Depression in Teenagers

Contents

• Depression in Teenagers

• Signs and Symptoms of Teenage Depression

• Triggers for Depression in Teenagers

• What are the Effects of Depression in Teenagers?

• Risk Factors for Suicide in Teenagers

• Events Precipitating Suicide in Teenagers

• What Teenagers Can Do to Help Themselves or a Friend if they Begin to Feel Depressed

• What Parents Can Do if a Teenager is Depressed

• If You Suspect Depression

• Treatment of Teenage Depression

Depression in teenagers

Teen depression is medically no different to depression in adults. It isn’t just bad moods and occasional melancholy. It is a serious condition that can affect emotions, thought processes and behaviours. Teenagers have unique challenges and symptoms such as peer pressure, academic expectations and changing bodies, which can bring a lot of ups and downs. For some teens, the lows are more than just temporary feelings and may be a sign of depression.

Signs and Symptoms of teenage depression

It can be difficult to tell the difference between the ups and downs that are just part of being a teenager and teen depression. Talk with your teen to ascertain if their feelings are overwhelming and if they need help to deal with them. If the depressive symptoms persist or begin to interfere in multiple areas of your teen’s life then they may be suffering from depression and professional help should be sought.

Depression may be indicated if an adolescent experiences an unusual degree of the following symptoms:

• Changes in eating and sleeping habits (eating and sleeping too much or too little)

• Significant weight gain or loss• Missed school, poor school performance • Withdrawal from friends and family • No longer enjoying activities that were once

pleasurable• Indecision, lack of concentration, or forgetfulness • Feelings of worthlessness or guilt • Overreaction to criticism, irritability • Feeling that nothing is worth the effort • Frequent health complaints when no physical

ailment exists • Anger, rage, anxiety • Crying spells for no apparent reason• Disruptive behavioral problems, particularly in boys• Anxiety, preoccupation with body image and

concerns about performance, particularly in girls• Lack of enthusiasm and motivation • Drug/alcohol abuse

• Thoughts of death or suicide• Symptoms such as insomnia, panic attacks,

delusions or hallucinations can indicate extreme depression, with a particular risk of suicide

Triggers for Depression in Teenagers

The reasons for depression can vary from adolescent to adolescent. Often, depression results from a number of factors:

• Significant events such as the death of a loved one, parents divorce, moving to a new area, or breaking up with a girlfriend or boyfriend can prompt symptoms. Adolescent depression can occur from neglect, prolonged absence from someone who is a source of care and nurturance, abuse and bullying, sexuality and the fear of coming out, damage to self-esteem, or too many life changes occurring too quickly. In some teenagers, any major change may provoke depression

• Earlier traumatic experiences such as abuse or incest often emerge and cause great distress as the child becomes a teen. This is because as a young child the victim did not have the life experience or language to process these painful experiences, or to protest. When such memories emerge in adolescence, the distress can be compounded if adults deny or discount the information

• Stress, especially if the adolescent lacks emotional support

• Hormonal/physical changes that occur during puberty also cause new and unexpected emotions. Moodiness and melancholy are often experienced and labeled as depression

• Medical conditions such as hypothyroidism can affect hormone balance and mood. Chronic physical illness also can cause depression. When a medical condition is diagnosed and treated by a doctor, the depression usually disappears

• Inadequate sleep is a risk factor for depression. Insufficient sleep may produce moodiness that hinders the ability to cope with the stresses of daily life. Teenagers typically need 9 hours sleep and this may provide some protection from depression

• Substance abuse can cause changes in brain chemistry

• Allergies to foods such as wheat, sugar, and milk can

cause or exacerbate symptoms of depression• Nutritional deficiencies may be caused by an amino

acid imbalance or vitamin deficiency

What are the Effects of Depressionin Teenagers?

• Drug and alcohol use – depressed teens often use substances in an attempt to self-medicate their symptoms

• Low self-esteem – depression can intensify feelings of ugliness and unworthiness

• Eating disorders – anorexia, bulimia, binge eating, or yo-yo dieting are often signs of unrecognised depression

• Self-injury – cutting, burning, head banging, or other kinds of self- mutilation are almost always associated with depression

• Acting out – depression in teenagers may appear as agitation, aggression, or high-risk behaviours rather than, or in addition to, gloominess

• Suicidal thoughts or attempts – teens who are seriously depressed or despondent often think, speak, or make “attention-getting” attempts at suicide, which should be taken seriously

• Anti-social behaviour, especially in young males

Risk Factors for Suicide in Teenagers

An alarming and increasing number of teenagers attempt suicide. Suicide is now the third highest cause of death in adolescents. It is also probable that suicidal statistics for teens are underreported, as they might overlook those whose reckless or dangerous behaviour resulted in death, or those in which the cause cannot be definitely identified.

