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Teen depression

Teen depression is a serious medical problem that causes a persistent feeling of sadness and loss of interest in activities. It affects how your teen thinks, feels and behaves, and it can cause emotional, functional and physical problems. Although mood disorders, such as depression, can occur at any time in life, symptoms may be different between teens and adults.

Issues such as peer pressure, academic expectations and changing bodies can bring a lot of ups and downs for teens. But for some teens, the lows are more than just temporary feelings — they're a symptom of depression.

Teen depression isn't a weakness or something that can be overcome with willpower — it can have serious consequences and requires long-term treatment. For most teens, depression symptoms ease with treatment such as medication and psychological counseling.

Symptoms Causes Risk factors Complications Prevention

Teen depression signs and symptoms include changes in your teen's emotions and behavior, such as the examples below.

Emotional changes

Be alert for emotional changes, such as:

  • Feelings of sadness, which can include crying spells for no apparent reason
  • Irritability, frustration or feelings of anger, even over small matters
  • Loss of interest or pleasure in normal activities
  • Loss of interest in, or conflict with, family and friends
  • Feelings of worthlessness, guilt, fixation on past failures or exaggerated self-blame or self-criticism
  • Extreme sensitivity to rejection or failure, and the need for excessive reassurance
  • Trouble thinking, concentrating, making decisions and remembering things
  • Ongoing sense that life and the future are grim and bleak
  • Frequent thoughts of death, dying or suicide

Behavioral changes

Watch for changes in behavior, such as:

  • Tiredness and loss of energy
  • Insomnia or sleeping too much
  • Changes in appetite, such as decreased appetite and weight loss, or increased cravings for food and weight gain
  • Use of alcohol or drugs
  • Agitation or restlessness — for example, pacing, hand-wringing or an inability to sit still
  • Slowed thinking, speaking or body movements
  • Frequent complaints of unexplained body aches and headaches, which may include frequent visits to the school nurse
  • Poor school performance or frequent absences from school
  • Neglected appearance — such as mismatched clothes and unkempt hair
  • Disruptive or risky behavior
  • Self-harm, such as cutting, burning, or excessive piercing or tattooing

What's normal and what's not

It can be difficult to tell the difference between ups and downs that are just part of being a teenager and teen depression. Talk with your teen. Try to determine whether he or she seems capable of managing challenging feelings, or if life seems overwhelming.

If depression symptoms continue or begin to interfere in your teen's life, talk to a doctor or a mental health professional trained to work with adolescents. Your teen's family doctor or pediatrician is a good place to start. Or your teen's school may recommend someone.

When to see a doctor

If you suspect your teenager is depressed, make a doctor's appointment as soon as you can. Depression symptoms likely won't get better on their own — and they may get worse or lead to other problems if untreated. Depressed teenagers may be at risk of suicide, even if signs and symptoms don't appear to be severe.

If you're a teen and you think you may be depressed — or you have a friend who may be depressed — don't wait to get help. Talk to a health care professional such as your doctor or school nurse. Share your concerns with a parent, a close friend, a spiritual leader, a teacher or someone else you trust.

Suicidal thoughts

If your teen is having suicidal thoughts, get help right away. Take all talk of suicide seriously. Here are some steps you can take:

  • Call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) to reach a trained counselor or encourage your teen to do so.
  • Seek help from your doctor, a mental health provider or other health care professional.
  • Reach out to family members, friends or spiritual leaders for support as you seek treatment for your teen.

When to get emergency help

If you think your teen is in immediate danger of self-harm or attempting suicide, make sure someone stays with him or her. Call 911 or your local emergency number immediately. Or if you think you can do so safely, take your teen to the nearest hospital emergency department.

It's not known exactly what causes depression. A variety of factors may be involved. These include:

  • Biological chemistry. Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression. When these chemicals are out of balance, it may lead to depression symptoms.
  • Hormones. Changes in the body's balance of hormones may be involved in causing or triggering depression.
  • Inherited traits. Depression is more common in people whose biological (blood) relatives also have the condition.
  • Early childhood trauma. Traumatic events during childhood, such as physical or emotional abuse, or loss of a parent, may cause changes in the brain that make a person more susceptible to depression.
  • Learned patterns of negative thinking. Teen depression may be linked to learning to feel helpless — rather than learning to feel capable of finding solutions for life's challenges.

Many factors increase the risk of developing or triggering teen depression, including:

  • Having issues that negatively impact self-esteem, such as obesity, peer problems, long-term bullying or academic problems
  • Having been the victim or witness of violence, such as physical or sexual abuse
  • Having other conditions, such as an anxiety disorder, anorexia or bulimia, attention-deficit/hyperactivity disorder (ADHD) or learning disabilities
  • Having a chronic medical illness such as cancer, diabetes or asthma
  • Having few friends or other personal relationships
  • Having certain personality traits, such as low self-esteem or being overly dependent, self-critical or pessimistic
  • Abusing alcohol, nicotine or other drugs
  • Being a girl — depression occurs more often in females than in males
  • Being gay, lesbian, bisexual or transgender — becoming socially isolated or experiencing bullying may increase the risk of depression

Family history and issues with family or others may also increase your teen's risk of depression:

  • Having a parent, grandparent or other biological (blood) relative with depression, bipolar disorder or alcoholism
  • Having a family member who committed suicide
  • Having a dysfunctional family and conflict
  • Having experienced recent stressful life events, such as parental divorce, parental military service or the death of a loved one

Untreated depression can result in emotional, behavioral and health problems that affect every area of your teen's life. Complications related to teen depression can include:

  • Low self-esteem
  • Alcohol and drug abuse
  • Academic problems
  • Family conflicts and relationship difficulties
  • Social isolation
  • Involvement with the juvenile justice system
  • Suicide

There's no sure way to prevent depression. However, these strategies may help. Encourage your teen to:

  • Take steps to control stress, such as not committing to too many obligations at once.
  • Boost low self-esteem by recognizing small steps toward getting better.
  • Reach out for friendship and social support, especially in times of crisis.
  • Get treatment at the earliest sign of a problem to help prevent depression from worsening.
  • Maintain ongoing treatment, if recommended, even after symptoms let up, or have regular therapy sessions to help prevent a relapse of depression symptoms.
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