All of us have times when we feel down or sad. However, depression is a feeling of sadness, despair, or hopelessness that does not go away. For 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 the mood, outlook, thoughts, and behavior. It also can cause fatigue, irritability, loss of appetite, headaches, and insomnia.

People with depression often see the world in a negative light. They can be 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.  This is worse if it happens to teen. Depression in teens is known as teen depression.

The medical community once thought depression affected only adults. However, teen depression is real. The risk for the condition can begin in childhood or the early teens, however, and increases steadily through the mid-20s. Around 11 percent of 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. This article will provide a detailed analysis of teen depression, discussing the causes, symptoms, diagnosis, treatment and prevention.

Parents Guide to Teen Depression

Causes of teen depression

Academic stress

Teens are under an enormous amount of pressure to succeed academically, especially as the costs of higher education rise and more families are reliant upon scholarships to help offset the expense. Stressing over classes, grades and tests can cause them to become depressed, especially if they’re expected to excel at all costs or are beginning to struggle with your course load.

Social anxiety or peer pressure

During adolescence, teenagers are learning how to navigate the complex and unsettling world of social interaction in new and complicated ways. Popularity is important to most teens, and a lack of it can be very upsetting. The appearance of peer pressure to try illicit drugs, drinking or other experimental behavior can also be traumatic for teens that aren’t eager to give in, but are afraid of damaging their reputation through refusal.

Romantic problems

In adolescence, romantic entanglements become a much more prominent and influential part of life. From breakups to unrequited affection, there are plethoras of ways in which budding love lives can cause teens to become depressed.

Traumatic events

The death of a loved one, instances of abuse or other traumatic events can have a very real impact on anyone, causing them to become depressed or overly anxious. In the aftermath of a trauma, it’s wise to keep an eye out for any changes in the behavior of your teen or signs of depression.

Separating or divorcing parents

Divorced or separated parents might be more common today than it was in generations past, but that doesn’t mean that the situation has no effect on emotional wellbeing. The dissolution of the family unit or even the divorce of a parent and step-parent can be very upsetting for teens, often leading to depression.

Heredity

Some people are genetically predisposed to suffer from depression. If you or close relative has issues with depression, your teen may be suffering from a cruel trick of heredity that makes them more susceptible.

Family financial struggles

Your teen may not be a breadwinner in your household or responsible for balancing the budget, but that doesn’t mean that they’re unaffected by a precarious financial situation within the family. Knowing that money is tight can be a very upsetting situation, especially if you’re worried about the possibility of losing your home or the standard of living you’re accustomed to.

Physical or emotional neglect

Though your may seem like a fiercely independent being that wants or needs nothing from you and your partner, they still have emotional and physical needs for attention. The lack of parental attention on either level can lead to feelings of depression.

Low self-esteem

Being a teenager isn’t easy on the self-esteem. From a changing body to the appearance of pimples, it can seem as if mother nature herself is conspiring against them to negatively affect their level of self-confidence. When the self-esteem level drops below a certain point, it’s not uncommon to become depressed.

Feelings of helplessness

Knowing that they’re going to be affected on a personal level by things teens have no control over can easily throw them into the downward spiral of depression. Feelings of helplessness and powerlessness often go hand in hand with the struggle with depression, and can make the existing condition even more severe.

Symptoms of teen depression

Sleep problems

Depression can affect their body as well as their minds. Trouble falling or staying asleep is common in people who are depressed. But some may find that they get too much shut-eye.

Chest pain

It can be a sign of heart, lung, or stomach problems, so see your doctor to rule out those causes. Sometimes, though, it’s a symptom of depression. Depression can also raise your teen’s risk of heart disease. Plus, people who’ve had heart attacks are more likely to be depressed.

Fatigue and exhaustion

If your teen feels so tired that you don’t have energy for everyday tasks — even when they sleep or rest a lot — it may be a sign that they’re depressed. Depression and fatigue together tend to make both conditions seem worse.

Aching muscles and joints

When your teen lives with ongoing pain it can raise their risk of depression. Depression may also lead to pain because the two conditions share chemical messengers in the brain. People who are depressed are three times as likely to get regular pain.

Digestive problems

Our brains and digestive systems are strongly connected, which is why many of us get stomachaches or nausea when we’re stressed or worried. Depression can get you in your gut too — causing nausea, indigestion, diarrhea, or constipation.

Headaches

One study shows that people with major depression are three times more likely to have migraines, and people with migraines are five times more likely to get depressed.

