Teenage Depression:  Know The Signs
Friday, April 8, 2011

By Karla L. Robinson, MD

Many recognize depression as a disease impacting the nation at an alarming rate.   According to the Centers for Disease Control and Prevention (CDC) nearly 1 in 10 Americans is battling the symptoms of depression.  The Black community has seen even more difficulty battling this disease.  Studies demonstrate that African Americans on average have more severe and longer lasting symptoms of depression.
Not only is this a major health concern for adults, but teens and adolescents are also experiencing a rise in the rates of depression.   It is estimated that up to 30% of teenagers meet the criteria for major depression but only 20% ever receive the help of a medical professional.  Untreated depression is a major health and social issue for adolescents as this can often lead to self destructive behaviors such as substance abuse, self-mutilation, risky sexual practices, poor school performance, and even violence such as suicide or homicide.
Diagnosing depression in teens is often complicated by the fact that subtle signs of depression may go unnoticed.  Its onset is often overlooked by parents, because the “typical” symptoms of crying spells, fatigue, and appetite changes may not be present in the depressed teen.  It’s important to be familiar with the signs and symptoms of depression in teenagers and recognize when it is time to seek help.
Top Signs Your Teen May Be Depressed
1.       Withdrawal
If your teen is spending more time alone and foregoing social activities, it may be cause for concern.  It is also common for depressed teens to start withdrawing from established friendships and start hanging with a different crowd.
2.       Unexplained Scars
Never ignore unexplained scars on the hands, feet, arms, or legs.  Teens often resort to “cutting” or self-mutilation in an effort to express their pain.
3.       Excessive Sleep
Yes, teens sleep a lot.  However, excessive sleeping can be a sure sign of depression or a teen self-medicating to treat depression.  Teens may resort to substance abuse in an effort to numb the pain, or “sleep the pain away”.  Never ignore excessive sleepiness in a teen, assuming it is “normal”.
4.       Unusual Behavior at School
Failing grades, a lack of participation, or disruptive behavior can all be signs of depression in teens.  Communication with teachers, counselors, and other care-givers when you notice behavior changes in your teen is essential.
5.       Increased Irritability
Bursts of anger and mood swings filled with rage are not normal teen behavior.  It may be a manifestation of depression.  Talk to your teen about seeking help if you notice extreme frustration, anger, or violent tendencies.
6.       Drug and Alcohol Abuse
Depressed teens are more likely to turn to mind altering substances like drugs and alcohol in an effort to avoid the pain of depression.  Never assume your teen is “just experimenting” or that it is “just a phase”.  Seek help immediately if you suspect any substance abuse.
7.       A Sense of Hopelessness and Helplessness
Buzz words such as “What’s the point?”; “Nothing matters anyway”; “Nobody cares anyway”; “It would be better if I weren’t here”, are all statements alluding to a sense of hopelessness.  These are major signs of a depressed teen.  Additionally, a fascination with death, dying, or suicide including writing poems, stories, or songs about it can be clues to a teen that is struggling.  Never ignore these signs and address them immediately.
8.       Giving Away Belongings
If you notice your teen emptying themselves of prized possessions or belongings seek help right away.  This is often a teen considering suicide.  According to the CDC, suicide is the 3rd leading cause of death in those teens and adolescents aged 15-24.   
9.       Unexplained Aches and Pains
Depressed teens will often complain of stomachaches, headaches, or other generalized malaise.  If there is no medical explanation for these symptoms, consider depression as a cause.
10.   Crying Spells
Excessive crying and sadness is not normal in teens.  Don’t mistake depression in your teen for “raging teenage hormones”.  Depressed teens often have a sense of worthlessness, low self-esteem, and are highly self-critical.  This may manifest as crying spells as they may be overly sensitive to criticism or rejection.
If you are concerned that you may have a depressed teen, seek medical attention immediately.  Never assume the symptoms of depression will resolve on their own.   Visit a primary care physician or specialist for a depression screening and exam.  If there is a diagnosis of depression, there are many treatment options available including counseling, support groups, therapy, and in some cases medication.
Unlike adults, teens are often unable to seek help for themselves.  It is up to parents, teachers, coaches, family members, and other care givers to recognize the signs and symptoms of depression in the teens you love. o address these issues today, before it is too late.

5. Stress is necessary to perform well. This can’t be further from the truth.  There is a distinct difference between stress and motivation.  Having goals and pushing yourself to reach them can be considered motivating factors.  Experiencing anxiety, the inability to concentrate, and extreme frustration while trying to accomplish a goal is considered stress and often times leads to poor performance.  For some who are still able to reach their goals under these circumstances, it is often times in spite of stress, not because of stress.

Teen Depression-Urban Legends
1.       Depression looks the same in teens as it does in adults.   This is untrue.  The manifestation of depression in teenagers can often time vary greatly from adults.  While sadness, withdrawal, and an overall slowing of thoughts and actions are often associated with adult depression, teens can have symptoms of increased aggression, anger, rage and agitation.  Make sure you aren’t missing the signs of a hopeless teen by looking for a sad teen.

2.       My teen would tell me if he or she were depressed.  This is not true.  It is often times hard for an adult to recognize when they are suffering from depression.   It’s even harder for a teenager or adolescent.  They are often struggling to even understand the emotions they are feeling, let alone the causes for those emotions. Take an interest in physical or behavior changes of the teen in your life and take action immediately. 
3.       Mood swings are just a normal part of being a teen.   While it is true that adolescence is a difficult time for both parents and teens that are navigating the transition into adulthood, it is never normal for your teen to have long lasting emotional or psychological changes.  If your teen is persistently sad, angry, withdrawn, or is experiencing significant changes to the mood or behavior, seek the help of a professional.
4.       Symptoms of depression in my teen will go away on its own.   It is never OK to assume that symptoms of depression will resolve on its own.  Always seek the professional help of a physician or specialist to determine the severity of depression symptoms and if treatment is necessary.  Depression is a major risk factor for violence such as homicide and suicide.  The CDC reports that the 3rd leading cause of death in those aged 15-24 is suicide.  Don’t ever wait if you see red flags.

April 10, 2011 - April 23, 2011 Edition


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