Talking to Your Teen About Mental Health and Depression (Without Saying ‘Mental’ or ‘Depression’)

Day to day ups and downs are a normal part of adolescence, making it difficult to distinguish between normal teenage moodiness and depression. Teens might not always be able to articulate what they’re going through, and they might not want to talk about it to you, but starting the conversation will help to protect their mental well-being.

Rates of teen depression increase sharply during adolescence, peaking around 16 years old. The exact reasons for the rise in depression during this time is unknown but it’s widely accepted that a number of factors contribute, including school transitions, academic and social stress and hormonal changes. Add to this their developmental goals of figuring out who they are, where they fit in and establishing their independence and it’s clear that teens have a lot going on. 

The Conversation That Will Help Protect Your Teen

One of the best things you can do for your teen in your life is to let them him or her know that you’re available to talk on their terms.  Here are some ideas for how to make that happen:

  1. Let them see you.

    Let them know you’re there for them unconditionally and whenever they want – no limits. Be careful not to ask too many questions. You don’t want them to feel crowded or patronised.

  2. Put the invite out there.

    Sometimes starting the conversation is the hardest part. Here are a few ideas to get things started:

    • ‘Are you okay? I’m here if you ever want to talk.’
    • ‘It’s really normal to feel stressed/ cranky/ sad/ tired sometimes but if it gets to the point where you’re feeling like that all the time we should talk about it. You don’t have to feel like that and there are ways to feel better.’
    • ‘You seem a bit down/ stressed/ tired/ sad lately. Is that how you’re feeling at the moment?’ Then, depending on the answer, ‘Would you like to talk about it?’ or ‘Well I’m here if you ever need to talk.’ 
  3. Validate them.

    Casually acknowledge that high school can be tough and that it’s all part of the gig. Acknowledge the things that might be going on – ‘I know that you want to do well so it’s not surprising that you might feel the pressure of school/ staying on the team/ staying with the crowd. Everyone’s going through the same thing so there might be some crazy stuff that happens with your friends. It’s pretty normal. I’m here if you ever want to talk.

  4. Give them an easy out.

    Have the duration of a car trip as the time limit so they know there is an easy end to any difficult conversation and that they have control. Let them know that you will only talk until you pull into the driveway and then they can decide whether or not to keep the conversation going. It’s completely up to them – no questions or argument from you. ‘Do you think we can talk about how you’re travelling. Let’s do it like this. Let’s chat until we pull into the driveway and then I promise we’ll talk about something else if you want to. Totally up to you.’

  5. Your physical presence can make a difference.

    This can depend on the teen and the situation. Sometimes your teen might respond better if you avoid eye contact. Try starting the conversation in the car (this is a favourite of mine) or while you’re doing something else (like cooking dinner) rather than when sitting down and facing them. Then there might be other times when they’ll appreciate the one on one close attention from you. I’ve found that my kids tend to open up when I go in and sit on the edge of the bed just before they go to sleep. When it’s late and dark outside, the rest of the world seems a bit more removed – no distractions, no expectations. They won’t always talk of course – sometimes they’ll have nothing to say, or they might not feel like talking – but if they’re going to talk, this seems to be the time they do. 

  6. Be gentle but persistent and available but not intrusive.

    Your teen might not open up straight away – and that’s okay. Keep trying but be mindful of pushing too hard. It’s a tricky line this one. The main thing is to keep making yourself available for when they’re ready.

  7. Don’t try to talk them out of their depression.

    Even if their thinking seems irrational or their thoughts trivial, it isn’t that way to them. Validate them, ‘It’s bothering you isn’t it,’ or ‘I can see how upset you are,’ so they know they can come to you again.

Teenage Depression: The Warning Signs

Knowing the warning signs is important because with early detection plenty can be done.

If you’re not sure whether the teen in your life is depressed or just going through the usual growing pains that come with adolescence, consider the duration and severity of the symptoms and how different your teen is acting from his or her usual self.