There are several high-risk factors associated with teen suicide including:

• Previous suicidal behaviour• History of psychiatric disorder or substance abuse

particularly binge drinking• Family history of suicide or mental ill health• Loss of parent• History of abuse, violence or neglect

• Social isolation/alienation• Sexuality• Bullying/ Social isolation – both those who bully

and their victims are at risk of suicidal behaviour

Events Precipitating Suicide in Teenagers

Adolescence is typically a time of extreme moods, as hormonal changes and academic and social challenges escalate. Suicidal behaviour in adolescents is commonly precipitated by events or challenges that the teenager finds too difficult to tolerate. Even things that seem minor to an adult can be major to a young person, who does not have the life experience to put them into perspective or the coping skills that an adult has learned. Some common precipitants of suicidal behaviour in teenagers include:

• Death of a family member or close friend (particularly if by suicide)

• Loss of a romantic relationship or good friendship • Loss of a parent through divorce or separation• Loss of a pet, treasured object, job or opportunity• Fear of punishment• Physical, sexual or psychological abuse• Unwanted pregnancy• Poor grades• Fight or argument with family member or loved one • Belief one has harmed or brought harm to a family

member or friend• Embarrassment or humiliation• Concerns about sexuality• Suicide of a friend, acquaintance or celebrity

What teenagers Can Do to Help themselves or a friend if they begin to feel depressed

Teenage moodiness is a normal part of adolescent development. In part, it is caused by hormonal changes that cause moods to fluctuate. Just knowing that these mood swings are normal can help reduce the anxiety that often accompanies these intense feelings. However, teens can become depressed beyond normal moodiness, and need help to get past these feelings. It is very helpful to share your worries with someone who will listen and who cares and who can help you get help from a trained

professional who can guide you to feeling better.

• Reach out and talk to friends, parents or someone you trust

• If you are stressed out by exams, talk to your teacher or school counsellor

• If you are worried about being pregnant, see your general practitioner or family-planning clinic

• Keep yourself occupied. Spend time with friends, especially those who are active and upbeat and make you feel good about yourself

• Avoid the company of friends and acquaintances who use alcohol or drugs to cope with their problems

• Remember that you are not alone. Depression is a common problem and usually a passing state. Even though it feels like it will never lift, depression almost always does come and go on its own—and with proper intervention it can be controlled, greatly reduced and overcome

• You might need medication to temporarily help you while you sort out your feelings. Talk to your doctor to get the most appropriate treatment

• Above all, do not do anything that can cause permanent damage to yourself or could result in your death

If you have a depressed friend, especially one who talks about suicide or is giving things away, do not consider it a betrayal to tell a responsible adult. Depression depletes energy and clouds judgment, and your friend may do something that can never be repaired if help is not received. Even if you promised not to tell, your friend needs your help, and it is better to have a friend who is temporarily angry with you than one who is no longer alive.

What Parents Can Do if a teenager is depressed

The first problem is to distinguish between a more serious depression and “normal” typical adolescent moodiness, caused by hormonal changes. If grouchy behavior seems to have a pattern or cycle, it is likely that the symptoms are tied to hormonal changes, and are not indicative of clinical depression. In contrast, one hallmark of clinical depression is the tendency to become isolated – to stop talking to family and friends – and this kind of moodiness does not seem to lift after a couple of weeks.

