Disease: Teen depression

Appointments & care

At Mayo Clinic, we take the time to listen, to find answers and to provide you the best care.

Teen depression is a serious medical problem that causes a persistent feeling of sadness and loss of interest in activities. It affects how your teen thinks, feels and behaves, and it can cause emotional, functional and physical problems. Although mood disorders, such as depression, can occur at any time in life, symptoms may be different between teens and adults.

Issues such as peer pressure, academic expectations and changing bodies can bring a lot of ups and downs for teens. But for some teens, the lows are more than just temporary feelings — they're a symptom of depression.

Teen depression isn't a weakness or something that can be overcome with willpower — it can have serious consequences and requires long-term treatment. For most teens, depression symptoms ease with treatment such as medication and psychological counseling.

Source: http://www.mayoclinic.com

Teen depression signs and symptoms include changes in your teen's emotions and behavior, such as the examples below.

Emotional changes

Be alert for emotional changes, such as:

  • Feelings of sadness, which can include crying spells for no apparent reason
  • Irritability, frustration or feelings of anger, even over small matters
  • Loss of interest or pleasure in normal activities
  • Loss of interest in, or conflict with, family and friends
  • Feelings of worthlessness, guilt, fixation on past failures or exaggerated self-blame or self-criticism
  • Extreme sensitivity to rejection or failure, and the need for excessive reassurance
  • Trouble thinking, concentrating, making decisions and remembering things
  • Ongoing sense that life and the future are grim and bleak
  • Frequent thoughts of death, dying or suicide

Behavioral changes

Watch for changes in behavior, such as:

  • Tiredness and loss of energy
  • Insomnia or sleeping too much
  • Changes in appetite, such as decreased appetite and weight loss, or increased cravings for food and weight gain
  • Use of alcohol or drugs
  • Agitation or restlessness — for example, pacing, hand-wringing or an inability to sit still
  • Slowed thinking, speaking or body movements
  • Frequent complaints of unexplained body aches and headaches, which may include frequent visits to the school nurse
  • Poor school performance or frequent absences from school
  • Neglected appearance — such as mismatched clothes and unkempt hair
  • Disruptive or risky behavior
  • Self-harm, such as cutting, burning, or excessive piercing or tattooing

What's normal and what's not

It can be difficult to tell the difference between ups and downs that are just part of being a teenager and teen depression. Talk with your teen. Try to determine whether he or she seems capable of managing challenging feelings, or if life seems overwhelming.

If depression symptoms continue or begin to interfere in your teen's life, talk to a doctor or a mental health professional trained to work with adolescents. Your teen's family doctor or pediatrician is a good place to start. Or your teen's school may recommend someone.

When to see a doctor

If you suspect your teenager is depressed, make a doctor's appointment as soon as you can. Depression symptoms likely won't get better on their own — and they may get worse or lead to other problems if untreated. Depressed teenagers may be at risk of suicide, even if signs and symptoms don't appear to be severe.

If you're a teen and you think you may be depressed — or you have a friend who may be depressed — don't wait to get help. Talk to a health care professional such as your doctor or school nurse. Share your concerns with a parent, a close friend, a spiritual leader, a teacher or someone else you trust.

Suicidal thoughts

If your teen is having suicidal thoughts, get help right away. Take all talk of suicide seriously. Here are some steps you can take:

  • Call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) to reach a trained counselor or encourage your teen to do so.
  • Seek help from your doctor, a mental health provider or other health care professional.
  • Reach out to family members, friends or spiritual leaders for support as you seek treatment for your teen.

When to get emergency help

If you think your teen is in immediate danger of self-harm or attempting suicide, make sure someone stays with him or her. Call 911 or your local emergency number immediately. Or if you think you can do so safely, take your teen to the nearest hospital emergency department.

Source: http://www.mayoclinic.com

It's not known exactly what causes depression. A variety of factors may be involved. These include:

  • Biological chemistry. Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression. When these chemicals are out of balance, it may lead to depression symptoms.
  • Hormones. Changes in the body's balance of hormones may be involved in causing or triggering depression.
  • Inherited traits. Depression is more common in people whose biological (blood) relatives also have the condition.
  • Early childhood trauma. Traumatic events during childhood, such as physical or emotional abuse, or loss of a parent, may cause changes in the brain that make a person more susceptible to depression.
  • Learned patterns of negative thinking. Teen depression may be linked to learning to feel helpless — rather than learning to feel capable of finding solutions for life's challenges.

Source: http://www.mayoclinic.com

Appointments & care

At Mayo Clinic, we take the time to listen, to find answers and to provide you the best care.

When teen depression is suspected, the doctor will generally do these exams and tests.