Teenage depression can look similar or very different to depression in adults. The usual signs of depression are: 

  • mood changes – sadness or irritability
  • a sense of hopelessness
  • tearfulness or crying
  • withdrawal from social and family relationships
  • loss of interest in activities
  • changes in sleep habits – sleeping more or less, change in waking times (later, earlier, during the night)
  • changes in appetite and eating habits
  • restlessness
  • feelings of worthlessness and guilt
  • lack of enthusiasm or motivation
  • tiredness and fatigue
  • difficulty concentrating
  • suicidal thoughts

For teens the warning signs can look different to this:

  • They may be negative, cranky, irritable, angry, easily frustrated or prone to outbursts. Often, depressed teens come across primarily as irritable and cranky, more than sad.
  • They may complain of aches and pains (such as headaches or tummy aches) for which there is no medical explanation. 
  • They may feel misunderstood or highly sensitive to criticism. Because of their feelings of worthlessness, depressed teens can be extremely sensitive to failure, rejection or criticism. Overachievers are particularly vulnerable.
  • They might withdraw from some, but not all, of their relationships. Depressed adults tend with pull away from relationships generally but the withdrawal is not as clear in teens. They might pull away from some and keep others, start mixing with a different crowd or just pull away from their parents.
  • There may be problems at school. Difficulty concentrating and low energy may lead to attendance problems, poorer grades and frustration with school work in previously good students.
  • Drug and alcohol abuse.
  • Low self-esteem that might play out as expressions of ugliness, shame, unworthiness and failure.
  • They may spend excessive time on the computer.
  • They may engage in risky behaviour – recklessness, drinking, unsafe sex.

Remember that these warning signs can look like a normal part of adolescence and in many cases that’s exactly what it will be. The symptoms exist on a spectrum and the main thing is to be alive to the duration and severity of the symptoms and the departure from whatever is ‘normal’ for your teen.

If You Suspect Your Teen is Depressed

  • The most important thing is to let them know that depression and anxiety is treatable. The sense of helplessness that comes with depression doesn’t only touch those who are struggling with depression, but also those who love them. Know that even if it doesn’t seem as though the things you are doing are making a difference – they are. See here for ways to support your teen if he or she is struggling with depression. 
  • Things can change and they won’t always feel the way they do today. Let them know this. It’s critical and will make a difference.
  • If there’s any chance your teen might be suicidal, ask them directly if they are having thoughts of suicide. Many people avoid asking the question for fear it will put the idea into their head, but it won’t. It might be the most important question you ask them. If they are suicidal, help them seek professional help straight away through a counsellor, doctor or hospital. To find a suicide helpline in your country, see suicide.org or IASP (International Association for Suicide Prevention).
  • Help them to challenge the negative thinking that contributes to depression. See here for effective ways to do this.
  • Exercise can protect against depression and for mild to moderate depression, exercise causes the same changes in the brain as antidepressants. A 20-30 minute walk five times a week will make a difference.
  • Have your teen assessed by a doctor to determine whether or not medication is appropriate. Medication can be very effective but the effects of antidepressants on the adolescent brain aren’t fully known. Close monitoring is important particularly in the first two months of treatment to pick up any worsening of symptoms, suicidal thinking or further changes in mood or behaviour. If medication is recommended, it should always be used as part of wider treatment plan that includes counselling (to equip them with the skills to protect themselves from depression) and lifestyle factors (such as diet, exercise, mindfulness). Medication isn’t a magic bullet and changes generally won’t be seen for at least a few of weeks. 
  • Understand that depression is physiological. It’s NOT a deficiency in personality or character. Living with a depressed teen might expose you to rejection, conflict, despair and extreme sadness yourself. Living with someone who is depressed requires a heroic effort from those who love them. Understand that your teen is still the child you’ve always known and they aren’t pushing you away or hurting you on purpose. They’re hurting. It’s just what depression does.
  • Do whatever you can to accommodate your teen socially. One of the symptoms of depression is withdrawal from relationships, but isolation will make their depression worse. Anything you can do to support them in maintaining friends or getting out will be important. 
  • Be patient and don’t compare. Depression can take aim at anybody. It is not a reflection on parenting or personality. The most loving, involved parents can have a teen with depression. It’s chemical. It’s important for your own sake that you don’t compare yourself or your family to others. Your teen will come back. Be patient and don’t be disheartened by temporary setbacks – it’s a normal part of the recovery.

And finally …

I’ve yet to meet a parent who isn’t racked with self-doubt now and then, wondering if they’re getting it right. I do it regularly. As in often. Adolescence seems particularly adept at taking any self-doubts we have and flourishing them to spectacular proportions.

Whether your teen is depressed or not, if you are arming yourself with information and making yourself available, know that you’re doing what they need you to do. They’re lucky to have you. Deep down inside them, whether they show you or not, they know it too.

6 Comments

Zoe C

Thank you for reminding me that I should always validate my daughter’s feelings and acknowledge the things she’s been going through. I have noticed that my usually cheerful child has been too moody and down these days and I’m afraid that her high school life is pressuring her too much. It might be better if I can bring up counseling in our next conversation and see if she wants to do it.

