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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How we are with them, when they are their everyday selves and when they aren’t so adorable, will build their view of three things: the world, its people, and themselves. This will then inform how they respond to the world and how they build their very important space in it. 

Will it be a loving, warm, open-hearted space with lots of doors for them to throw open to the people and experiences that are right for them? Or will it be a space with solid, too high walls that close out too many of the people and experiences that would nourish them.

They will learn from what we do with them and to them, for better or worse. We don’t teach them that the world is safe for them to reach into - we show them. We don’t teach them to be kind, respectful, and compassionate. We show them. We don’t teach them that they matter, and that other people matter, and that their voices and their opinions matter. We show them. We don’t teach them that they are little joy mongers who light up the world. We show them. 

But we have to be radically kind with ourselves too. None of this is about perfection. Parenting is hard, and days will be hard, and on too many of those days we’ll be hard too. That’s okay. We’ll say things we shouldn’t say and do things we shouldn’t do. We’re human too. Let’s not put pressure on our kiddos to be perfect by pretending that we are. As long as we repair the ruptures as soon as we can, and bathe them in love and the warmth of us as much as we can, they will be okay.

This also isn’t about not having boundaries. We need to be the guardians of their world and show them where the edges are. But in the guarding of those boundaries we can be strong and loving, strong and gentle. We can love them, and redirect their behaviour.

It’s when we own our stuff(ups) and when we let them see us fall and rise with strength, integrity, and compassion, and when we hold them gently through the mess of it all, that they learn about humility, and vulnerability, and the importance of holding bruised hearts with tender hands. It’s not about perfection, it’s about consistency, and honesty, and the way we respond to them the most.♥️

#parenting #mindfulparenting
Anxiety and courage always exist together. It can be no other way. Anxiety is a call to courage. It means you're about to do something brave, so when there is one the other will be there too. Their courage might feel so small and be whisper quiet, but it will always be there and always ready to show up when they need it to.
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But courage doesn’t always feel like courage, and it won't always show itself as a readiness. Instead, it might show as a rising - from fear, from uncertainty, from anger. None of these mean an absence of courage. They are the making of space, and the opportunity for courage to rise.
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When the noise from anxiety is loud and obtuse, we’ll have to gently add our voices to usher their courage into the light. We can do this speaking of it and to it, and by shifting the focus from their anxiety to their brave. The one we focus on is ultimately what will become powerful. It will be the one we energise. Anxiety will already have their focus, so we’ll need to make sure their courage has ours.
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But we have to speak to their fear as well, in a way that makes space for it to be held and soothed, with strength. Their fear has an important job to do - to recruit the support of someone who can help them feel safe. Only when their fear has been heard will it rest and make way for their brave.
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What does this look like? Tell them their stories of brave, but acknowledge the fear that made it tough. Stories help them process their emotional experiences in a safe way. It brings word to the feelings and helps those big feelings make sense and find containment. ‘You were really worried about that exam weren’t you. You couldn’t get to sleep the night before. It was tough going to school but you got up, you got dressed, you ... and you did it. Then you ...’
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In the moment, speak to their brave by first acknowledging their need to flee (or fight), then tell them what you know to be true - ‘This feels scary for you doesn’t it. I know you want to run. It makes so much sense that you would want to do that. I also know you can do hard things. My darling, I know it with everything in me.’
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#positiveparenting #parenting #childanxiety #anxietyinchildren #mindfulpare
Separation anxiety has an important job to do - it’s designed to keep children safe by driving them to stay close to their important adults. Gosh it can feel brutal sometimes though.

Whenever there is separation from an attachment person there will be anxiety unless there are two things: attachment with another trusted, loving adult; and a felt sense of you holding on, even when you aren't beside them. Putting these in place will help soften anxiety.

As long as children are are in the loving care of a trusted adult, there's no need to avoid separation. We'll need to remind ourselves of this so we can hold on to ourselves when our own anxiety is rising in response to theirs. 

If separation is the problem, connection has to be the solution. The connection can be with any loving adult, but it's more than an adult being present. It needs an adult who, through their strong, warm, loving presence, shows the child their abundant intention to care for that child, and their joy in doing so. This can be helped along by showing that you trust the adult to love that child big in our absence. 'I know [important adult] loves you and is going to take such good care of you.'