Changes in appetite or weight

Some people feel less hungry when they get depressed. Others can’t stop eating. The result can be weight gain or loss, along with lack of energy. Depression has been linked to eating disorders like bulimia, anorexia, or binge eating.

Back pain

When it hurts your teen there on a regular basis, it may contribute to depression. And people who are depressed may be four times more likely to get intense, disabling neck or back pain.

 Agitated and restless

Sleep problems or other depression symptoms can make your teen feel this way. Boys are more likely than girls to be irritable when they’re depressed.

Sexual problems

If your teen is depressed, they might lose their interest in sex. Some prescription drugs that treat depression can also take away their drive and affect performance.

Exercise

Research suggests that if your teen does it regularly, it releases chemicals in their brain that make them feel good, improve their mood, and reduce their sensitivity to pain. Although physical activity alone won’t cure depression, it can help ease it over the long term. If they’re depressed, it can sometimes be hard to get the energy to exercise. But try to remember that it can ease fatigue and help them sleep better.

Diagnosis of teen depression

Many providers of health care may help make the diagnosis of clinical depression in teens, including licensed mental health therapists, pediatricians or other primary care providers, specialists whom you see for a medical condition, emergency physicians, psychiatrists, psychiatric physician’s assistants, psychologists, psychiatric nurses, nurse practitioners, and social workers. Since the symptoms of depression can mimic those of other mental health disorders and depression can co-occur with other mental health disorders, the professional will ask about many other emotional problems to make that distinction.

One of these professionals described above also will likely conduct or refer for an extensive medical interview and physical examination as part of establishing the diagnosis. Depression may be associated with a number of other medical conditions or can be a side effect of various medications. For this reason, routine laboratory tests are often performed during the initial evaluation to rule out other causes of symptoms. Occasionally, an x-ray, ct or mri scan, or other imaging study may be needed. As part of this examination, the sufferer may be asked a series of questions from a standardized questionnaire or self-test to help assess the risk of depression and suicide.

Treatment of teen depression

If the symptoms indicate that a teen is suffering from clinical depression, the health care provider will likely strongly recommend treatment. Treatment may include addressing any medical conditions that cause or worsen depression. For example, an individual who is found to have low levels of thyroid hormone might receive hormone replacement with levothyroxine (synthroid). Other components of treatment may be supportive therapy, such as changes in lifestyle and behavior, psychotherapy, and complementary therapies. Treatment may include medication for moderate to severe depression. If symptoms are severe enough to warrant treatment with medication, symptoms tend to improve faster and for longer when medication treatment is combined with psychotherapy.

Most practitioners will continue treatment of major depression for at least six months to a year after symptoms have stabilized. Treatment for teens with depression can have a significantly positive effect on how well the adolescent functions with peers, family, and at school. Without treatment, symptoms tend to last much longer and may never get better. In fact, they may get worse. With treatment, chances of recovery are improved.

Psychotherapy of teen depression

Psychotherapy (“talk therapy”) is a form of mental health counseling that involves working with a trained therapist to figure out ways to solve problems and cope with depression. It can be a powerful intervention, even producing positive biochemical changes in the brain. In addition to individual psychotherapy, group therapies have been found to be beneficial forms of treatment based on the normal developmental tendencies for adolescents to value their peer relationships. Two major approaches are commonly used to treat teen depression: interpersonal therapy and cognitive behavioral therapy. In general, these therapies take weeks to months to complete. Each has a goal of alleviating the symptoms. More intense psychotherapy may be needed for longer when treating very severe depression or for depression with other psychiatric symptoms.

Interpersonal therapy (ipt): this form of psychotherapy helps to alleviate depressive symptoms and helps the sufferer develop more effective skills for coping with social and interpersonal relationships. Ipt employs two strategies to achieve these goals:

• The first is education about the nature of depression. The therapist will emphasize that depression is a common illness and that most people can expect to get better with treatment.
• The second strategy is defining problems (such as abnormal grief or interpersonal conflicts). After the problems are defined, the therapist is able to help set realistic goals for solving these problems and work with the depressed teen using various treatment techniques to reach these goals.

Cognitive behavioral therapy (cbt): this type of psychotherapy has been found to be effective as part of treatment for even severe adolescent depression. This approach helps to alleviate depression and reduce the likelihood it will come back by helping the teen change his or her way of thinking about certain issues. In cbt, the therapist uses three techniques to accomplish these goals.