  • Physical exam. The doctor may do a physical exam and ask in-depth questions about your teen's health to determine what may be causing depression. In some cases, depression may be linked to an underlying physical health problem.
  • Lab tests. For example, your teen's doctor may do a blood test called a complete blood count or test your teen's thyroid to make sure it's functioning properly.
  • Psychological evaluation. This evaluation will include a discussion with your teen about thoughts, feelings and behavior, and may include a questionnaire. These will help pinpoint a diagnosis and check for related complications.

Diagnostic criteria for depression

To be diagnosed with depression, your teen must meet the symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.

Symptoms can be based on your teen's feelings or on the observations of someone else. For a diagnosis of major depression, the following symptoms must occur most of the day, nearly every day, during at least a two-week period, and be a change or worsening in the teen's usual attitude and behavior.

Your teen must have at least one of the following:

  • Depressed mood, such as feeling sad, empty or tearful (in teens, depressed mood can appear as constant irritability)
  • Diminished interest or feeling no pleasure in any or most activities

Your teen must also have four or more of the following:

  • Significant weight loss when not dieting, weight gain, or decrease or increase in appetite (in teens, failure to gain weight as expected can be a sign of depression)
  • Insomnia or increased desire to sleep
  • Restlessness or slowed behavior that can be observed by others
  • Fatigue or loss of energy
  • Feelings of worthlessness, or excessive or inappropriate guilt
  • Trouble making decisions, thinking or concentrating
  • Recurrent thoughts of death or suicide, making a suicide plan or a suicide attempt

To be considered major depression:

  • Symptoms aren't due to a mixed episode, which is mania along with depression that sometimes occurs as a symptom of bipolar disorder
  • Symptoms must be severe enough to cause noticeable problems in day-to-day activities, such as school, social activities or relationships with others
  • Symptoms are not due to the direct effects of something else, such as drug abuse, taking a medication or having a medical condition such as hypothyroidism
  • Symptoms are not caused by grieving, such as temporary sadness after the loss of a loved one

Other types of major depression include:

  • Atypical depression. In this type of depression, key signs and symptoms include increased hunger, weight gain, sleeping a lot, feeling that your arms and legs are heavy, and difficulty maintaining relationships.
  • Postpartum depression. This type of depression can occur in new mothers. It can begin shortly after delivery or even several weeks later. Signs and symptoms are more intense and longer lasting than the baby blues, eventually interfering with the ability to care for the baby and handle other daily tasks.
  • Psychotic depression. This is severe depression accompanied by psychotic symptoms, such as delusions or hallucinations.
  • Dysthymia. Dysthymia (dis-THIE-me-uh) is a less severe, but more long-term form of depression. While it's usually not disabling, dysthymia can prevent your teen from functioning normally in a daily routine and from living life to the fullest.

Other conditions that cause depression symptoms

There are several other conditions with symptoms that can include depression. It's important to get an accurate diagnosis so that your teen gets appropriate treatment. Your doctor or mental health provider's evaluation will help determine if the symptoms of depression are caused by one of the following conditions:

  • Seasonal affective disorder. This type of depression is related to changes in seasons and diminished exposure to sunlight.
  • Adjustment disorder. An adjustment disorder is a severe emotional reaction to a difficult event in your life. It's a type of stress-related mental illness that may affect feelings, thoughts and behavior.
  • Bipolar disorder. Bipolar disorder is characterized by mood swings that range from the highs of mania to the lows of depression. It's sometimes difficult to distinguish between bipolar disorder and depression, but it's important to get an accurate diagnosis because treatment for bipolar disorder is different from that for other types of depression.
  • Cyclothymia. Cyclothymia (sy-kloe-THIE-me-uh), or cyclothymic disorder, is a milder form of bipolar disorder.
  • Schizoaffective disorder. Schizoaffective disorder is a condition in which a person meets the criteria for both schizophrenia and a mood disorder such as depression.

Source: http://www.mayoclinic.com

Untreated depression can result in emotional, behavioral and health problems that affect every area of your teen's life. Complications related to teen depression can include:

  • Low self-esteem
  • Alcohol and drug abuse
  • Academic problems
  • Family conflicts and relationship difficulties
  • Social isolation
  • Involvement with the juvenile justice system
  • Suicide

Source: http://www.mayoclinic.com

There's no sure way to prevent depression. However, these strategies may help. Encourage your teen to:

  • Take steps to control stress, such as not committing to too many obligations at once.
  • Boost low self-esteem by recognizing small steps toward getting better.
  • Reach out for friendship and social support, especially in times of crisis.
  • Get treatment at the earliest sign of a problem to help prevent depression from worsening.
  • Maintain ongoing treatment, if recommended, even after symptoms let up, or have regular therapy sessions to help prevent a relapse of depression symptoms.

Source: http://www.mayoclinic.com

Avoid replacing conventional medical treatment or psychotherapy with alternative medicine. When it comes to depression, alternative treatments aren't a substitute for professional care. But some mind-body therapies may help.

