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Understanding Teenage Depression

The medical community once thought depression affected only adults. The risk for the condition can begin in childhood or the early teens, however, and increases steadily through the mid-20s. As many as one in 10 young people will have experienced an episode of depression by the end of his or her teenage years.

Depression in children, teens, and young adults is much more than a phase. It's a real condition that can interfere with daily life, lead to suicidal thoughts and behavior, and go on to affect a person throughout life.

What is depression?

We all have times when we feel down or sad. Depression is a feeling of sadness, despair, or hopeless that does not go away. In someone with depression, this feeling can last for weeks or months and interfere with the person's ability to participate in everyday activities. Depression affects mood, outlook, thoughts, and behavior. It also can cause tiredness, irritability, loss of appetite, headaches, and insomnia.

People with depression often see the world in a negative light. They often are overly critical of themselves, and feel worthless and unloved. They may feel overwhelmed by small problems the rest of us take in stride. They feel like giving up. They pull away from people and drop out of activities, but this isolates them and makes them feel worse.

Depression's causes

Teens can face many difficulties they're ill-equipped to handle emotionally: divorce, learning disabilities, and abuse and neglect, to name a few. By nature, they feel powerless against these situations, and the effects can remain with them well into adulthood.

Even a teen who doesn't face any of these challenges can be depressed. An inherited tendency toward depression also can cause the problem.

Depression runs in families, but not everyone with a depressed family member becomes depressed. People with no family history of depression also can have depression. Besides life events and family history, other factors that play a role in causing depression include social environment, medical conditions, and negative thought patterns.

For teens, a stressful home environment or neighborhood poverty and violence can lead to depression. Other possible triggers for teen depression include learning disabilities that make academic success difficult, hormonal changes affecting mood, and physical illness. Drug and alcohol abuse also can affect mood and lead to depression.

Signs of depression

To recognize a depressed teen, you need to know the symptoms.

These are warning signs of depression:

  • Feeling deep sadness or hopelessness.

  • Lack of energy.

  • Loss of pleasure or interest in activities that once excited the teen.

  • Anxiety and panic.

  • Turmoil, worry, and irritability. The teen may brood or lash out in anger because of the distress he or she feels.

  • Difficulty organizing, concentrating, or remembering.

  • Negative views of life and the world.

  • Feeling worthless and guilty. The teen may feel stupid, ugly, or bad.

  • Drastic changes in appetite or weight.

  • Difficulty falling asleep and staying asleep or sleeping too much.

  • Sluggishness. A depressed teen often talks, reacts, and walks more slowly than other teens.

  • Avoiding and withdrawing from friends and family.

  • Restlessness. The restlessness brought on by depression may lead to behaviors such as fidgeting or acting up in class.

  • Self-mutilation and suicidal thoughts.

Getting help

Depression is one of the most common of all mental health problems. The good news is that it's also one of the most treatable conditions. Young people with depression and their families and friends often don't know how to spot the problem or where to seek help.

Seek professional help if you suspect your teen suffers from depression, and choose a therapist who specializes in treating teenagers. Find a different counselor if the one you visit makes your son or daughter feel ill at ease or doesn't seem to understand your teen's needs.

A therapist who's too formal or can't establish good rapport with children will make your child more apprehensive. If possible, get a recommendation from your health care provider, a school counselor, or friend.

Depending on the severity of your teen's depression and its causes, the therapist may suggest either talk therapy or medication, or both.

Usually, a combination of both will get the best results. An antidepressant helps correct the chemical imbalance within the brain, so the child begins to feel better. But the negative thought patterns that lead to depression may still remain, and therapy will help change these patterns, so the child can better cope with the stressors in life that contribute to depression.

The Food and Drug Administration issued a warning in September 2004 that antidepressants may cause some children and teenagers to become suicidal. Still, the overall risk for suicide is low. If 100 patients are given antidepressants,  two or three will develop suicidal thoughts. Adolescents who begin antidepressant medications should be monitored closely for any suicidal behaviors, especially in the early weeks of treatment.