mental health such as depression or anxiety. Sometimes, it’s also hard to know whether your teen is suffering from depression or going through the normal ups and downs of growing up.
I have many years of experience helping parents to deal with children and teens who are working through a variety of issues, so in this blog post I’ll outline the most important things that you need to consider as a parent when dealing with a teen who could be depressed.
Signs Your Teenager Is Depressed
Signs of depression in teenagers and children have significant overlap with signs of depression in adults, but may not manifest in exactly the same way. For example, a depressed teenager might:
- suffer from mood swings, consistently low mood, or show no signs of emotion at all
- sleep a lot more or a lot less than they usually do, or seem very tired a lot of the time
- eat a lot more or a lot less than usual, gain or lose a lot of weight quickly, or not gain the weight they should be gaining as they grow
- become very fidgety or very lethargic
- lose interest in pastimes they used to enjoy
- become irritable, angry, or tearful for seemingly no reason or a disproportionate reason, or not react to things which would usually provoke them
- avoid spending time with friends and family
- lose confidence in themselves or their skills, struggle to make decisions, feel it’s pointless to try to do anything
- mention feeling sad, guilty, unworthy, or other negative feelings
- have suffered a traumatic experience you know about, whether they show obvious signs of trauma or not
- mention self-harm, actually harm themselves, or attempt suicide
Is it depression or “growing pains”?
Being a teenager is very hard, as all adults know. Over those few short years, massive changes happen in the body and mind and the child takes on more responsibilities and more difficult tasks in preparation for adulthood.
Hormones affect mood, and relationships, school, jobs, and planning for the future are all common sources of massive stress. It’s only natural that teenagers as a group have a well-deserved reputation for bad moods, but this often results in serious depression or anger issues going unnoticed.
If any of the signs listed above persists for a week or more or seems unusually severe, if you know about a traumatic experience they’ve had, or if you see any signs at all of self-harm, talk to the teenager and contact a doctor.
This is especially important if they have a family history of depression or suicide, or if they’ve recently been put on new medication which may have depression as a side effect.
Even if it is simply “growing pains” or a temporary low mood, something being common and quick to pass doesn’t mean it isn’t miserable to live through at the time. It’s good to be supportive and kind to teenagers when they have problems even if you think those problems are trivial. Remember that teenagers have fewer experiences to compare new ones to; the first heartbreak or big disappointment feels like the worst they’ve ever felt because, until they experience another one, it is.
Respect their feelings on such matters and don’t make them feel ashamed for their emotions, and they’ll be more likely to tell you when they have serious problems you need to know about.
Depression in teens vs. adults – The Difference
As stated above, teenage depression can be hard to tell apart from normal teenage behaviour, and it’s complicated further by the differences between typical teenage and typical adult manifestations of depression. Here are some differences:
- Teenagers are more likely to experience and describe their depression as a physical pain, e.g. reporting stress headaches, as they are less familiar with the emotions and psychological terminology involved.
- Depressed adults will often withdraw from all social contact, while teens may continue to associate with close friends of their own age while avoiding adults, or start associating with different peer groups. Often these will be peers their parents or guardians specifically don’t want them to be around, as a way of expressing dissatisfaction with authority and their current situation. They may also withdraw from real life social interaction and spend all their time on the internet; see the Japanese phenomenon of hikikomori, teenagers and young adults who rarely or never leave their rooms for months or years on end[1].
- Teenagers are more likely to express depression with outward anger and irritability, especially sensitivity to criticism, while adults, especially women, are more likely to have muted and sad outward reactions.
- Teenagers physically require more sleep than adults as their bodies are still growing and this uses a lot of energy, so they are more likely to sleep too much than too little, though either extreme can happen in either group. They are also more likely to suffer changes in their weight and eating patterns, while adults are more likely to lose concentration abilities and interest in pleasurable activities.
How to help a depressed teenager get treatment
Depression in teenagers often causes irritability and anger, and teens in general are often resistant to adults’ suggestions. This is normal, as they are learning to advocate for themselves and determine what’s best for themselves.
However, they might also be loath to let you know anything’s wrong, as they wish to show that they’re strong and mature, so they might react badly to suggestions that they see a doctor. This is less likely if they already trust you and respect your opinions, and if you handle the suggestion carefully.
Only a doctor can officially diagnose depression or prescribe treatment, but before trying to make an appointment for your teenager, talk to them directly. Ask them how they’re feeling and if there’s anything you can do to help. They might say they’re fine, but keep an eye on them, and if symptoms continue, talk to them again.
Suggest a GP visit without forcing it; forced treatment is ineffective and will make them resent you and feel worse. Let them decide on their own time. In my experience as a therapist and parent teenagers often struggle to cope with their emotions in general and will welcome help that’s offered appropriately.
What Is the Treatment for Depression in Teens?
First, they need to talk to their general practitioner, who can help you find appropriate therapy and may offer medication. The GP will discuss what options they can help.
Talk therapy, CBT and counselling for teens are often very helpful for depression, though it may require additional medication. Your GP can help you with this too. It may also be helpful to attend family counselling together, depending on the situation.
In very severe cases, such as after a suicide attempt, a teenager may be hospitalised.
What to Expect from Child &Teen Counselling
Therapy most commonly occurs as one-hour sessions once a week, though more frequent sessions for more severe cases are not unknown.
The therapist will talk to the patient and build rapport giving a safe and confidential space, in the first session, and this is an opportunity for the patient to decide whether that therapist suits them or if they don’t get along and want to be referred to a different one.
Once trust is established, the therapist will encourage the patient to explain their problem and will suggest solutions and coping skills to practice.
The parent or guardian should talk to the therapist beforehand to ensure they trust them and agree with their methods, but the child or teen may be offered to be alone with the therapist for the sessions for reasons of privacy if required.
Therapists are not allowed to share confidential information about their clients’ sessions unless confidentiality has to be broken in matters of serious life threatening risk of harm to self or others, so talk to your teen directly to find out if they’re feeling better or need different help.
Things to avoid with a depressed teenager
- Don’t dismiss mood or behaviour changes as typical teenager issues, and especially don’t assume they’re forms of intentional defiance or punish them. They might be harmless growing pains, but could be signs of serious problems, and it is better to make sure.
- Don’t assume depression will go away on its own. It rarely does, and help is often very effective quite quickly, so it’s worth trying.
- Offer to help and make gentle suggestions for healthy activities and coping strategies, but don’t try to force them or present it as trying to “fix” them.
- Never dismiss their feelings as trivial, especially not just because they’re young. Feelings are very intense for teenagers, and their causes matter.
How to Find the right Therapist for your teenager
Your family GP or the teenager’s school will be happy to help you find a therapist, and may have recommendations suggested by prior patients. Internet searches will also bring up lists of therapists working in your local area, or accessible online or via phone. Look for one who specialises in treating teenagers like myself and knows how to build rapport with them, as depressed teenagers particularly may be distrustful of adults.
[1] https://en.wikipedia.org/wiki/Hikikomori