Depression in Teens: The Warning Signs and How to Help Them Through

Depression in Teens The Warning Signs and How to Help Them Through

One of the things that can make depression so difficult to recognise is that the symptoms can be things we all struggle with from time to time – sadness, hopelessness, lethargy, lack of engagement. When these very normal human experiences happen in a combination, duration or intensity that start to interfere with day-to-day life (school, relationships), it’s possible that depression might be waving a heavy hand over your teen.

During adolescence, the rates of depression skyrocket. According to the World Health Organisation, depression is the number one cause of illness and disability in adolescents. But there’s something else. Research shows that in half of all adults who have problems with their mental health, their symptoms showed up before age 14. Three-quarters had symptoms by age 24. This puts flashing lights around the importance of noticing when our teens are struggling and making sure they get the support they need. The earlier symptoms are caught, the easier it will be to stop those symptoms expanding into something bigger and more difficult to shift.

What are the symptoms of depression in teens to watch out for?

For a diagnosis of depression, a particular cluster of symptoms needs to have been there for at least for two weeks. These symptoms must include at least one of either a depressed mood, or a loss of interest or pleasure in things that were once enjoyable. Many times these will just be a normal part of adolescence and nothing at all to worry about, but if depression is happening, there will be other telltale signs. Here are some to watch out for:

  1. Happiness, anger, indifference – the many faces of depression.

    Depression doesn’t always look like sadness or withdrawal. Some of depression’s classic disguises are:

    •  Anger or irritability.

    Depression often comes with lethargy, pain and/or hopelessness. Understandably, this can make people angrier, more irritable or more impatient than usual.

    •  Happy, but reluctant to spend time with friends or family.

    It’s takes a huge amount of strength to move through the day with depression hanging on. If your teen has depression they might use this strength to put on a happy face, but where there is depression, there is also likely to be increasing withdrawal. It’s very normal for teens to withdraw from family activities – it’s part of them experimenting with their growing independence. The thing to watch out for is if they withdraw more from friends and spend more time on their own than usual.

•  Indifference.
Depression doesn’t just steal happy feelings. Sometimes it can steal all feelings, which can make people seem flat or indifferent. In teens, it can be difficult to tell whether their indifference is just a normal part of adolescence or whether it’s something more. It’s not at all unusual for teens to seem more indifferent and there’s a good reason for this. Dopamine is the chemical that creates the feel-good when we get something we want, and in teens the baseline levels in the brain are lower than they are in adults or children, creating a sense of flatness. There is a way though, to tell the difference between normal adolescence and depression. Watch out for what happens when your teen does something that feels good or when they get something they want. When adolescents do something that feels good, the dopamine levels are higher than they are in adults, so the feel-good feels better. In depression, this doesn’t happen. There is a constant sense that nothing makes a difference, and the flatness or indifference doesn’t shift even when they are doing something that they would normally have enjoyed.

  1. Pulling back from people and activities that were once enjoyable.

    Depression takes away the sense of enjoyment from things that were once enjoyable. Watch out for your teen cancelling plans or making excuses to avoid the things they once wouldn’t have missed. 

  2. Tiredness, lethargy, exhaustion.

    Depression is exhausting and can make people more tired than usual, even if they seem to spend more time sleeping.

  3. Depression hurts, literally.

    Depression is a physical illness, so sometimes the symptoms will show up physically. Watch out for unexplained headaches and migraine, stomach aches, back pain, joint aches and pains. Mood and pain share the same pathways in the brain and they are regulated by the same brain chemicals (serotonin and norepinephrine). When the balance of these neurochemicals is out, pain and mood might both be affected. 

  1. Giving up on things that are important.

    The hopelessness, helplessness and lowered self-esteem that come with depression might see depressed teens giving up on school, friendships, or other things that are important to them.

  2. Change in physical movements and speech.

    Depression can speed up movement (restlessness, agitation, fidgeting, pacing, leg shaking or hand-wringing), or it can slow down movement and speech.

  1. Fuzzy thinking, difficulty concentrating and remembering.

    As well as draining physical and emotional energy, depression can also take a swipe at mental energy. Teens with depression might have difficulty concentrating, remembering, or making decisions. Slowed thinking might mean they take longer to collect their thoughts, which can show itself as slowed speech.

