If one were to ask parents the most challenging part of raising kids; they’d probably say: the teen years. The “terrible teens” are more than just a cliché. Teen angst is a well-known part of adolescence. It’s a tumultuous developmental period when teens are making that big push for independence. Hormones are raging and they’re at that awkward place between child and adult. These physical and psychological shifts result in mood swings, changes in behavior, and often involve conflicts with others as they struggle to find their way.
For most teens, and much to their parents’ relief, this angst resolves over time with little more than a few tears and skirmishes. However, for some teens, the experience is quite intense and disruptive. The result can be depression, and the symptoms are often quite debilitating. While teenage depression is nothing new, mental health researchers are seeing a disturbing trend.
Teen depression is increasing at an alarming rate. A 2019 study found that over the last decade the number of adolescents with mental health disorders has more than doubled. Rates of major depression increased by a staggering 52%. It is estimated that about 13% of teens now have at least one bout of major depression.
There is a lot for parents to be concerned about, and a lot to know about teen depression.
The Face of Teen Depression
Depression is not a single mental health disorder, but rather, a group of mood disorders that share the common feature of a depressed mood. What varies is the ways the depressed mood presents itself, its duration, and other clinical features that might be present. Some examples of depression include:
- Major Depression
- Persistent Depressive Disorder (previously known as Dysthymia)
- Bipolar Disorder (often referred to as “manic depression”)
- Seasonal Affective Disorder
- Post-partum Depression
- Premenstrual Dysphoric Disorder (PMDD)
Each of these disorders has a depressive component, which is presented in a variety of ways. Similarly, depression also affects people differently. Passed studies reveal some stark differences in terms of who might be at greatest risk.
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- Teen girls (20%) are much more likely than boys (6.8%) to experience depression.
- Higher rates of depression were found with multiracial adolescents (16.9%).
- Having a parent with depression increased the rate of depression in teens by almost 50%.
- A history of trauma, abuse, or chronic illness was also associated with higher rates of depression.
One of the most concerning findings of the study was that nearly 70% of teens with depression had what would be considered severe impairment and 7.4% of teens in 9th -12th grade reported at least one suicide attempt in the previous 12 months.
What Causes Teen Depression
A number of factors have been identified as playing a role in the development of depression in teens.
Genetics – Kids who have a parent with depression are more likely to develop depression.
Brain Chemistry – Sometimes referred to as a “chemical imbalance,” the brain chemistry of a depressed teen can include neurotransmitters that aren’t working properly. As a result, the brain’s ability to regulate moods can become impaired, leading to depression.
Adverse Childhood Experiences (ACES) – These experiences are those that occur in childhood that can have a profound effect later on. Adverse experiences are thought to alter the brain and make a person more susceptible to difficulties. Early childhood trauma, profound loss, neglect, and other factors early in life have been shown to play a key role in the development of depression in adolescence and beyond.
Learned Patterns of Helplessness and Negative Thinking – There is also thought to be a learned behavior component to teen depression. Feelings of helplessness can leave teens feeling defeated and unable to find solutions to their problems. Instead, they take on patterns of pessimism and thinking negatively about themselves and the world around them. These patterns of thinking and behavior are learned from their surroundings.
Ironically, teens with major depression are most likely to go untreated. Depression doesn’t usually go away on its own. Left untreated, depression can cause problems that affect your teen’s ability to function and lead to some serious outcomes such as:
- Substance abuse
- Academic problems
- Increased conflicts with friends and family
- Behaviors that result in legal issues
- Thoughts and attempts of suicide
The pressing question is, why does teen depression go untreated so often? One answer is that it doesn’t look the way one would think it should.
What Teen Depression Looks Like
When you think of depression, you probably think of someone crying all the time, morose, refusing to get out of bed; stereotypical depression. If you were describing an adult, you wouldn’t be wrong.
Depression among teens is presented in a very different way. While adults tend to talk about emotional pain, depressed teens tend to have somatic symptoms. Complaints of headaches, stomachaches, and similar symptoms that have no medical basis are common. You might also see grades begin to fall. However, depressed teens can also maintain high grades, but feeling the pressure to do so can further complicate the picture.
