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Is Your Teenager Depressed?

Teens are known for being moody. After all, hormones are raging and it's often a time of self-discovery, identity formation and experimentation. But as a parent, it's sometimes easy to mistake moodiness for what is actually depression.

"It's more common than people think," said Lisa Boesky, San Diego-based psychologist and author of "When to Worry: How to Tell if Your Teen Needs Help -- And What to Do About it." "Across the country, almost a third of teens feel so sad or hopeless for more than two weeks that they stop doing some of their usual activities, which is a sign of depression.

"Most parents don't know how to recognize teenage depression," Boesky said. "It's harder because we know that teens are more moody than usual, so some parents think it's a phase. That's a reason I think teen suicide is so high. Parents don't intervene soon enough."

According to Boesky, part of the problem is the way television shows and movies portray depression.

"We think of depression as a sad, crying kid in the corner," Boesky said. "We now know just as many kids who are depressed show an irritable mood rather than sad. They don't look like sad kids, they look like bad kids. They're getting in trouble, they're angry, they're getting in fights. Their parents think they are acting out, not depressed, so they want to punish them. Punishment makes it worse."

Boesky encourages parents to look for these signs:

  • Change in mood -- either increasingly sad or increasingly irritable; having a short fuse and losing his or her temper.
  • Losing interest in things they used to enjoy. "For example, they used to love basketball or hanging out with friends and now they think that's lame and couldn't care less," Boesky said.
  • Change in appetite -- either eating too much or too little.
  • Change in sleeping pattern -- either too much or not enough.
  • A change in motor system functioning, leaving a teen restless or moving more slowly.
  • If your teen is constantly tired or has headaches; a lack of energy.
  • Really self critical, focused on mistakes and/or how he or she has ruined everything. Another warning sign is a loss of memory.
  • Talking about death, or being attracted to music, movies, books that relate to death.

Another risk factor for depression is a perfectionist attitude, especially in females who are trying to be the best at everything -- athletics, grades, popularity, school service and such.

"They're not getting pressure from school or parents, but from themselves," Boesky said. "It's black or white thinking. If they get a "B" or a zit, where another kid could be like, 'Oh well,' perfectionist teens could take it really hard."

Boesky suggests looking at three key areas: grades, friends and home.

"They should be doing adequately in all three areas," she said.

There are some things parents can do to circumvent the possibility of depression, which include setting up an open relationship with your child when he or she is young.

"The real work is done before the teenage years," Boesky said. "Then, when the teen years come, there is a lot of communication and exchange of information."

The biggest advice she has for parents? Listen!

"It's not about talking, it's about asking open-ended questions and really listening," Boesky said. "Follow up on comments your child made weeks ago, maybe about a frustrating teacher or problems with a friend."

Also, help your children find hobbies that make them feel good.

"And be active," Boesky added. "One of the worst things is staying at home playing video games all day long. Exercise plays a role in these brain chemicals that prevent depression and also help treat it."

Finally, spend quality time together.

"Research shows just having dinner a few nights a week together as a family makes a huge difference," Boesky said. "A lot of parents are under the myth that their teens need them less than when they did when they were younger. Your teens need you just as much during the teenage years. Some parents with more money end up buying their teens nice thing but don't do their dinners at home, and then they get kids who are depressed. These teens are given everything -- except their parents' time."

If your teen does show signs of depression, do your research on therapists in the area and choose one that specializes in teenagers.

"Finding the right person, the first time, is essential," Boesky said. "You really only have one, maybe two windows of opportunity with a teen. If they have a bad experience, they may never go again."

It's important to bring up the topic of suicide, says Dr. John Kelsoe, professor of psychiatry at University of California, San Diego.

"If you think someone might be depressed, the odds are they are probably a lot more depressed than you think, and they probably have had suicide going though their mind," Kelsoe said. "People think if they ask their teen about suicide, that will put the thought in their mind. Actually, it's likely been occurring to the teen and they feel relief that someone has asked them about that and they can talk about it."

A teen in therapy may also be prescribed an anti-depressant.

"Medications like Prozac, Paxil, Zoloft and Lexapro are common first line drugs for depression," Kelsoe said. "Teens tolerate them and respond to them in similar fashion to adults."

There's been some controversy surrounding anti-depressants and teenagers in the past decade. Antidepressants were thought to potentially cause suicide, and not prevent it. Kelsoe says that while there is a rare percentage of the population that responds to antidepressants in this fashion, for the majority of teenagers, these medications help.

"The overall effect of these vast drugs helping the majority of depressed teens washes out these few cases that make someone more suicidal," Kelsoe said.

A lot of research is being done in this area, he said, to hopefully learn what is causing certain people to become more depressed on antidepressants.

"The brain may recover from depression unevenly," Kelsoe said. "In some people, energy and impulsiveness may improve before hopelessness and outlook for the future improves, hence this window of time when they're prone to act on depressive and suicidal thoughts. A lot of attention is being put into trying to figure out how to spot kids that are vulnerable to this."

It's important to note that depression medications take a few weeks to begin working, so parents and teens shouldn't be discouraged if there isn't a rapid noticeable change.

"It's always advisable to be in therapy as well as taking medications," Kelsoe said. "They work in a synergistic fashion.

"There's a lot of suffering related to depression, and there is concern that if you go untreated, it may hurt you in the long run."

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