  1. Isolating from others.

    There’s nothing wrong with wanting some alone time, but when there’s a noticeable withdrawal, it might be a problem. This might be because being with people no longer brings joy (because nothing brings joy), or because fatigue, or having to put on a happy face when there is no ‘happy’ to hold it up feels too hard. Depression also has a way of convincing even the strongest of minds that they are a burden to those around them and that they are best keeping themselves to themselves.

  2. Change in sleeping habits.

    About 40% of young adults with depression have hypersomnia, which is excessive sleeping. Depression can make people oversleep, or wake earlier than usual and have trouble going back to sleep.

  1. Change in eating habits.

    Depression can create an emptiness that feels unbearable, and people might turn to food to try to fill the void. Eating habits can also change in the other direction, with people eating less.

  2. Change in grades.

    Depression brings fuzzy thinking, low energy and difficulty concentrating. All of this can make studying, listening and learning more difficult. The clue that this is happening will be a change in grades.

  3. Taking more, using more, doing more.

    Depression is more than sadness. It’s an inability to feel joy. This is confusing and frightening for anyone to feel, and as a way to find relief from that, or to distract themselves from their pain, teens might turn to all sorts of risky or addictive behaviour. They might be driven to do more of what has felt good before, or anything that helps them to feel – something. This might look like drinking, drugs, skipping school, gaming excessively, eating excessively or self-harm. 

  4. Self-injury.

    All of us can only push down big feelings for a certain amount of time before they start to push for attention. Physical pain and emotional pain share the same pathways in the brain. When emotional pain feels too big or when it stops making sense, self-harming can be a way to find short but needed relief from the heaviness that comes with depression. Teens don’t do this to manipulate or to control the people around them – they wish they could stop too. They do it to make the pain go away.

If you suspect your teen is depressed …

Depression is such a persuasive beast, and it can convince anyone it’s holding onto that nothing will make a difference. This hopelessness is a classic symptom of depression, and the very thing that gets in the way of healing from it. If you suspect your teen might have depression, the first step is getting a diagnosis so everyone knows what they’re dealing with. A doctor or mental health professional can help with this. Depression doesn’t always need medication, but it might. Having the support of a loving adult will be important for any teen who is trying to find their way through depression. If that supportive and loving adult is you, here are some things you can do to help your teen strengthen and heal:

  • Help them find ways to connect with other teens.

    Healthy friendships can be comfort and protection against the messy times that can come with adolescence. The problem can be finding these friends. School isn’t the only source of friendship. In fact, sometimes school friendships can be a huge source of sadness, fear and hurt. If your teen is struggling with friendships at school, it’s easy for them to be drawn into believing that it will be like this everywhere, but it won’t. Explain that school comes with different pressures and different problems that won’t be found in other environments. There will be people out there who would love to know your teen. Their tribe is out there, but sometimes they might have to look beyond the school ground to find them. Encourage your teen to try activities or join groups to expose themselves to people who share a more similar view of the world than the people at school. Some ways to do this are through sport, drama, music, part-time jobs, art classes, cooking classes. This might not be easy – depression drains energy for everything. Point out to your teen that it’s not necessarily about the activity, but about expanding their opportunity to find the people who will love being with them – and for certain those people are out there.

  • Meditation and exercise.

    Recent research has found that depression can be reduced by up to 40% in two weeks through a combination of thirty minutes of mindful meditation and thirty minutes of exercise (treadmill or static bike), twice a week. Encourage your teen to try anything that will get his or her heart pumping. If they’re depressed, they might not be jumping at the opportunity to exercise. It’s part of what depression does, so you might need to be a bit creative – let one of their chores be to take the dog for a walk, take a sibling to the park to kick a ball, or to walk with you at night-time to keep you company. For the meditation part, the Smiling Mind app is a free app that has guided meditations for teens. It’s an easy and no-hassle way to get started with mindfulness, which has been proven by a mountain of research to be helpful with depression.

