Depression in Teens: Signs, Causes and Treatment

Depression in teens (ages 13–17) is a serious medical illness. It is more than feeling sad or "blue" for a few days: it is an intense sadness, hopelessness, anger or frustration that lasts much longer — making it hard to function, focus, find energy or enjoy life, and sometimes hard just to get through the day.

Causes

Many things can play a part:

• genetics — depression can run in families;
• brain biology and chemistry;
• hormone changes;
• stressful childhood events — trauma, the death of a loved one, bullying, abuse.

Who is at higher risk

Depression can start at any age, but it often begins in the teens or early adulthood. The risk is higher for teens who:

• have other mental health conditions — anxiety, eating disorders, substance use;
• have other diseases such as diabetes, cancer or heart disease;
• have family members with mental illness;
• live with a dysfunctional family or family conflict;
• have problems with friends or others at school;
• have learning disabilities or ADHD;
• experienced trauma in childhood;
• have low self-esteem, a pessimistic outlook or poor coping skills.

Symptoms

With depression, you have one or more of these most of the time: sadness, a feeling of emptiness, hopelessness, or being angry, irritable or frustrated even over small things. You may also:

• stop caring about things you used to enjoy;
• lose or gain weight without trying;
• have trouble falling or staying asleep — or sleep much more than usual;
• feel restless, or unable to sit still;
• feel very tired, with no energy;
• feel worthless or very guilty;
• have trouble concentrating, remembering or deciding;
• think about dying or suicide.

Getting diagnosed

If you think you might be depressed, tell someone you trust — a parent or guardian, a teacher or counselor, or your doctor. Then see your doctor for a checkup. A physical exam and lab tests can rule out another health problem as the cause. If there isn't one, you'll have a psychological evaluation, from your doctor or a mental health professional, with questions about your thoughts and feelings, school, eating, sleep and energy, whether you are suicidal, and whether you use alcohol or drugs.

Treatment

Effective treatment is talk therapy, or talk therapy combined with medicine.

Talk therapy — psychotherapy or counseling, with a psychiatrist, psychologist, social worker or counselor — helps you understand and manage your moods, talk through your feelings with someone supportive, stop negative thinking and build confidence. Two kinds have been shown to help teens:

Medicines. Sometimes a doctor will suggest an antidepressant along with talk therapy; a few have been widely studied and proven to help teens. See your doctor regularly, and know that relief takes time:

• an antidepressant can take 3 to 4 weeks to work;
• you may need to try more than one;
• finding the right dose can take time.

Important: some teenagers have more suicidal thoughts or behavior on antidepressants, especially in the first few weeks and when the dose changes. Tell your parents or guardian if you feel worse or think about hurting yourself. Don't stop an antidepressant on your own — your doctor needs to lower the dose slowly and safely.

Severe depression. Teens with severe depression, or at risk of hurting themselves, may need more intensive care — a psychiatric hospital or a day program, with counseling, group discussions and activities. Day programs can be full or half days, often for several weeks.

If you or someone you know is thinking about suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline in the United States.

Sources

Based on "Teen Depression," MedlinePlus, National Library of Medicine; a work of the United States government in the public domain.