Surveys show that depression remains underdiagnosed among teenagers alone as over 3.2 million experienced at least one major depressive episode in 2017, compared to just about 2 million a decade earlier. While the data suggests that these episodes are more common in girls than boys, neither received as much treatment as they should, with only 45 percent of teenage girls and 33 percent of teenage boys getting help for their symptoms.
Major depressive disorder has been diagnosed in over 1.9 million children between the ages of 3 and 17, and depression and anxiety remain the two most diagnosed mental health disorders in the United States. Treatment for these disorders has come a long way, yet many remain confused about how to address depression at home and where to seek help. Teen depression can sometimes be mistaken for normal behavior, while in other cases, grief or typical sadness are mistaken for depression. Understanding how these conditions manifest and what sets them apart is important.
Understanding Teen Depression
Depressive disorders count as mood disorders caused or influenced by a wide variety of risk factors and potential co-occurring conditions. External and internal factors each play a significant role in mood regulation and motivation. They may contribute to the development of depression, from internal processes that affect how certain neurotransmitters are released and received to the long-term mental and neurological effects of chronic stress or sudden trauma. The defining characteristics of teen depression are a sudden loss of interest in old friends and hobbies, usually accompanied by a recurring or constant:
- Lack of energy
- Lack of motivation
- And physical symptoms (nagging aches, pains, and restlessness)
One of the hallmarks of teen depression is overwhelming irritability, more so than normal and more often than in adults. Teens who are depressed may suddenly become disinterested, but also more defiant and disrespectful, and unmanageably gloomy. Parents might expect a drop in academic performance, and while this is true for some cases, in other cases, the pressure to perform may fuel a teen’s depression. They may continue to perform well at school (physically and/or virtually) while feeling miserable.
Types of Teen Depression
Depressive disorders come in many shapes and sizes depending on the severity and origin of the depression and assorted symptoms. Teen depression can also be a symptom of other conditions, such as hypothyroidism or substance use disorder. These examples of secondary depression are not listed below. Furthermore, other rarer types of teen depression may also be diagnosed and are not listed.
Major Depressive Disorder (MDD)
Major depressive disorder (MDD), also referred to as major depression and clinical depression, is the most diagnosed type of teen depression. This is a mental health disorder diagnosed in cases where a person displays consistently low mood and other symptoms of depression without an apparent preexisting psychiatric or medical cause for longer than two weeks. Symptoms can range in severity from struggling to feel joy to regularly experiencing suicidal ideation.
Persistent Depressive Disorder (PDD)
Persistent depressive disorder (PDD), also referred to as dysthymia, is a milder form of depression that lasts at least two years and can last a lifetime.
Seasonal depression, also referred to as seasonal affective disorder (SAD), is characterized by symptoms being tied to a season, usually the winter, but sometimes the warmer months. Seasonal depression comes and goes, and teen depression treatment is unique in that it might address issues such as lack of natural sunlight via UV light therapy. Sometimes, seasonal depression is tied to the stress that comes from a hectic seasonal job or the financial and social strain of the holidays.
Bipolar disorder, also referred to as manic depression, is a mood disorder characterized by depression and/or mania symptoms. Different types of bipolar disorder exist depending on the severity of either depressive or manic symptoms. In some cases, mania can present itself without depression. While juxtaposed to depression, mania is not “happiness” – instead, it is a state of mental and sometimes physical hyperactivity that may be accompanied by dangerous thoughts, delusions, and insomnia. Social anxiety is also a commonly co-occurring issue.
Premenstrual Dysphoric Disorder (PMDD)
Premenstrual dysphoric disorder (PMDD) is tied to a teen’s menstrual cycle, with symptoms commonly occurring during a teen’s late luteal phase and usually the last one to two weeks. PMDD is recurring and is sometimes characterized as a very severe variant of PMS.
If you or your loved one struggles with low thoughts, low motivation, mood swings, and other signs of depression, be sure to contact a medical professional.
Recognizing Teen Depression
Symptoms of teen depression differ from disorder to disorder. They may sometimes be difficult to recognize due to their similarities with common tropes of teenage behavior and their differences in adult depressive symptoms. Some of the more common symptoms of teenage depression include:
- High irritability
- Low self-esteem
- Unexplained pain
- Problems with concentration
- Withdrawal from friends and social contact
- Loss of appetite or starkly increased appetite
- Loss of interest in old hobbies and no new ones
- Frequently expressing feelings of worthlessness
- Lethargy despite sleeping enough (cannot get out of bed)
Risk Factors for Teen Depression
Depression can occur for multiple reasons across the entire biopsychosocial spectrum. This means that one’s genetics, environment, personal experiences, and thresholds for trauma all play a role in how, when, and whether depressive symptoms develop. Some risk factors include:
- Substance use
- Genetic factors
- Chronic stressors
- Traumatic experiences
- Poor familial relationships
- Victimization online or at school
- Loss of a loved one or close friend
- Socioeconomic circumstances (poverty)
- Negative norms (violence, drug use among peers, competitiveness, and bullying)
Some types of depression are primarily tied to hormones, while others are largely neurological, tied to changes in the brain after trauma, or tied to recurring stressors. Sometimes, it is a little bit of everything. This can make identifying crucial risk factors difficult, which is why finding the right treatment can take time. Employing as many protective factors as possible is also important. Protective factors may lower the risk and help play a role in teen depression treatment. They include:
- Physical activity
- Familial relationships
- Developing healthy coping skills
- Positive norms (cooperative and nurturing environment)
- Healthier social connections (friendships) and interactions
- Access to better mental healthcare and healthcare resources
When, Where, and How to Seek Teen Depression Treatment
Treatments for teen addiction center around a combination of talk therapy and pharmacology. The most common and effective medical treatment for depression is a selective serotonin reuptake inhibitor (SSRI), although alternative antidepressants may be prescribed when multiple SSRIs fail. Some types of depression can only be treated by addressing the underlying condition.
In contrast, others cannot be successfully treated without addressing the co-occurring condition. Alternatives to antidepressants may also play a role in depression treatment, now and in the future. These include off-label treatments such as ketamine, and non-pharmacological options such as transcranial magnetic stimulation.
In nearly all cases of teen depression treatment, long-term CBT-based talk therapy is a central part of the plan and process. Teens with co-occurring disorders may be better treated through residential programs that help immerse them in a healing environment along with other teens. It may take time before you can find the right approach for your teen, which is why helping them create a strong support network is also important.