  • And while we’re on apps …

    A collection of 13 apps developed by researchers from Northwestern University has been found to reduce depression and anxiety by up to 50%. 

  • Keep it real.

    Push against the ridiculous ideas of how they ‘should’ look by helping them to develop a healthy idea of what ‘beautiful’ means. The concept of beauty isn’t the problem, the definition is. Our teens are barraged with unrealistic and very narrow versions of what ‘body beautiful’ means. Help them to expand this, and to nurture a healthy body image by pointing out the many different versions of body beautiful that you see. This important for teen boys too.

  • When they feel heard they feel cared for.

    Teens, particularly girls, will connect listening with caring. They might not always listen to you, and that’s okay, but if they feel as though you aren’t listening to them, they might feel as though you don’t care. It’s easy to dismiss their worries or mood swings as part of the normal ups and downs of adolescence – and it absolutely might be – but it’s still important to let them know that you hear them, that you notice them, and that you’re there for them.

  • Reduce gaming time – let them game with friends.

    True, it might feel easier to catch a falling star in a glass jar, but anything you do can make a difference. Research has found that teens who spend more than four hours a day gaming can be vulnerable to depression, but there is a way to turn that risk around – let them game with friends. Boys who spend time gaming with friends, or those who are connected to friends either online or in real life appear to be protected from the depressive effects of heavy gaming. Girls who spend a lot of time gaming and who are socially active online are less lonely and less socially anxious, but they also show lower self-esteem. The reason behind your teen’s gaming is important. Researchers suggest that if it seems to be an attempt to ward of loneliness or to cope with the world, it might be time to step in to reduce the time spent at the console. Otherwise, if it’s a way to socialise or to connect with others, either in person or online in interactive games, there’s less likely to be a need for concern.

  • Every day say something positive, and find something positive in everything.

    Even when teens mess up there’s gold in there somewhere, but they (you) might have to work hard to find it. Whether it’s about the way they come to you for advice or to download, whether it’s the way they learn from their experience, or that they didn’t pick a worse choice – there will be something. Try to say something positive every day, even if they don’t seem to take it in. Depression gives teens plenty of reasons to feel ‘less than’, so it’s important to protect them by pushing back against it whenever you can. 

  • Be available, but not intrusive.

    As little people, children turn to their parents for comfort and protection when they scrape against the hard edges of the world. As teens though, they are driven by the very important developmental goal of separating from parents and family. There can often be pressure (from inside of themselves or outside), to deal with things on their own, or at the very least without their parents. This can be tough for everyone. Finding the balance between holding them close and respecting their need for autonomy and independence isn’t easy, but it’s so important. Let your teen know they can talk to you about anything at all. When they do, listen and absorb whatever they tell you, even if it’s shocking. The more they can feel you as a strong, steady presence through their turmoil, the more they’ll trust that you can be there for them, even when things are messy.

  • All of their feelings are okay.

    Feelings that don’t get felt or expressed cause breakage. All feelings are valid and they are all okay to be there. It’s never feelings that cause trouble, it’s the way they are dealt with – or not dealt with. When feelings are pushed down or ignored, they’ll sprout little roots and they’ll grow. If teens don’t feel safe enough to feel anything they’re feeling – angry, confused, scared, guilty, jealous – the risk is they’ll cut themselves off from one feeling, then another and another. When they cut themselves off from bad feelings, it becomes easier to also cut themselves off from the good ones. 

  • Be available on their terms.

    Depression can be relentless, convincing people that they aren’t worthy of love or worthy of the fight. Your teen might crave company and someone to talk to, but at the same time push everyone away. Anything you can to do let them know that you’re there for them on their terms will be important. Some ways to gently do this are by sitting with them and watching whatever they’re watching on tv, or popping into their room just before they fall asleep – it’s often a time when they’re feeling safe and bundled away from the world, and when they might give you a little window into theirs. 

  • Know their ‘normal’.

    There are so many different versions of normal. Your teen’s version of ‘normal’ will change during adolescence, but the more you can get a handle on whatever their ‘normal’ is – feelings, behaviour, habits – the quicker you’ll get a feel for when something is off. This can be particularly difficult during adolescence because they’re changing so much, but trust your instincts. If you’re in doubt, ask. ‘I notice you’re sleeping a lot lately. Do you feel as though you are?’ If they say it’s fine, trust it for a while. If it feels like things aren’t fine, be open to the possibility that you’re absolutely right. Trust your intuition and continue to be gently curious.