Rather than overt sadness, depressed teens often display more irritability, agitation, and sometimes even defiance. While some mood shifts are normal, significant irritability should be considered a warning sign to be evaluated. Abrupt changes in peer groups or increased social isolation are common. Teens don’t always become “loners.” Sometimes they just change their friends, which can make seeing a potential problem difficult. They might also retreat into the virtual world and begin spending inordinate amounts of time online. Again, with today’s tech-savvy kids, it’s hard to know what’s normal and what is problematic.
In addition, there can be a change in their sleep patterns, appetite, and weight. Between the expected angst of adolescence and not quite fitting the common image of depression, it’s easy to miss the subtle cues that something is amiss. With rates of teen depression increasing, it’s more important than ever to understand what’s happening and how to help them.
Why Teen Depression Is Increasing
There is currently no single theory that can fully explain the rising rates of teen depression. As researchers explore the rise of teen depression, a few key factors seem to be emerging.
Increased Awareness and Diagnosis of Teen Depression – Until the 1990s, clinicians were reluctant to diagnose teens with a mood disorder. Not only was it hard to differentiate between teenage turmoil and depression, but their growing brains needed to be taken into consideration. A diagnosis of depression was generally considered inappropriate.
Technology Influence – Each successive generation of teens has become more engaged with technology. Tech has become the predominant way teens socialize and communicate. It is thought that the increase in depression, distress, and suicidal behaviors may be connected to the influence of social media. Teens are quite sensitive to the “likes” and “comments” they receive, and often base their self-worth on this feedback. Cyberbullying has become particularly problematic.
Poor Sleep – Sleep disturbances have long been associated with depression and people are now more sleep-deprived than ever. Teens tend to get about half of the recommended seven to nine hours of sleep per night. Their sleep can be further disrupted by excessive use of electronics in the evening. Insufficient sleep has consistently been shown to increase hopelessness, depressive symptoms, and suicidal ideation.
Lack of Security – Of course, every generation has its trials, but teens are increasingly confronted with the realities of the times. They are living in a world where violence has become commonplace and played out instantly on social media and 24-hour news outlets. The can result in feelings of isolation from one’s community and can contribute to depression and other issues.
What Parents Can Do
The good news is that there is a lot you can do as a parent, whether your teen is depressed or you want to try and support your teen to hopefully avoid depression.
Get Help – If you think your teen may be depressed, the first step is to get help. Sadly, less than 40% of depressed teens get treatment. Depression isn’t likely to go away on its own and you want to get an accurate diagnosis. A mental health clinician can do an assessment and provide you with recommendations for care.
Don’t be surprised if your teen is resistant to seeking help. They may even become quite upset about it. This is normal since the idea of seeking help can be hard, and for a teen, it can be mortifying. Even if they resist, take them anyway. A good place to start might be with their family doctor or other health provider with whom they have a good relationship.
Treatment – Treatment generally consists of medication, counseling, or a combination of the two. Not every teen needs antidepressant medications. Counseling can be quite effective and is by far the option utilized most often according to the National Institute of Mental Health.
Talk with Your Teen – Talk to your teen about depression. They may find all the things they’re feeling confusing or overwhelming. Talk to them about the option of treatment and explain that there is always hope.
Listen to Understand – When you’re talking with your teen, listen to what they’re saying and to what they are not saying. Listen in order to understand, because what you think they’re feeling might be very different from what they really feel.
Encourage Them to Seek Support – Let your teen know you support them. It’s also important to let them know they can talk to someone other than you if they need to. There may be a close relative or family friend who they feel particularly close to. It’s ok if it’s not you. Sometimes, kids need to confide in someone not so close to them.
Another thing you can do is to monitor their sleep patterns. Make sure your teen is getting a good, restful night’s sleep. Additionally, you should manage screen time to avoid difficulty with sleep. It is also important to be aware of what your teen is doing online, so keep an eye on social media use and talk to your teen often.
The most important thing you can do is to stay engaged with your teen. Changes that indicate depression can be subtle. When you know your child’s habits and what’s “normal” for them, you’re more likely to pick up on those changes that can signal a problem. Whether it’s depression or just that teenage turbulence, they’re counting on you to help them get through these stressful years; even if they don’t tell you so.