Adolescence can be a challenging time with rapid changes in life, school, and relationships. It’s no surprise that many teens experience feelings of overwhelm. But for some young people, these feelings go beyond everyday stress and develop into more serious mental health issues.
According to the World Health Organization, one in seven adolescents aged 10 to 19 experiences some form of mental disorder. Depression is one of the most common of these conditions and can affect every aspect of a young person’s life, from their mood and self-esteem to their ability to focus and enjoy activities. When left untreated, adolescent depression can continue to affect physical and mental health into adulthood.
In this article, we’ll explore the importance of adolescent mental health, what teen depression is, signs and symptoms of teen depression, and different ways to treat depression in adolescents.
Adolescents and mental health
Adolescence is a time when young people begin to form their identity and sense of self. But it’s also a time when mental health challenges can surface.
The most common mental health issues amongst teens are depression, anxiety disorders, behavioral disorders like attention deficit hyperactivity disorder (ADHD), and eating disorders. These conditions can all significantly impact a young person’s daily life and relationships, resulting in social withdrawal, struggles at school, or risky behaviors such as substance abuse. If left unaddressed, mental disorders such as depression can have tragic outcomes, with suicide being the third leading cause of death for young people aged 15 to 29 years old.
It’s important to address adolescent mental health conditions early on to prevent these issues from continuing into adulthood. Adolescence is a period of numerous life transitions, from forming relationships to developing new interests and planning for the future, and experiencing disruptions due to mental illness can make it easy for a young person to ‘fall out of step’ with their peers. This can lead to social isolation, feelings of inadequacy, and reduced potential for future success.
What is teen depression?
Teen depression, also known as adolescent depression, is a mental health condition that causes persistent feelings of sadness, hopelessness, and a lack of interest in activities that were once enjoyable. It impacts a young person’s thoughts, feelings, and behaviors, and can interfere with daily life, relationships, and school performance.
Because adolescence is a time filled with challenges, from peer pressure to academic stress and physical changes, it can be easy to overlook or dismiss depression as typical teen mood swings. But unlike occasional mood swings or temporary sadness, teen depression is deeper, more intense, and lasts for a longer period of time.
It’s important to understand that adolescent depression is not a sign of weakness – it’s a serious condition that requires attention, support and treatment. If left unaddressed, teen depression can lead to lasting consequences into adulthood. Fortunately, with proper care through counseling, therapy, or treatments like TMS, most young people can find relief from their symptoms and improve their mental health.
What causes depression in teens?
Teenage depression can stem from a variety of factors, and the causes are often unique to each individual. Usually, a combination of causes is involved.
Some common risk factors for developing teen depression include:
- Family history of depression or other mental health conditions
- Personal struggles with anxiety disorders or other mental health issues
- Ongoing conflict at home, or a stressful family environment
- Social pressures, including bullying, peer pressure, or difficulty fitting in
- Substance abuse
- Certain personality traits or thought patterns, i.e. pessimism, low self-esteem, self-doubt
- High levels of stress from academic pressure, social relationships, or family issues
- Experiencing trauma, including physical or sexual abuse, loss of a loved one, or a major life change.
Signs and symptoms of adolescent depression
Symptoms of adolescent depression include a combination of emotional, physical, and behavioral changes. They can vary in severity and every teenager will experience depression differently. Below, we look at the most common symptoms of teen depression.
Emotional symptoms of adolescent depression include:
- Persistent sadness
- Feelings of hopelessness, worthlessness, or emptiness
- Frequent crying
- Irritability, frustration, or anger
- Loss of interest or pleasure in activities
- Withdrawal from friends and family
- Low self-esteem
- Feelings of guilt
- Self-criticism or self-blame
- Lack of motivation or enthusiasm
- Fixation on past failures
- Difficulty focusing, making decisions, or remembering things
- Extreme sensitivity to rejection or failure
- Negative body image
- Apathy
- Excessive need for reassurance
- Thoughts of death, dying, or suicide.
Behavioral symptoms of adolescent depression include:
- Lack of energy or fatigue
- Slowed thinking or body movements
- Difficulty sleeping or sleeping too much
- Changes in appetite
- Restlessness or inability to sit still
- Substance use
- Unexplained aches and pains
- Withdrawal from friends and family
- Poor performance at school or frequent absences
- Risky or disruptive behavior
- Disinterest in personal appearance or hygiene
- Self-harm
- Thoughts or attempts of suicide.
Sometimes, it can be tricky to tell the difference between the normal ups and downs of adolescence and more serious signs of teen depression. If you’re not sure whether your child has depression, try talking with them to see if they’re managing their feelings well or feeling overwhelmed. It might also be helpful to speak to a mental health specialist who’s trained in teen depression and better able to spot the signs.
Similar Reading: Depression vs. Anxiety: Which One Do I Have? Symptoms & Treatment
Different types of depression
Depression is not a singular illness, there are many different types and each can show up in different ways. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) outlines several different types of depressive disorder. These include:
- Major depressive disorder (or major depression)
- Persistent depressive disorder (previously called dysthymia)
- Disruptive mood dysregulation disorder
- Premenstrual dysphoric disorder
- Substance or medication-induced depressive disorder
- Depressive disorder due to another medical condition (i.e. bipolar disorder).
The above types of depression vary in intensity, duration, and causes, but all feature the following core symptoms:
- Sad, empty, or irritable mood
- Physical or biological changes, such as appetite changes or sleep issues
- Cognitive changes, namely negative thought patterns.
Treatments for adolescent depression
Thankfully, there are ways to treat adolescent depression and relieve symptoms before they have lasting consequences. In most cases, the first line of treatment for children and adolescents with mild depression is psychotherapy. If symptoms don’t approve within six to eight weeks, or if they worsen, antidepressant medication may be prescribed.