Reply
Gooden Center

The younger generation of millennials are experiencing a much higher risk for mental health issues than previous generations. Levels of depression, anxiety, and suicidal thoughts are becoming problematically high for today’s teens. While there may be many factors causing these issues, experts believe that more millennials struggle with perfectionism and elevated expectations which can lead to depression.

Reply
Valeri S

This article (and the symptoms link) was very helpful. We are so very concerned about our 15-year old daughter. Thank you.

Reply
Karen Young

You’re very welcome. If you are at all concerned, I would really encourage you to speak with a doctor or a counsellor. I understand how frightening it can be to see your child in pain. Know that you don’t have to do this on your own.

Reply
Adrienne

I found this article extremely helpful as it gives me some tools to recognize when my teen is just plain sad and in a funk or whether there is something deeper and darker happening. More importantly it helps to validate that our child’s pain/sadness can also give us intense pain and self blame and that we must actively try to “shake off” so we can be present and offer help and support. Life can get hard navigating through not only our own personal range of issues and accompaning emotions, but riding the waves of ups and downs of our beloved teen(s)and trying to help and soothe or just be there for them
(or recognize when professional help should be consideredfor the parent and/or teen). Thank you for clues and advice as we navigate our own lives and those of our family members.

Reply
Hey Sigmund

Adrienne you’re so right – between our own issues and theirs, it can be a tough to know exactly what’s going on sometimes. I’m pleased the article was helpful for you. It sounds as though your teen is in wonderful hands.

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Behaviour is never from ‘bad’. It’s from ‘big’. Big hungry, big tired, big disconnection, big missing, big ‘too much right now’. The reason our responses might not work can often be because we’ve misread the story, or we’ve missed an important piece of it. Their story might be about now, today, yesterday, or any of the yesterdays before now. 

Our job isn’t to fix them. They aren’t broken. Our job is to understand them. Only then can we steer our response in the right direction. Otherwise we’re throwing darts at the wrong target - behaviour, instead of the need behind the behaviour. 

Watch, listen, breathe and be with. Feel what they feel. This will help them feel you with them. We all feel safer and calmer when we feel our people beside us - not judging or hurrying or questioning. What don’t you know, that they need you to know?♥️
We all have first up needs. The difference between adults and children is that we can delay the meeting of these needs for a bit longer than children - but we still need them met. 

The first most important question the brain needs answered is, ‘Is my body safe?’ - Am I free from threat, hunger, exhaustion, pain? This is usually an easier one to take care of or to recognise when it might need some attention. 

The next most important question is, ‘Is my heart safe?’ - Am I loved, noticed, valued, claimed, wanted, welcome? This can be an easy one to overlook, especially in the chaos of the morning. Of course we love them and want them - and sometimes we’ll get distracted, annoyed, frustrated, irritated. None of this changes how much we love and want them - not even for a second. We can feel two things at once - madly in love with them and annoyed/ distracted/ frustrated. Sometimes though, this can leave their ‘Is my heart safe?’ needs a little hungry. They have less capacity than us to delay the meeting of these needs. When these needs are hungry, we’ll be more likely to see big feelings or big behaviour. 

The more you can fill their love tanks at the start of the day, the more they’ll be able to handle the bumps. This doesn’t have to be big. It just has to be enough. It might look like having a cuddle, reading a story, having a chat, sitting with them while they have breakfast or while they pat the dog, touching their back when they walk past, telling them you love them.

All brains need to feel loved and wanted, and as though they aren’t a nuisance, but sometimes they’ll need to feel it more. The more their felt sense of relational safety is met, the more they’ll be able to then focus on ‘thinking brain’ things, such as planning, making good decisions, co-operating, behaving. 

(And if this today was a bumpy one, that’s okay. Those days are going to happen. If most of the time their love tanks are full, they’ll handle when it drops a little. Just top it up when you can. And don’t forget to top yours up too. Be kind to yourself. You deserve it as much as they do.)♥️
Things will always go wrong - a bad decision, a good decision with a bad outcome, a dilemma, wanting something that comes with risk. 

Often, the ‘right thing’ lives somewhere in the very blurry bounds of the grey. Sometimes it will be about what’s right for them. Sometimes what’s right for others. Sometimes it will be about taking a risk, and sometimes the ‘right’ thing just feels wrong right now, or wrong for them. Even as adults, we will often get things wrong. This isn’t because we’re bad, or because we don’t know the right thing from the wrong thing, but because few things are black and white. 