  • You don’t have to fix them.

    See them and notice them but remember that you don’t have to fix them. None of us like feeling as though we’re a problem that needs fixing, which is how it can feel when people jump into problem-solving mode, even when it’s done with the most loving intent. Instead, listen with an open heart and an open mind and without judgement. Create opportunities for your teen, but express them incidentally and without expectation. Rather than, ‘You know if you exercised you’d probably feel better,’try, ‘I’m taking the dogs for a walk a little bit later if you want to come.’

And finally …

Adolescence is a time of massive change, which can be confusing for teens and the people who love them. Adding to the confusion, ‘normal’ teenage behaviour and signs of a mental health struggle can look the same. Changes in sleep and eating patterns, moodiness, pulling away from family, irritability – these can all be a very normal part of adolescence, or they can be symptoms of depression. It’s important to let your teen pull away when they need to. The push for independence from family and parents is a really important part of adolescence, but it’s also important to stay gently curious, vigilant and available. The more we notice when those we love are struggling, or the more we listen to the heart whispers when something isn’t right, the more empowered we are to respond in a way that can heal and strengthen.

60 Comments

Naomi G

My son is 18 and should be gratuating from HS in may. He seems to have no interest in school. I mean he is not even trying. He played football…which is his dream. He has recently changed his diet. He has gone from 225lbs to 180. He does not seem to be focused and he foregets a lot. When he was 14 he was diagnosed with depression, anxiety and OCD. Although since then he has gotten better, I am concerned now because he seems so withdrawn. I plan to find him a therapist to speak with. This should be one of the happiest times of his life.

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Faith

My 17 year old son has been having problems without us noticing. He started using drugs and alcohol and we never noticed. He dropped his grades and stopped all the sports he loved. He was once diagnosed with peptic ulcer at the age of 14 and he is always in and out of hospital. If the hand is not broken it’s the legs and he complains of headaches. The whole family thinks he wants attention and the father thinks beating him is the best. He was seeing a psychologist who never bothered to give me a call but gave him different types of medication. Now my son is in hospital because of alcohol abuse and is missing out on school. I am the only one visiting and talking to him. My husband says he will chase him away. He says he really want to change that’s why he went to sick for help. How can l help my son. Please help me.

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April W

Leave the sack of shit father who is beating him. You should love your son and want more for him than to have anyone physically abuse him. Get him out of that situation and into counseling. Normally, spouses that beat their kids beat their wives. Find a safe place to go and start over. Stick up for your son and go.

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Kristin

Please get his father away from him. Physical abuse is not the answer to any problem. It sounds like your family needs to be more understanding and supportive of your son. Your son is reaching out for help and your family sees it as attention getting. If his Doctor is not helping, get a new one right away. Please allow your son to open up to you about his feelings by being attentive and nonjudgmental. He needs love and support from you.

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Eli R

My best friend told me that his daughter has been sleeping more than usual since she started high school. I’m glad that you noted that teens who appeal to oversleep suffer from hypersomnia. I will advise my friend to consider going to a Counselor as soon as possible.

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yes

try to talk to him as much as you can by bringing up some conversation. try go out for walk together as family and bring some casual talks then slowly which can mention you guys love him and care about him no matter what.tell him to play games where you all sit most(if posiible shift his desk to common room where everyone can see him tell him that you guys will miss him when he goes to college so its better to be stay cozy).Junior year is stressful for every high school student give him confidence that you all trust him he will try his best whatever result he gets its fine.