Another treatment option that has recently been FDA-approved for teenage depression is TMS therapy, which is non-invasive and non-surgical. The best treatment plan for your child will depend on their needs and preferences, unique circumstances, and the severity of depression.
Below, we’ll explore each of these treatment options in more detail.
Psychotherapy
Psychotherapy, also known as talk therapy or counseling, involves talking about depression with a mental health professional. It might include discussing how to deal with negative thoughts and feelings, practicing more productive behaviors, managing relationships, or developing coping strategies. Sessions can be conducted one-on-one, with family, or in a group.
During a psychotherapy session, the client can discuss their feelings, thoughts, behaviors, and relationships. They may be offered alternate ways of thinking or shown new ways to cope with depressive symptoms.
The two main types of psychotherapy used to treat adolescent depression are:
- Cognitive behavioral therapy (CBT): This can help depressed adolescents recognize and change unhealthy thoughts and behaviors that contribute to depression.
- Interpersonal psychotherapy: This focuses on identifying and improving issues in relationships, such as with parents or friends.
Psychotherapy sessions can be conducted online or in-person. While it’s important for parents or caregivers to be involved in their child’s depression treatment, they don’t usually join therapy discussions.
See: How to Find & Choose a Good Psychiatrist for You
Medication
Teenagers with moderate to severe depression are usually treated with antidepressant medication as well as psychotherapy. This is called ‘combination therapy’.
Most teenagers with depression will be prescribed a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs). Specifically, the FDA has approved two antidepressants for teen depression: fluoxetine (Prozac) and escitalopram (Lexapro). If an SSRI is not effective or has side effects, atypical antidepressants may be used instead (i.e. Effexor, Cymbalta, or Wellbutrin). In very rare cases, a tricyclic antidepressant may be prescribed if SSRIs and atypical antidepressants do not work. However, these medications can cause many side effects.
Keep Reading: Do Antidepressants Work and How Effective Are They?
All antidepressants are required to carry a black box warning by the FDA. This is because, in rare cases, some children, teenagers, and young adults under the age of 25 can experience an increase in suicidal thoughts or behavior, particularly in the first few weeks after starting antidepressants or if the dosage is changed.
For this reason, it’s important to keep a careful eye on your teen when they start a new medication or change their dose. If you notice any of the following symptoms after your teen starts antidepressants, contact your doctor or medication management provider immediately:
- New or more frequent thoughts/talking of suicide
- Suicide attempts
- Worsening depression
- New or worsening anxiety
- Difficulty sleeping
- Restlessness or agitation
- Panic attacks
- New or worsening irritability, aggression, or violent behavior
- Reckless behavior
- Hyperactive speech or behavior
- Any other unusual changes in behavior.
For most teenegers, the benefits outweigh the risks of antidepressant medications. If you have any concerns or worries about your child taking medication, be sure to speak about them with the medication management provider. Don’t be afraid to ask about:
- Expected benefits
- Potential risks and side effects
- Dose and timing instructions
- Anticipated length of time to response
- Potential interactions with other medications (prescription or non-prescription)
- Alternatives to medication (i.e. continued psychotherapy or TMS therapy).
Treating adolescent depression with medication can be a journey. It can take several weeks to feel full effects and for side effects to ease. Every person is different and some trial and error may be needed to find the right medication or dosage that works for your child. To work properly, antidepressants need to be taken regularly at the prescribed dose. It’s important to be patient and not give up.
If your teen feels unpleasant side effects from antidepressants, they shouldn’t stop taking them without speaking to their medication management provider first. In most cases, antidepressants should be tapered off slowly and quitting suddenly can worsen symptoms or cause withdrawal.
TMS therapy
Transcranial magnetic stimulation, or TMS, therapy is a non-invasive, non-systemic treatment for depression and other mental health conditions. It has recently been FDA-approved for the treatment of adolescent depression. This approval is a huge step towards providing more treatment options for teenagers struggling with depressive symptoms.
TMS therapy works by delivering targeted magnetic pulses to the parts of the brain that govern mood. These pulses stimulate nerve cells which are considered to cause depressive symptoms. Over time, TMS therapy can rebalance brain activity to relieve symptoms of depression and improve mental well-being. Each TMS session lasts around 20 minutes, and afterwards, patients are free to go home or back to school. It is a completely safe and painless procedure and no anesthesia is needed.
While studies are still confirming the efficacy of TMS therapy in adolescents, it has a well-documented history of success in treating adult depression. In one Harvard Medical School study, more than half of people with depression who haven’t seen results with medications responded well to TMS therapy. Nearly a third of these patients experienced full remission with symptoms disappearing completely.
For adolescents, TMS therapy provides a safe and effective alternative to antidepressants and can be a game-changer for those who experience side effects or haven’t responded to medications.
See More: Is TMS Appropriate for Treating Adolescents With Depression?
When to get help for adolescent depression
If you think your teen may be experiencing signs of depression, or you feel concerned about their mental well-being, don’t hesitate to contact a mental health professional trained in adolescent psychiatry. If left untreated, these symptoms can worsen or lead to other issues.
If you’re a teen and think you may have depression, or you have a friend who may be depressed, support is available. Don’t be afraid to reach out to a mental healthcare provider, close family member, friend, teacher, or someone else you trust. Help is available and things can get better.
Whether you’re a parent or a teen, the team at BestMind Behavioral Health is here to provide support for adolescent depression. Our team of compassionate mental health specialists are available for telemedicine or in-person consultations at our clinics in Colorado and Oregon. We offer a variety of services, including medication management and TMS therapy, and can guide you on your journey towards better mental health.
Get in touch with our team now to get help for teen depression.
