Teen depression: It’s more than a passing mood swing

The teen years can be a trying time filled with emotional highs and lows as bodies and brains change rapidly. But if a teen seems to experience more lows for longer than normal, that may be a sign of depression.

Teens are at risk for depression because of both biological and social reasons, says David Brent, MD, professor of psychiatry, pediatrics and epidemiology at the University of Pittsburgh School of Medicine and a National Institute of Mental Health-funded researcher.

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As teens go through puberty, their brains are still maturing, including the areas that relate to how they manage emotions. While they have emotions, they may not have all the tools to deal with them yet.

Brent says the difference between the “ups and downs” or moodiness of teens and depression is that symptoms, such as irregular sleeping habits or eating too much or too little, last for a long time and are associated with impairment. Other signs of depression in teens may be difficulty with concentration, less motivation and feelings of worthlessness, guilt and possibly suicide.

“Depression is associated with functional impairment,” Brent says. “They’re not doing as well in school. They’re withdrawing from their friends. They’re fighting more with their parents. That doesn’t mean that everybody who has those problems is depressed. But if you have somebody with a mood problem and you see a change in their function, those are the people you suspect have a difficulty with clinical depression.”

If you’re a parent of a teen who has signs of depression, ask questions about how they’re doing and seek the help of a mental health professional or their primary care physician to get a proper diagnosis, Brent says.

If you’re a friend of a teen, encourage them to seek help, but also make sure to inform your friend’s parents or guidance counselor about what’s going on, he says.

If a teen you know is in crisis and is thinking about self-harm, call 911, or share information on the National Suicide Prevention Lifeline at 1-800-273-8255.

“Whoever is in contact with kids should be able to recognize the signs…so they can get them to treatment.” Brent says. “That might more likely be school personnel, people involved in athletics and primary care clinicians.”

Failing to diagnose depression is a health risk. The longer depression goes untreated, the harder it becomes to treat. Chronic depression, he added, is more difficult to treat and recovery time takes longer. During a time when they’re supposed to be growing, teens with depression may fall behind and need help to catch up, he says.

“Adolescence isn’t a static period of time,” Brent says. “You’re supposed to be acquiring knowledge, social skills…if you’re depressed, you’re not doing that.”

Talking with a trained therapist can help teens with depression feel better again. Two kinds of therapy have been shown to help teens with depression: interpersonal and cognitive. In interpersonal therapy, teens focus on restoring relationships between themselves, family and friends. Teens who strengthen those bonds can help build a support system.

In cognitive behavior therapy, teens work with a therapist to tackle the connections between their feelings, thoughts and behaviors and the reasons why they may focus on negative things.

Teens who have more severe depression or have symptoms that don’t respond to therapy alone may need prescription medications, such as antidepressants, to help improve mood.

“People sometimes feel that once they’re depressed, there’s no hope,” Brent says. “There’s evidence that these treatments are effective for many people. And even if one treatment doesn’t work, a different one or a combination of treatments can help the majority of people.”

NIMH also suggests teens take the time for self-care. The institute recommends eating healthy foods, getting daily exercise and enough sleep. Social activity, such as hanging out with friends, can also help to ease the symptoms of depression.

• Copyright The Nation’s Health, American Public Health Association