From the moment a child reaches puberty up until their mid-20s, they begin the long journey of physically and neurologically developing into adulthood. This is a biological, psychological, and social journey. Even 18-year-olds – who are, by definition of the law, adults – have a lot of growing up left to do.
Teens are on the cusp of being independent and responsible members of society, and with that comes an innumerable list of uncomfortable physical changes, volatile emotions, complex interpersonal relationships, and a growing list of expectations and social mores.
When teens lack healthy coping skills, and the guidance to work through these day-to-day challenges, they may be more likely to struggle with feelings of anxiety, or even depression.
Understanding the most common mood and thought disorders can help teens and parents alike recognize and address their symptoms and provide the necessary support to better manage symptoms in adulthood.
Here are five common teen mood and thought disorders.
What is a Mood Disorder?
Mood disorders are a class of mental health problem characterized by an unconventionally low mood (depression), or an unconventionally high mood (mania). An important characteristic for most mood disorders is that these feelings of overwhelming sadness or bursts of energy have no reasonable cause or explanation.
A teen isn’t necessarily struggling with depression if they feel sad about a classmate’s death. But the loss of a close friend may be a trigger for the onset of a mood disorder, especially if they struggle to cope with their friend’s passing.
Common Mood Disorders in Teens
Most mood disorders feature some form of depression, and depression itself is considered the second most common type of mental health issue in the world (next to anxiety).
However, some conditions – specifically bipolar disorder – also feature symptoms of mania, which include racing thoughts, insomnia, uncharacteristic productivity or creative energy, delusions of grandeur, and an exaggerated self-confidence.
Current definitions of mood disorders and known mood disorders are based on the Diagnostic and Statistical Manual, 5th Edition, Text Revision (DSM-5-TR). Under the DSM, common mood disorders include:
- Major depressive disorder
- Bipolar I disorder
- Bipolar II disorder
- Cyclothymic disorder
- Disruptive mood dysregulation disorder
- Persistent depressive disorder
- Premenstrual dysphoric disorder
In addition to these conditions, the DSM also identifies other types of mood disorders, including depressive or bipolar symptoms triggered by another medical condition (with physiological causes, such as an endocrine disease), substance or medication-induced mood disorder, and other specified or unspecified mood disorder.
Major Depressive Disorder
Usually known as clinical depression, major depressive disorder (MDD) is the most common mood disorder in the world.
It is diagnosed when symptoms of depression last for at least two weeks with no apparent physical or identifiable cause, characterized by feelings of emptiness and hopelessness.
Bipolar disorder may refer to up to five different mood disorders, but most people will recognize three: bipolar I, bipolar II, and cyclothymia.
Bipolar I is characterized by symptoms of mania, or intense euphoric and irritable moods. Sometimes, these can lead to behavior that lands a person in the hospital. People with mania can work feverishly on a project for days before crashing, and do not consider negative consequences for themselves or others.
Bipolar II more frequently features cycles of depression, alongside hypomania, or less severe manic symptoms.
Cyclothymia is characterized by mild manic and depressive symptoms that do not qualify for bipolar I or II, but have been ongoing for at least two years.
Contrary to popular belief, bipolar disorder does not typically cycle between states in rapid succession. A person with bipolar disorder will usually experience a handful of shifts or episodes per year.
Persistent Depressive Disorder
Persistent depressive disorder, chronic depressive disorder, or dysthymia is diagnosed when a person is experiencing a depressive episode for at least two years. These long-term episodes may be less intense but can be just as severe.
Disruptive Mood Dysregulation Disorder
Disruptive mood dysregulation disorder (DMDD) is a mood disorder diagnosed in children between the ages of 6 and 18, characterized by extreme irritability and temper tantrums, at the drop of a hat. DMDD exceeds normal moodiness. A teen must exhibit inappropriate temper tantrums across different settings with intense mood swings between tantrums to qualify for a DMDD diagnosis. It is a relatively new diagnosis, and a controversial one.
Premenstrual Dysphoric Disorder
Premenstrual dysphoric disorder (PMDD) is a complicated and recently recognized mood disorder closely related to premenstrual syndrome (PMS). While teens with PMDD share some of PMS’ symptoms such as cyclical symptoms, food cravings, and irritability, PMDD is much more severe, with often debilitating depressive symptoms, anxiety, and suicidal ideation in the weeks leading up to a teen’s period. These feelings wane two to three days after the period starts and return in the next cycle.
Like other forms of depression, PMDD is largely hereditary. Our current understanding of PMDD assumes that it’s caused by an abnormal reaction in the brain’s neurochemistry to the hormonal changes that occur after ovulation, and before menstruation.
Is My Teen Sad or Depressed?
When talking to your teen about mood disorders and mental health issues, it helps to be able to distinguish between “normal” and concerning behavior and thought patterns.
The truth is that it can be hard to make these individual distinctions, and it often isn’t appropriate to make sweeping generalizations about what is and isn’t within the realm of a teen’s healthy spectrum of thoughts and behaviors. A few red flags to keep in mind may include:
- Extreme or sudden changes in behavior or personality. If your teen was previously outgoing, but has become intensely reclusive, it may be a serious sign of danger.
- Frequently talking about death, especially one’s own passing. Suicidal ideation can be masked and is often very private, but it may drop as hints in conversations.
- Loss of affection in relationships, loss of interest in physical contact. For teens with close partners, common signs of a depressive episode include pulling away from intimacy and becoming emotionally colder.
- Signs of substance use. Whether as a consequence or symptom of a mood disorder, or as one of the causes, substance use in teens is often a significant mental red flag.
One of the biggest challenges when talking about mental health is recognizing that there often isn’t a single cause or villain to every story. It’s not satisfying to blame a mixture of circumstances and neurological predisposition for a person’s depressive episodes, but that’s often the truth: while tough times can make depression harder, people can also be depressed for no reason, or seek to harm or kill themselves at a time when they’re ostensibly at their “happiest” and most successful.
Depression is exceptionally insidious because it does not offer a clear answer or a satisfying why.
It’s often erroneously portrayed as a result of dire circumstances, when it can happen to anyone, at any point, for no reason. Expecting a reason or cause for depression leads to the unhelpful expectation that outwardly happy people are doing okay, or that there must have been a cause for them to feel worse.
Recognizing and understanding that is crucial to making resources and help for depressive symptoms available to all people, regardless of their circumstances.