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D

I was googling any article about teenage depression and found this. Good article. My son 17 yrs old started showing a few symptoms last year. He stopped swimming ( was in the swim team for 10 yrs) and triathlon. I never thought more about depression until last year it got worse. Recently refused to go to school. Was on therapy for 1 yr, no help. Changed him to different therapist and signed him up for group therapy. The new therapist recommended me to take him to psychiatrist – thinking my son falls in the category of depression. Psychiatrist presribed him for Prozac 10mg. So far okay with med. BTW he is also on Vyvanse for his ADHD. I also started giving him melatonin.My husband does not believe all of the symptoms. He thinks my son is manipulating us. I, myself so confused. My son does not look like sad, more like unfriendly and no interest in having conversation with family. He plays game on iPad literally for hours and hours. He looks normal and happy when he plays games.
Does not want to go out the house at all, other than school and therapy. Just with iPad in the room the entire time. He looks much calmer with med and Melatonin. Refuses even to do homeworks or study. He is junior year and make me so nervous to deal with this, especially with my husband who consistently saying our son is normal, just trying to manipulate. My siblings said the same thing, if he does not want to go to school, tell him to work or do something else. I can’t force him to do that. I truly believe he struggles with something. Feeling hard for no support from surrounding how to handle him. Every one against my thought. My husband and sibings try to convince me, he got depressed because of too much time on device. My argument is he burries himself in device because of the depression. What else can I do to help him come out from this situation?

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Helz

Hiya i believe in you what you are saying my 17 year old son went to school if was a happy child since hes left secondary he passed few exams got himself a place at college doing computin which hes very good at he wasnt there long month if that he hated it because this twat was taking the micky out my son for bein so tall and skinny he got very upset about it all i went crazy with the school and that boy anyway my son will never go back hes got know interest in anything only his ps4 and online connection with his friends he sees them once in a blue moon he locks himself away in his room with his tv gaming stuff and only comes out for bit of food and a drink brings that uo to this room so i dont know what to do with him i feel for you really im in same boat how old is your son ?

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Mbuvi

I would love to hear how this progresses. My son is now 22 and from what the counsellor told me developed depression a few years ago. All of us in the family didn’t understand the problem. We thought he was merely unhappy over his college grades and wanted to drink for fun.

What puzzled me until I took him to a psychiatrist was that he would get drunk, even on stuff he had stolen from home, but on being confronted he would own up to having stolen for the purpose of getting high.

He has asked to be taken for a 3 month rehab course. I am hoping it will help him. He seems so distraught and unhappy, yet he used to be bright and happy in high school.

Your son’s issue resembles his so much.

I am a Kenyan based in Nairobi. I have three other children, all girls and doing alright.

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Melanie R

My almost 16 year old grandson has been exactly like this for at least 2 years….
It truly breaks my heart. I am soooo concerned for this dear boy. If you get any constructive answers Please forward to me. He lives across the country so we only get to see him a couple Times a year. He does want to fly to our home and visit for 10 days this summer so this does make me hopeful.
Thank you so much. PS. He is in counseling….. butNO medicine, which I think would be so helpful.

Reply
John

Karen,
Thank you. Lots that resonates and constructive strategies for supporting my daughter and how to connect with her.

Reply

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When our kids or teens are struggling, it can be hard to know what they need. It can also be hard for them to say. It can be this way for all of us - we don't always know what we need from the people around us. It might be space, or distraction, or silence, or maybe acknowledging and being there is enough. Sometimes we might need to know that the people we love aren't taking our need for space, or our confusion or anger or sadness personally, and that they are still there within reach.
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What can be easier is thinking about what other people might need. Asking this when they are calm can invite a different perspective and can give you some insight into what they need to hear when they are going through similar. Don't worry if you just get a shrug, or a disheartened, 'I don't know'. They don't need to know, and neither do we. The question in itself might be enough to open a new way through any sense of 'stuckness' or helplessness they might be feeling.
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#parenthood #parenting #positiveparenting #parentingtips #childdevelopment #parentingadvice #parentingtip #mindfulparenting #positiveparentingtips #neurodevelopment #parentingteens
Give them space to talk but you don’t need to fix anything. You’ll want to, but the answers are in them, not us. Sometimes the answer will be to feel it out, or push for change, or feel the futility of it all so the feeling can let go, knowing it’s done it’s job - it’s recruited support, or raised awareness that something isn’t right.

