Teen Depression
Depression in teens (ages 13-17) is a serious medical illness. It’s more than just a feeling of being sad or “blue” for a few days. It is an intense feeling of sadness, hopelessness, and anger or frustration that lasts much longer. These feelings make it hard for you to function normally and do your usual activities. You may also have trouble focusing and have no motivation or energy. Depression can make you feel like it is hard to enjoy life or even get through the day.
Many factors may play a role in depression, including:
- Genetics. Depression can run in families.
- Brain biology and chemistry.
- Hormones. Hormone changes can contribute to depression.
- Stressful childhood events such as trauma, the death of a loved one, bullying, and abuse.
Which teens are at risk of depression?
Depression can happen at any age, but often begins in the teens or early adulthood. Certain teens are at higher risk of depression, such as those who:
- Have other mental health conditions, such as anxiety, eating disorders, and substance use
- Have other diseases, such as diabetes, cancer, and heart disease
- Have family members with mental illness
- Have a dysfunctional family/family conflict
- Have problems with friends or other kids at school
- Have learning disabilities or attention deficit hyperactivity disorder (ADHD)
- Have had trauma in childhood
- Have low self-esteem, a pessimistic outlook, or poor coping skills
If you have depression, you have one or more of these symptoms most of the time:
- Sadness
- Feeling of emptiness
- Hopelessness
- Being angry, irritable, or frustrated, even at minor things
You also may also have other symptoms, such as:
- No longer caring about things you used to enjoy
- Changes in weight, such as losing weight when you are not dieting or gaining weight from eating too much
- Changes in sleep, such as having trouble falling asleep or staying asleep, or sleeping much more than usual
- Feeling restless or having trouble sitting still
- Feeling very tired or not having energy
- Feeling worthless or very guilty
- Having trouble concentrating, remembering information, or making decisions
- Thinking about dying or suicide
Effective treatments for depression in teens include talk therapy, or a combination of talk therapy and medicines:
Talk therapy
Talk therapy, also called psychotherapy or counseling, can help you understand and manage your moods and feelings. It involves going to see a therapist, such as a psychiatrist, a psychologist, a social worker, or counselor. You can talk out your emotions to someone who understands and supports you. You can also learn how to stop thinking negatively and start to look at the positives in life. This will help you build confidence and feel better about yourself.
There are many different types of talk therapy. Certain types have been shown to help teens deal with depression, including:
- Cognitive behavioral therapy (CBT), which helps you to identify and change negative and unhelpful thoughts. It also helps you build coping skills and change behavioral patterns.
- Interpersonal therapy (IPT), which focuses on improving your relationships. It helps you understand and work through troubled relationships that may contribute to your depression. IPT may help you change behaviors that are causing problems. You also explore major issues that may add to your depression, such as grief or life changes.
In some cases, your doctor will suggest medicines along with talk therapy. There are a few antidepressants that have been widely studied and proven to help teens. If you are taking medicine for depression, it is important to see your doctor regularly.
It is also important to know that it will take some time for you to get relief from antidepressants:
- It can take 3 to 4 weeks until an antidepressant takes effect
- You may have to try more than one antidepressant to find one that works for you
- It can also take some time to find the right dose of an antidepressant
In some cases, teenagers may have an increase in suicidal thoughts or behavior when taking antidepressants. This risk is higher in the first few weeks after starting the medicine and when the dose is changed. Make sure to tell your parents or guardian if you start feeling worse or have thoughts of hurting yourself.
You should not stop taking the antidepressants on your own. You need to work with your doctor to slowly and safely decrease the dose before you stop.
Programs for severe depression
Some teens who have severe depression or are at risk of hurting themselves may need more intensive treatment. They may go into a psychiatric hospital or do a day program. Both offer counseling, group discussions, and activities with mental health professionals and other patients. Day programs may be full-day or half-day, and they often last for several weeks.
Helping your teen with depression
Your teen’s depression may be treated with talk therapy, antidepressant medicines, or a combination of these. Learn about what is available and what you can do at home to help your teen.
Treatment Options for Your Teenager
You, your teen, and your teen’s health care provider should discuss what might help your teen the most. The most effective treatments for depression are:
Talk therapy
Antidepressant medicines
If your teen uses illicit drugs or alcohol, discuss this with their provider.
If your teen has severe depression or is at risk for suicide, your teen may need to stay in the hospital for treatment.
Find a Good Therapist or Counselor
Talk to your teen’s provider about finding a therapist for your teen.
Most teens with depression benefit from some type of talk therapy.
