Sep 192011

The symptoms of depression are similar in men, women, children, and teens. In fact, the DSM IV, the official psychiatric book on the subject, only makes the following notes about depression in teens as being different from depression in adults:

  1. The essential feature of a Major Depressive Episode is a period of at least 2 weeks during which there is either depressed mood or the loss of interest or pleasure in nearly all activities. In children and adolescents, the mood may be irritable rather than sad.
  2. There may be marital problems (e.g., divorce), occupational problems (e.g., loss of job), academic problems (e.g., truancy, school failure)…
  3. The core symptoms of a Major Depressive Episode are the same for children and adolescents, although there are data that suggest that the prominence of characteristic symptoms may change with age.
  4. In children and adolescents, an irritable or cranky mood may develop rather than a sad or dejected mood. This presentation should be differentiated from a “spoiled child” pattern of irritability when frustrated.
  5. In adolescents, Major Depressive Episodes are frequently associated with Disruptive Behavior Disorders, Attention-Deficit Disorders, Anxiety Disorders, Substance-Related Disorders, and Eating Disorders.

So, where does that leave us? Not really much help in determining if a teen is depressed or simply going through the normal adjustments of growing up.

To parents: The best way to tell is to know your teen. Know who their friends are, know the symptoms of depression, and look for those symptoms in your teen. Not easy, I know, because teens can be pretty closed about their feelings.

However, take special note on: academic problems (e.g., truancy, school failure)…

Looking back at my teens, I know that I had a major depressive episode at the end of high school into my first semester of college.

I was an overachiever: almost 400 hours of volunteer work, tons of Girl Scout Badges, the two highest awards in Girl Scouts, Honor Society, class government, got into the college of my choice on early admission, honor roll every quarter…

…until I didn’t. Until I failed Physics one quarter. And didn’t do so well in Calculus either.

Now, let me stop and say that I don’t blame my parents at all for not noticing this and thinking only that my grades were an anomaly. Because, from their perspective, it was. They didn’t know the turmoil that was going on underneath.

Which is why the next part is for teens: If you find yourself feeling like everyone is smarter than you, people are picking on you, that all the achievements you’ve done don’t mean a thing – reach out for help. I’m not going to tell you to go to your guidance counselor, although you can. I remember that was dorky and no one went, even though that’s what they are there for.

Your friends may not be the best help either. They don’t know techniques to really help depression. And, if your experience was like mine, those friends can have a way of sticking up for you one minute, then cutting you down the next minute.

Your parents can help. But, that depends on how comfortable you feel with them.

A favorite teacher may be able to help. Tell them you’ve been feeling down lately and you’re not sure your parents would understand. Ask them if they have any suggestions.

If you are close to a religious leader, or the leader of a club or organization (such as the Girl or Boy Scouts), talk to them.

Don’t suffer alone.

To parents and teens: here’s a bit more of my story.

When crap happened at school, I kept it to myself. I didn’t talk to my parents about it. I remember many a night listening to sad songs and crying.

I wrote things like the following in my journal:

  • “The wonderful feeling I had of being included and wanted is turning to a horrible one of dread.”
  • “We then went on to Algebra where we took a test that I will be happy to get a C on. 70% will make me happy.”
  • “I went for a walk after dark and I feel so empty.”
  • “Why is my life the way it is? Is it me or others around me?…I need to talk to someone, but I don’t know who.”
  • “I hardly have the will to put pen to paper, but I know I must…I hurt so much.”

Looking back, I see these as clear signs of the depression I now know I had. Although, I didn’t recognize it as depression until years later when, as an adult, I sought treatment for another major depressive episode.

Fortunately, I didn’t contemplate suicide, but unfortunately, many teens do. And often, parents and others don’t even realize the teen was depressed until they have ended their lives.

Checklist of things to look for as possible signs of depression in teens

  1. A down mood. This may present as irritability not sadness. This could be passing, but if it persists for 2 weeks or more, it’s a cause for concern.
  2. Changes in the usual behavior. This may not be just an irritability mood, but could also include lack of interest in things, or sudden problems in school. 
  3. Withdraw from some people. They may still maintain a core group of friends, but not seem as outgoing as they used to.
  4. Increased complaints of physical complaints such as aches and pains, headaches, or stomachaches. These could have other medical causes, but could also be a sign of depression.
  5. Sensitivity to criticism. No one likes to be criticized, but depression makes you much more sensitive to these things. It can also make you feel like everyone is ganging up on you. Therefore, a teen that appears to get mad at a gentle joke or other comment that wouldn’t have upset them in the past may be hypersensitive due to depression.
  6. Increased negative comments and criticism of others. True, puberty and “growing up” involve a period of differentiating yourself from others. However, if this behavior continues, with the teen putting down others regularly, calling them names, or refusing to hang around them when they did before, this could be a sign of depression. The could also manifest in the teen calling themselves names. Perhaps mentioning that they are stupid, or scoffing at once enjoyed activities.

The important thing to remember when it comes to recognizing teen depression is that these symptoms persist for more than two weeks. It may seem like a “phase” the teen is going through, but it very well may not be. Teens may also feel like it’s something they just have to endure, but it’s not.

Children and teens respect their parents, even if they don’t show it. If you think that something is amiss with your teen, let them know that you are there to help. Or, they don’t feel like talking with you, ask them if they would like an appointment with a doctor. Emphasize the physical problems over the emotional ones.

two young girls laughing behind another girls back
Creative Commons License photo credit: studiostoer

Teens don’t want to let their parents in on their emotional life because they think they won’t understand. But, they may respond to an opportunity to see a doctor for the physical symptoms.

You can make a note to the nurse when the appointment is made that you suspect depression, but your teen isn’t talking about it with you.

Then, stay in the waiting room. Do not go into the examining room with your teen. They didn’t want to talk to you before, they won’t suddenly open up to the doctor if you are in the room. Respect that they are no longer your “little” boy or girl and give them the room to speak with the doctor confidentially.

If your teen isn’t willing to talk about the discussion with the doctor, you do have the right to ask the doctor if there is anything that you need to do to help your teen. Depending on where you live, the law may say that parents have the right to know exactly what was said, but don’t violate your teen’s trust.

And don’t put the doctor in the position of violating that trust either. What’s important is that you support your teen, not that you know every minute detail.

If you have suffered from depression as an adult, and that is quite possible since teens are more likely to get depression of they have family members who have suffered, then you know how horrible it can be. Try to imagine suffering from depression while also trying to get along in school, fit in with a bunch of people, and please your parents all at the same time. That is what depression during your teens feels like. And, if you suffered from depression in school yourself, then you know how difficult it is.

No one needs to suffer from depression. It is treatable and life is so much better without that dark cloud hanging over you. Look for the symptoms of depression in your teen, or teens you interact with regularly and help them get relief.

If you have any questions or comments, please leave me a comment below.

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