If You Suspect Depression:

• Respond with love, kindness, and support• Actively listen, don’t jump in with responses and

solutions - teenagers often feel that parents aren’t actually hearing what they are saying

• Do not try to talk them out of their feelings but acknowledge the pain and sadness they are feeling

• Pay attention to any changes in mood, how long they last, and if they continually re-occur

• Repeatedly let your child know that you are there, whenever she or he needs you

• Be gentle but persistent if your adolescent shuts you out

• Do not criticise or pass judgment once the adolescent begins to talk

• Spend more time with them and be involved in their activities

• Take them to movies and concerts, and discuss them afterwards

• Know their friends and show an interest in their lives • Encourage activity and praise their efforts to

socialise and be active• Seek help from a doctor or mental health

professional if the depressed feeling doesn’t pass with time. Do not wait and hope that symptoms will go away on their own

• Parents of depressed adolescents may themselves need support. Seek out groups of parents or organisations that have experience with teen depression

Parents should express their concerns directly but gently. It is likely that the teenager will get angry and will say harsh things (“It’s none of your business!” “Get out of my room!” “I hate you!”), but this kind of response is often an unintentional test to see if you are really willing to help them. Depressed teenagers will seek answers to the following questions before confiding in an adult:

• Will you be able to handle my big feelings? Often children will keep their feelings inside if they worry that their parents already have too much on their minds

• Can I trust you to hang in there with me, even when I act like this?

• Can I rely on you to be here for me and not to walk

away or push me away?• Will you provide a strong and safe place for me?• Will you love me even when I don’t know how to

love you or myself?

Parents, who show their children that disagreements and painful feelings can safely be expressed, and that they can be resolved, make it safe for them to open up and help them communicate without fear or reprisal. This in turn reduces the isolation that is such a large part of depression.

Treatment of Teenage Depression

Depression is commonly treated with therapy or with therapy and medication. A combination of approaches is usually most effective.

• Cognitive-behavioural therapy focuses on the causes of the depression and helps change negative thought patterns

• Group therapy is often very helpful for teenagers, because it breaks down the feelings of isolation that many adolescents experience (sometimes it helps just to know that “I’m not the only one who feels this way”)

• Family therapy as an adjunct to individual therapy can address patterns of communication and ways the family can restructure itself to support each member, and can help the teenager feel like others share the responsibility for what happens in the family

• Physical exercise is helpful in lifting depression, as it causes the brain’s chemistry to create more endorphins and serotonin, which lift mood

• Creative expression through drama, art or music is often a positive outlet for the strong emotions of adolescents

• Volunteer work is sometimes helpful for adolescents. Helping someone else whose problems are greater than one’s own offers a perspective and also an opportunity to be helpful, which can create a sense of purpose and meaning

• Medication for depression should be used with great caution, and only under careful supervision. If suicidal thoughts or behaviours develop during treatment with an antidepressant, the dose may be adjusted, an alternative antidepressant may be tried, or the medication may be discontinued. It is

important that medications are taken correctly and as directed by your doctor

• Hospitalisation may be necessary in situations where a teenager needs constant observation and care to prevent self-destructive behaviour. Hospital treatment programs for adolescents usually include individual, group and family counselling as well as medication

Any mention of suicidal thoughts or feelings in a depressed adolescent should be taken seriously. Parents who are concerned that their child is considering suicide should seek care as soon as possible.

Getting help for Teenagers:

Headstrong The National Centre for Youth Mental Health www.headstrong.ie

InspireHelping young people lead happier liveswww.reachout.com

National Office for Suicide Preventionwww.letsomeoneknow.ie

SpunOut Online health and social information for young peoplewww.spunout.ie

Heads UpA mental health promotion project which provides appropriate information and support to young people.www.headsup.ie

Teenline 1800 833 634

Childline 1800 66 66 66

FURTHER BOOKLETS AVAILABLE FROM THE IRISH ASSOCIATION OF SUICIDOLOGY

SUICIDE DEPRESSION GRIEF

Risk Factors and Myths About

Suicide

Depression Self-Help

Managing Grief and Loss After Suicide

If You are Feeling Suicidal

Living with a Depressed Person

Helping / Supporting

Someone Who is Grieving

Living with a Suicidal Person - What Families

can do

Teen Depression

Signs, Symptoms and Risk Factors

For details on local and regional support organizationsee “Getting Help” section on www.ias.ie

SAMARITANS1850 60 9090

www.samaritans.org

AWARE1890 303 302www.aware.ie

Getting Help

GROW1890 474 474www.grow.ie

Republic of Ireland

Northern Ireland

AWARE08451 202961

www.aware.ni.org

Phone: +353 1 667 4900Email: info@ias.ieWeb: www.ias.ie

SAMARITANS08457 90 90 90

www.samaritans.org

Lifeline NI0808 808 8000

www.lifelinehelpline.info