Talk therapy is a good place to talk about their feelings and concerns, and to learn ways to deal with them. Your teen can learn to understand issues that may be causing their behavior, thoughts, or feelings.
Your teen will likely need to see a therapist at least once a week to start.
There are many different kinds of talk therapy, such as:
Cognitive-behavioral therapy teaches your teen to reason through negative thoughts. Your teen will be more aware of their symptoms, and will learn what makes their depression worse as well as problem-solving skills.
Family therapy is helpful when family conflict is contributing to the depression. Support from family or teachers may help with school problems.
Group therapy can help teens learn from the experiences of others who are struggling with the same type of problems.
Check with your health insurance company to see what they will cover.
Learn about Antidepressant Medicines
You, your teen, and your teen’s provider should discuss whether antidepressant medicine might help your teen. Medicine is more important if your teen is severely depressed. In these cases, talk therapy alone won’t be as effective.
If you decide that medicine would help, your teen’s provider will most likely prescribe a type of anti-depressant medicine called a selective serotonin reuptake inhibitor (SSRI) for your teen.
The two most commonly used SSRI medicines are fluoxetine (Prozac) and escitalopram (Lexapro). These are approved to treat depression in teenagers. Fluoxetine is also approved for children age 8 and older.
Another class of antidepressants, called tricyclics, is not approved for use in teens.
There are risks and side effects of taking antidepressants. Your teen’s provider can help manage these side effects. In a small number of teens, these medicines can make them more depressed and give them more suicidal thoughts. If this happens, you or your teen should talk to their provider right away.
If you, your teen, and your teen’s provider decide that your teen will take an antidepressant, make sure that:
You give it time to work. Finding the right medicine and dose can take time. It could take 4 to 8 weeks or longer to get to full effect.
A psychiatrist or other provider who treats depression in teens is watching for side effects.
You and other caregivers watch your teen for suicidal thoughts or behaviors, and for nervousness, irritability, moodiness, or sleeplessness that is getting worse. Get medical help for these symptoms right away.
Your teen does not stop taking the antidepressant on their own. Talk to your teen’s provider first. If your teen decides to stop taking the antidepressant, your teen may be instructed to lower the dose slowly before stopping altogether.
Keep your teen going to talk therapy.
If your teen is depressed in the fall or winter, ask their provider about light therapy. It uses a special lamp that acts like the sun and may help with depression.
You Can Help Your Teenager
Keep talking with your teen.
Give them your support. Let your teen know that you are there for them.
Listen. Try not to give too much advice and do not try to talk your teen out of being depressed. Try not to overwhelm your teen with questions or lectures. Teens often shut down with that kind of approach.
Help or support your teen with daily routines. You can:
Schedule your family life to help your teen get enough sleep.
Create a healthy diet for your family.
Give gentle reminders for your teen to take their medicine.
Watch for signs that depression is getting worse. Have a plan if it does.
Encourage your teen to exercise more and to do activities they like.
Talk to your teen about alcohol and illicit drugs. Let your teen know that alcohol and illicit drugs make depression worse overtime.
Keep your home safe for teens.
Do not keep alcohol in the home, or keep it securely locked.
If your teen is depressed, it is best to remove any guns from the home. If you feel you must have a gun, lock up all guns and keep ammunition separate.
Lock up all prescription medicines.
Work out a safety plan of who your teen feels comfortable talking to if they are suicidal and need urgent help.
When to Contact a Medical Professional
If you or someone you know is thinking about suicide, call or text 988 or chat 988lifeline.org. You can also call 1-800-273-8255 (1-800-273-TALK). The 988 Suicide and Crisis Lifeline provides free and confidential support 24/7, anytime day or night.
You can also call 911 or the local emergency number or go to the hospital emergency room. DO NOT delay.
If someone you know has attempted suicide, call 911 or the local emergency number right away. DO NOT leave the person alone, even after you have called for help.
If you think you might be depressed, tell someone that you trust, such as your:
- Parents or guardian
- Teacher or counselor
- Doctor
The next step is to see your doctor for a checkup. Your doctor can first make sure that you do not have another health problem that is causing your depression. To do this, you may have a physical exam and lab tests.
If you don’t have another health problem, you will get a psychological evaluation. Your doctor may do it, or you may be referred to a mental health professional to get one. You may be asked about things such as:
- Your thoughts and feelings
- How you are doing at school
- Any changes in your eating, sleeping, or energy level
- Whether you are suicidal
- Whether you use alcohol or drugs
References
Teen Depression (medlineplus) (https://medlineplus.gov/teendepression.html)
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