Depression in Teens May Be Hard to Spot

Teenagers have a tough time. They’re dealing with raging hormones plus the social and emotional pressures of growing up. Many juggle the demands of school, a job, and outside activities. On top of that, they often don’t get the sleep they need. It’s no wonder they are sometimes grouchy.

But what seems like a bad mood may actually be depression. It affects about 1 out of 5 teens sometime during adolescence. Girls are twice as likely as boys to be diagnosed with depression. Children of military families and those with sexual identity issues are at high risk.

Parents expect teenagers to be moody, tired, or difficult at times. As a result, depression in teens often goes unnoticed. If it’s not treated, depression can undercut a young person’s self-esteem and lead to destructive behaviors, such as drug abuse and suicide.

Most teens aren’t able to step back and realize what’s happening to their emotions. So it’s up to parents or other concerned adults to help them get the treatment they need to feel better.

What causes depression in teens?
Depression is a serious medical illness that has many possible causes. Teens with a family history of mood disorders are at increased risk for depression. In others, chemical changes in the brain may be triggered by a stressful event such as a death in the family, sexual abuse, or bullying. In some cases it may not be clear why depression occurred.

Regardless of the cause, depression needs treatment. Some teens may gradually get better on their own. But 4 out of 10 teens will have another episode of depression within 2 years.

How can I tell if my teen is depressed?
It can be tough to know if a teen’s behavior is normal moodiness or a sign of depression. Important clues a parent can look for include:

•Irritable or angry mood. You may think a depressed person should seem sad, but depressed teens are more likely to be grumpy or hostile or have angry outbursts.
•Unexplained aches and pains. A teen who is depressed may go to the school nurse more often or complain of vague problems such as stomach ache and headache.
•Self-criticism. Depressed teens may be consumed with feelings of worthlessness, rejection, and failure.
•Drop in school performance. Depression may cause a lack of motivation or organization that results in lower grades.
•Risky behaviors. Depressed teens may engage in unsafe sex, stealing, fighting, reckless driving, or substance use. Self-injury such as cutting, scratching, burning, or excessive piercing or tattooing may be a sign a teen needs help.
If you are concerned, take your child to see a doctor. A complete physical exam can help rule out other conditions that could be causing the problems. In general, a doctor may diagnose depression if a teen acts grumpy or depressed for at least 2 weeks and has four or more of the following symptoms:

•Sleep problems (usually sleeping too much)
•Loss of interest in activities he or she used to enjoy
•Loss of interest in friends
•Change in appetite or weight
•Lack of energy
•Trouble concentrating or making decisions
•Feelings of worthlessness or guilt
•Acting restless or sluggish
•Thoughts of death or suicide
Suicide is a very real risk in depressed teens. Take seriously any talk of suicide or wanting to die. Call 9-1-1 right away if you think a teen might try to harm himself or herself or others.

How is it treated?
The main treatments for teens with depression are:

•Antidepressant medication. A medication called fluoxetine (Prozac) seems to help adolescents with depression.
•Psychotherapy. A type of psychotherapy called cognitive behavioral therapy is often used. This type of therapy challenges negative thought patterns. It can help a teen develop a better outlook and greater sense of self-worth.
Using both medication and psychotherapy often achieves better results than using either treatment alone.

Antidepressants can have side effects. Be sure you understand the risks and benefits of these medications before your child starts them.

Note: Anyone being treated with antidepressants should be watched closely for worsening depression and increased suicidal thinking or behavior. Close watching may be especially important early in treatment or when the dose is changed. Discuss any concerns with your doctor.

Antidepressants should be continued for as long as the doctor recommends. Then the dose needs to be slowly tapered off. Quitting suddenly can have serious effects.

How can I help my teen?

•Learn about depression. Explain to your teen that depression is an illness, and like other illnesses, it needs to be treated. Help the family understand what your teen is going through.
•Be patient and supportive. Understand that it will take some time for treatment to work.
•Encourage your teen to be physically active. Exercise can help fight off depression.
•Urge your child to get out and see friends. Spending too much time alone is not good for emotional health.
•Help your teen follow through on treatment. Be sure he or she gets to therapy sessions and takes medicine as prescribed.
•Keep an eye on your teen’s mood. Call the doctor if depression seems to be getting worse instead of better.

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