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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One of our rituals was in the week before Christmas, we’d go shopping and each kiddo would choose a keepsake decoration for the tree. This would forever be their decoration. To make sure we’d remember who owned what (a year is a long time!) I wrote their name and year on the box. The idea is that when they leave home, they’ll have a collection of special decorations for their own tree, plump with throwbacks (‘Oh I remember when we bought this!).

Then of course there was Christmas morning. Santa would leave a note on the table and bootprints on the front path, which smelled remarkably like talcum powder. So magical the way the snow was under the boot and never melted, even in an Australian summer! But that’s the magic of Christmas, right?!

We often put so much pressure on ourselves to make Christmas magical. Rituals can make this easier. They get the special memories, you get to make the ‘magic’ without having to come up with something new and different each year.

It’s very likely that there will already be Christmas rituals happening in your family, even if you don’t realise it. Ask them what they remember most, or what they loved most about last Christmas, aside from the presents.

They might surprise you with things you’d completely forgotten about, or which at the time didn’t seem to be a biggie. It can be the simplest things. Maybe they loved the way they were allowed to have ice-cream with pancakes at breakfast last Christmas. (Ice-cream at breakfast?! Told you Christmas was magical!!). 

If it’s what they remember, and if it lights them up, let it become a ‘thing’. Maybe they loved the magic ‘neverending carrot’ sprinkles you put on the scrawny carrot you found in the vege drawer (remembering reindeer groceries can be so hard sometimes!)

You’d be surprised what they find special. It doesn’t have to be big to feel magical.

What are your Christmas rituals? Let’s share ideas in the comments.♥️
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There's no need to enter a code. The books and bundles are already marked with their special sale prices. You'll find them all there - plushies, books, bundles - doing shopping cartwheels, beside themselves excited about helping your young ones feel bigger than anxiety, and shimmy on to brave. 
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It can feel as though the only way to strengthen them against their anxiety is to make sure they have nothing to worry about, but when their worries are real this might not happen quickly. 

Instead, we need to focus on helping them know that even though those worries are there, they will be okay. ‘Not worrying’ isn’t the antidote to anxiety, trust is. This will start with trust in you and your belief that they will be okay, and trust in your reaction if things don’t go to plan. Eventually, as they grow this will expand into trust in themselves and their own capacity to find their way through challenges to a place of hope and strength. 
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Strong steady breathing will reverse the fight or flight physiology that causes nausea, butterflies, or sick or sore tummies during anxiety. BUT telling an anxious brain to take a strong steady breath will potentially make anxiety worse unless strong steady breathing feels familiar. Practising during calm times will make it familiar. 

During anxiety we’re dealing with their amygdala, and it wants short shallow breathing to conserve oxygen. It doesn’t want strong steady breathing and will work hard to resist this. 

An anxious brain is a busy brain and it will be less able to do anything unfamiliar. A few minutes of strong steady breathing each day will set up a strong neural pathway to make strong breathing more automatic and accessible during anxiety. 

In the meantime though, you can do it for them. This is the magic of co-regulation. When you do strong steady breathing during their anxiety, it will calm your nervous system which will eventually calm theirs. You will catch their anxiety, and this will feed into their anxiety. Your strong steady breathing is the circuit breaker. They will catch your anxiety, but they will also catch your calm. Don’t worry if this takes a few minutes (and maybe a few more after that). Anxious brains are strong, powerful, beautiful brains working hard to protect. Breathe and be with. This will open the way for that distressed young nervous system to find its way home. And you don’t need to do more than that.♥️
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Needs and behaviour can get tangled up and treated as one. When you can, separate the need from the behaviour. Give voice to the need - let it find a way to breathe - and redirect the behaviour. 

The need might always be clear, especially if it’s being smothered by angry shouting words. If we stifle the behaviour without acknowledging the need, the need stays hungry. Help usher it into the light by making it clear that you’re ready to receive it. Then wait. Wait for the big behaviour to ease, for bodies to calm, and angry voices to soften - but keep the way to you open. ‘You’re a great kid and I know you know that behaviour wasn’t okay. Talk to me about what’s happening for you.’

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