To help your young one feel held on to by you, even in absence, let them know you'll be thinking of them and can't wait to see them. Bolster this by giving them something of yours to hold while you're gone - a scarf, a note - anything that will be felt as 'you'.

They know you are the one who makes sure their world is safe, so they’ll be looking to you for signs of safety: 'Do you think we'll be okay if we aren't together?' First, validate: 'You really want to stay with me, don't you. I wish I could stay with you too! It's hard being away from your special people isn't it.' Then, be their brave. Let it be big enough to wrap around them so they can rest in the safety and strength of it: 'I know you can do this, love. We can do hard things can't we.'

Part of growing up brave is learning that the presence of anxiety doesn't always mean something is wrong. Sometimes it means they are on the edge of brave - and being away from you for a while counts as brave.
Even the most loving, emotionally available adult might feel frustration, anger, helplessness or distress in response to a child’s big feelings. This is how it’s meant to work. 

Their distress (fight/flight) will raise distress in us. The purpose is to move us to protect or support or them, but of course it doesn’t always work this way. When their big feelings recruit ours it can drive us more to fight (anger, blame), or to flee (avoid, ignore, separate them from us) which can steal our capacity to support them. It will happen to all of us from time to time. 

Kids and teens can’t learn to manage big feelings on their own until they’ve done it plenty of times with a calm, loving adult. This is where co-regulation comes in. It helps build the vital neural pathways between big feelings and calm. They can’t build those pathways on their own. 

It’s like driving a car. We can tell them how to drive as much as we like, but ‘talking about’ won’t mean they’re ready to hit the road by themselves. Instead we sit with them in the front seat for hours, driving ‘with’ until they can do it on their own. Feelings are the same. We feel ‘with’, over and over, until they can do it on their own. 

What can help is pausing for a moment to see the behaviour for what it is - a call for support. It’s NOT bad behaviour or bad parenting. It’s not that.

Our own feelings can give us a clue to what our children are feeling. It’s a normal, healthy, adaptive way for them to share an emotional load they weren’t meant to carry on their own. Self-regulation makes space for us to hold those feelings with them until those big feelings ease. 

Self-regulation can happen in micro moments. First, see the feelings or behaviour for what it is - a call for support. Then breathe. This will calm your nervous system, so you can calm theirs. In the same way we will catch their distress, they will also catch ours - but they can also catch our calm. Breathe, validate, and be ‘with’. And you don’t need to do more than that.
When things feel hard or the world feels big, children will be looking to their important adults for signs of safety. They will be asking, ‘Do you think I'm safe?' 'Do you think I can do this?' With everything in us, we have to send the message, ‘Yes! Yes love, this is hard and you are safe. You can do hard things.'

Even if we believe they are up to the challenge, it can be difficult to communicate this with absolute confidence. We love them, and when they're distressed, we're going to feel it. Inadvertently, we can align with their fear and send signals of danger, especially through nonverbals. 

What they need is for us to align with their 'brave' - that part of them that wants to do hard things and has the courage to do them. It might be small but it will be there. Like a muscle, courage strengthens with use - little by little, but the potential is always there.

First, let them feel you inside their world, not outside of it. This lets their anxious brain know that support is here - that you see what they see and you get it. This happens through validation. It doesn't mean you agree. It means that you see what they see, and feel what they feel. Meet the intensity of their emotion, so they can feel you with them. It can come off as insincere if your nonverbals are overly calm in the face of their distress. (Think a zen-like low, monotone voice and neutral face - both can be read as threat by an anxious brain). Try:

'This is big for you isn't it!' 
'It's awful having to do things you haven't done before. What you are feeling makes so much sense. I'd feel the same!

Once they really feel you there with them, then they can trust what comes next, which is your felt belief that they will be safe, and that they can do hard things. 

Even if things don't go to plan, you know they will cope. This can be hard, especially because it is so easy to 'catch' their anxiety. When it feels like anxiety is drawing you both in, take a moment, breathe, and ask, 'Do I believe in them, or their anxiety?' Let your answer guide you, because you know your young one was built for big, beautiful things. It's in them. Anxiety is part of their move towards brave, not the end of it.

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