Mind-body connections

Complementary and alternative medicine practitioners believe the mind and body must be in harmony to stay healthy. Examples of mind-body techniques that may be helpful for depression include:

  • Yoga or tai chi
  • Meditation
  • Guided imagery
  • Massage therapy
  • Relaxation techniques
  • Music or art therapy
  • Spirituality
  • Acupuncture

Relying solely on these therapies is generally not enough to treat depression. But they may be helpful when used in addition to medication and psychotherapy.

Source: http://www.mayoclinic.com

You are your teen's best advocate to help him or her succeed. Here are some steps you and your teen can take that may help:

  • Stick to the treatment plan. Make sure your teen attends appointments, even if he or she doesn't feel like going. Even if your teen is feeling well, make sure he or she continues to take medications as prescribed. If your teen stops taking medications, depression symptoms may come back. Quitting suddenly may cause withdrawal-like symptoms.
  • Learn about depression. Education can empower your teen and motivate him or her to stick to a treatment plan. It can also benefit you and other loved ones to learn about your teen's depression and understand that it's a treatable condition.
  • Encourage communication with your teen. Talk to your teen about the changes you're observing and emphasize your unconditional support. Create an environment where your child can share concerns while you listen.
  • Pay attention to warning signs. Work with your teen's doctor or therapist to learn what might trigger depression symptoms. Make a plan so that you and your teen know what to do if symptoms get worse. Ask family members or friends to help watch for warning signs.
  • Make sure your teen adopts healthy habits. Even light physical activity can help reduce depression symptoms. Sleeping well is important for all teens, especially those with depression. If your teen is having trouble sleeping, ask the doctor for advice.
  • Help your teen avoid alcohol and other drugs. Your teen may feel like alcohol or drugs lessen depression symptoms, but in the long run they worsen symptoms and make depression harder to treat.

Source: http://www.mayoclinic.com

Showing interest and the desire to understand your teen's feelings lets him or her know you care. You may not understand why your teen feels hopeless or why he or she has a sense of loss or failure. Listen to your teen without judging and try to put yourself in his or her position. Help build your teen's self-esteem by recognizing small successes and offering praise about his or her competence.

Encourage your teen to:

  • Make and keep healthy friendships. Positive relationships can help boost your teen's confidence and stay connected with others. Encourage your teen to avoid relationships with people whose attitudes or behaviors could make depression worse.
  • Stay active. Participation in sports, school activities or a job can help keep your teen focused on positive things, rather than negative feelings or behaviors.
  • Ask for help. Teens may be reluctant to seek support when life seems overwhelming. Encourage your teen to talk to a family member or other trusted adult whenever needed.
  • Have realistic expectations. Many teens judge themselves when they aren't able to live up to unrealistic standards — academically, in athletics or in appearance, for example. Let your teen know that it's OK not to be perfect.
  • Simplify life. Encourage your teen to carefully choose obligations and commitments, and set reasonable goals. Let your teen know that it's OK to do less when he or she feels down.
  • Structure time. Help your teen plan activities by making lists or using a planner to stay organized.
  • Encourage your teen to keep a private journal. Journaling may help improve mood by allowing your teen to express and work through pain, anger, fear or other emotions.
  • Connect with other teens who struggle with depression. Talking with other teens facing similar challenges can help your teen cope. So can learning skills to manage life's challenges. Local support groups for depression are available in many communities. And support groups for depression are offered online, but check them out to make sure they're credible and trustworthy sites. Good places to start are the National Alliance on Mental Illness and the Depression and Bipolar Support Alliance.
  • Stay healthy. Do your part to make sure your teen eats regular, healthy meals, gets regular exercise and gets plenty of sleep.

Source: http://www.mayoclinic.com

Many factors increase the risk of developing or triggering teen depression, including:

  • Having issues that negatively impact self-esteem, such as obesity, peer problems, long-term bullying or academic problems
  • Having been the victim or witness of violence, such as physical or sexual abuse
  • Having other conditions, such as an anxiety disorder, anorexia or bulimia, attention-deficit/hyperactivity disorder (ADHD) or learning disabilities
  • Having a chronic medical illness such as cancer, diabetes or asthma
  • Having few friends or other personal relationships
  • Having certain personality traits, such as low self-esteem or being overly dependent, self-critical or pessimistic
  • Abusing alcohol, nicotine or other drugs
  • Being a girl — depression occurs more often in females than in males
  • Being gay, lesbian, bisexual or transgender — becoming socially isolated or experiencing bullying may increase the risk of depression

Family history and issues with family or others may also increase your teen's risk of depression:

  • Having a parent, grandparent or other biological (blood) relative with depression, bipolar disorder or alcoholism
  • Having a family member who committed suicide
  • Having a dysfunctional family and conflict
  • Having experienced recent stressful life events, such as parental divorce, parental military service or the death of a loved one

Source: http://www.mayoclinic.com

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