The problem with punishment and harsh consequences is that we remove ourselves as an option for them to turn to next time things end messy, or as a guide before the mess happens. 

Feeling safe in our important relationships is a primary need for all of us humans. That means making sure our relationships are free from judgement, humiliation, shame, separation. If our response to their ‘wrong things’ is to bring all of these things to the table we share with them with them, of course they’ll do anything to avoid it. This isn’t about lying or secrecy. It’s about maintaining relational ‘safety’, or closeness.

Kids want to do the right thing. They want us to love and accept them. But they’re going to get things wrong sometimes. When they do, our response will teach them either that we are safe for them to come to no matter what, or that we aren’t. 

So what do we do when things go wrong? Embrace them, reject the behaviour:

‘I love that you’ve been honest with me. That means everything to me. I know you didn’t expect things to end up like this, but here we are. Let’s talk about what’s happened and what can be different next time.’

Or, ‘Something must have made this (wrong thing) feel like the right thing to do, otherwise you wouldn’t have done it. We all do that sometimes. What do you think it was that was for you?’

Or, ‘I know you know lying isn’t okay. What made you feel like you couldn’t tell me the truth? How can we build the trust again. Let’s talk about how to do that.’

You will always be their greatest guide, but you can only be that if they let you.♥️
Whenever there is a call to courage, there will be anxiety - every time. That’s what makes it brave. This is why challenging things, brave things, important things will often drive anxiety. 

At these times - when they are safe, but doing something hard - the feelings that come with anxiety will be enough to drive avoidance. When it is avoidance of a threat, that’s important. That’s anxiety doing it’s job. But when the avoidance is in response to things that are important, brave, meaningful, that avoidance only serves to confirm the deficiency story. This is when we want to support them to take tiny steps towards that brave thing. It doesn’t have to happen all at once.l and it doesn’t matter how long it takes. Brave is about being able to handle the discomfort of anxiety enough to do the important, challenging thing. It’s built in tiny steps, one after the other. 

We don’t have to get rid of their anxiety and neither do they. They can feel anxious, and do brave. At these times (safe, but scary) they need us to take a posture of validation and confidence. ‘I believe you, and I believe in you.’ ‘I know this feels big, and I know you can handle it.’ 

What we’re saying is we know they can handle the discomfort of anxiety. They don’t have to handle it well, and they don’t have to handle it for too long. Handling it is handling it, and that’s the substance of ‘brave’. 

Being brave isn’t about doing the brave thing, but about being able to handle the discomfort of the anxiety that comes with that. And if they’ve done that today, at all, or for a moment longer than yesterday, then they’ve been brave today. It doesn’t matter how messy it was or how small it was. Let them see their brave through your eyes.‘That was big for you wasn’t it. And you did it. You felt anxious, and you stayed with it. That’s what being brave is all about.’♥️
A relationally unsafe (emotionally unsafe) environment can cause as much breakage as as a physically unsafe one. 

The brain’s priority will always be safety, so if a person or environment doesn’t feel emotionally safe, we might see big behaviour, avoidance, or reduced learning. In this case, it isn’t the child that’s broken. It’s the environment.

But here’s the thing, just because a child doesn’t feel safe, doesn’t mean the person or environment isn’t safe. What it means is that there aren’t enough signals of safety - yet, and there’s a little more work to do to build this. ‘Safety’ isn’t about what is actually safe or not, it’s about what the brain perceives. Children might have the safest, warmest, most loving adult in front of them, but that doesn’t mean they’ll feel safe. This is when we have to look at how we might extend bigger cues of warmth, welcome, inclusiveness, and what we can do (or what roles or responsibilities can we give them) to help them feel valued and needed. This might take time, and that’s okay. Children aren’t meant to feel safe with every adult in front of them, so sometimes what they need most is our patience and understanding as we continue to build this. 

This is the way it works for all of us, everywhere. None of us will be able to give our best or do our best if we don’t feel welcome, liked, valued, and free from hostility, humiliation or judgement. 

This is especially important for our schools. A brain that doesn’t feel safe can’t learn. For schools to be places of learning, they first have to be places of relationship. Before we focus too sharply on learning support and behaviour management, we first have to focus on felt sense of safety support. The most powerful way to do this is through relationship. Teachers who do this are magic-makers. They show a phenomenal capacity to expand a child’s capacity to learn, calm big behaviour, and open up a child’s world. But relationships take time, and felt safety takes time. The time it takes for this to happen is all part of the process. It’s not a waste of time, it’s the most important use of it.♥️

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