Sometimes the feelings might be seismic but the words might be gone for a while. That’s okay too. Do they want to start with whatever words are there? Or talk about something else? Or go for a walk with you? Watch a movie with you? Or do a spontaneous, unnecessary drive thru with you just because you can - no words, no need to explain - just you and them and car music for the next 20 minutes. 

The more you can validate what they’re feeling (maybe, ‘Today was big for you wasn’t it’) and give them space to feel, the more they can feel the feeling, understand the need that’s fuelling it, and experiment with ways to deal with it. Sometimes, ‘dealing with it’ might mean acknowledging that there is something that feels big or important and a little out of reach right now, and feeling the fullness and futility of that. 

Part of building resilience is recognising that some days are rubbish, and that sometimes those days last for longer than they should, but we get through. First we feel floored, then we feel stuck, then we shift because the only choices we have we have are to stay down or move, even when moving hurts. Then, eventually we adjust - either ourselves, the problem, or to a new ‘is’. But the learning comes from experience.

I wish our kids never felt pain, but we don’t get to decide that. We don’t get to decide how our children grow, but we do get to decide how much space and support we give them for this growth. We can love them through it but we can’t love them out of it. I wish we could but we can’t.

So instead of feeling the need to silence their pain, make space for it. In the end we have no choice. Sometimes all the love in the world won’t be enough to put the wrong things right, but it can help them feel held while they move through the pain enough to find their out breath, and the strength that comes with that.♥️
Speaking to the courage that is coming to life inside them helps to bring it close enough for them to touch, and to imagine, and to step into, even if doesn’t feel real for them yet. It will become them soon enough but until then, we can help them see what we see - a brave, strong, flight-ready child who just might not realise it yet. ‘I know how brave you are.’ ‘I love that you make hard decisions sometimes, even when it would be easier to do the other thing.’ ‘You might not feel brave, but I know what it means to you to be doing this. Trust me – you are one of the bravest people I know.’
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 #neurodevelopment #positiveparenting #parenting #parenthood #neuronurtured #parentingtip #childdevelopment #braindevelopment #mindfulparenting #parentingtips #parentingadvice
So often, our children will look to us for signs of whether they are brave enough, strong enough, good enough. Let your belief in them be so big, that it spills out of you and over to them and forms the path between them and their mountain. And then, let them know that the outcome doesn't matter. What matters is that they believe in themselves enough to try. 

Their belief in themselves might take time to grow, and that's okay. In the meantime, let them know you believe in them enough for both of you. Try, ‘I know this feels big and I know you can do it. What is one small step you can take? I’m right here with you.’♥️
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 #neurodevelopment #positiveparenting #parenting #parenthood #neuronurtured #parentingtip #childdevelopment #braindevelopment #mindfulparenting
Anxiety will tell our kiddos a deficiency story. It will focus them on what they can't do and turn them away from what they can. We know they are braver, stronger, and more powerful than they could ever think they are. We know that for certain because we’ve seen it before. We’ve seen them so held by anxiety, and we’ve seen them move through - not every time but enough times to know that they can. Even when those steps through are small and awkward and uncertain, they are brave. Because that’s how courage works. It’s fragile and strong, uncertain and powerful. We know that that about courage and we know that about them. 

Our job as their important adults is to give them the experiences that will help them know it too. This doesn't have to happen in big leaps. Little steps are enough, as long as they are forward. 

When their anxiety has them focused on what they can't do, focus them on what they can. By doing this, we are aligning with their capacity for brave, and bringing it into the light. 

Anxiety will have them believing that there are only two options - all or nothing; to do or not to do. So let's introduce a third. Let's invite them into the grey. This is where brave, bold beautiful things are built, one tiny step at a time. So what does this look like? It looks like one tiny step at a time. The steps can be so small at first - it doesn't matter how big they are, as long as they are forward. 
If they can't stay for the whole of camp, how much can they stay for?
If they can't do the whole swimming lesson on their own, how much can they do?
If they can't sleep all night in their own bed, how long can they sleep there for?
If they can't do the exam on their own, what can they do?
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When we do this, we align with their brave, and gently help it rise, little bit, by little bit. We give them the experiences they need to know that even when they feel anxious, they can do brave, and even when they feel fragile they are powerful.

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