• Didactic component: this phase helps to set up positive expectations for therapy and promote the youth’s cooperation with the treatment process.
• Cognitive component: this aspect of cbt helps to identify the thoughts and assumptions and ways of thinking that influence the teen’s behaviors, particularly those that may predispose the sufferer to being depressed.
• Behavioral component: this employs behavior-modification techniques to teach the teenager more effective strategies for dealing with problems.

Medications of teen depression

The major types of antidepressant medications prescribed for adults are the selective serotonin reuptake inhibitors (ssris), the tricyclic antidepressants (tcas), and the atypical antidepressants. Tcas are sometimes prescribed in adults in severe cases of depression or when ssri medications don’t work but have been determined not to be largely effective in treating teen depression. The monoamine oxidase inhibitors(maois) have fallen out of favor as antidepressants, particularly in adolescents, because of the negative interactions this group of medications can have with numerous foods and medications.

Ssri medications affect levels of serotonin in the brain. For many prescribing doctors, these medications are the first choice because of the high level of effectiveness and general safety of this group of medicines. Examples of these medications are listed here. The generic name is first, with the brand name in parentheses.

• Fluoxetine (prozac)
• Sertraline (zoloft)
• Paroxetine (paxil)
• Fluvoxamine (luvox)
• Citalopram (celexa)
• Escitalopram (lexapro)
• Vortioxetine (trintellix)
• Vilazodone (viibryd)

Non-neuroleptic mood-stabilizer medications are also sometimes used with an antidepressant to treat teens with unipolar depression who do not improve after receiving trials of different antidepressants. These medications might also be considered in addition to or instead of an antidepressant in adolescents who suffer from bipolar disorder. Examples of non-neuroleptic mood stabilizers that are used for this purpose include divalproex sodium (depakote), carbamazepine (tegretol), and lamotrigine (lamictal). Of the non-neuroleptic mood stabilizers, lamictal seems to be unique in its ability to also treat unipolar depression effectively by itself as well as in addition to an antidepressant. It is only used in people older than 16 years of age or older due to rare but potentially serious side effects.

Atypical antidepressant medications work differently than the commonly used ssris. The following medications might be prescribed when ssris have not worked: bupropion (wellbutrin), venlafaxine (effexor), duloxetine (cymbalta), desvenlafaxine (pristiq), or levomilnacipran (fetzima).

About one-half of teens who take antidepressant medications get better. It may take anywhere from one to six weeks of taking medication at its effective dose to start feeling better. The prescribing mental health professional (for example, psychiatrist or other physician, nurse practitioner, physician assistant) will likely assess the depressed teen that is receiving the medication soon after it is started to see if the medication is being well tolerated and if symptoms have begun to improve. If not, the doctor may adjust the dose of the medication or prescribe a different one.

After symptoms begin to improve, the prescribing doctor will likely encourage the depressed teen to continue taking the medication for six months to a year since stopping the medication too soon may cause symptoms to return or to get worse. Some people need to take the medication for longer periods of time to keep the depression from returning. Stopping abruptly may cause the depression to return or for serious withdrawal effects to occur, depending on the medication that is being taken.

Source: https://www.medicinenet.com/teen_depression/article.htm#where_can_teens_get_information_about_and_support_for_depression

Other kinds of treatment

Several nonprescription herbal and dietary supplements are used by some people to treat depression. Little is known about the safety, effectiveness, or appropriate dosage of these remedies, although they are taken by thousands of people around the world.

• A few of the best-known alternative remedies continue to be studied scientifically to see how well they work, but to date, there is little evidence that herbal remedies effectively treat moderate to severe clinical depression.
• Medical professionals usually are hesitant to recommend herbs or dietary supplements, particularly in teens, because they are not regulated by the u.s. Food and drug administration (fda), as prescription drugs are, to ensure their purity, quality, and safety.

Prevention of teen depression

Attempts at prevention of teen depression tends to address both specific and nonspecific risk factors, strengthen protective factors, and use an approach that is appropriate for the teen’s developmental level. Such programs often use cognitive behavioral and/or interpersonal approaches, as well as family based prevention strategies because research shows that these interventions are the most helpful to teens’ well-being.

The inverse of most risk factors, protective factors for teen depression include having the involvement of supportive adults, strong family and peer relationships, healthy coping skills, and skills in emotion regulation. Children and adolescents of a depressed parent tend to be more resilient when the teen is more able to focus on age-appropriate tasks in their lives and on their relationships, as well as being able to understand their parents’ illness. For depressed parents, their children seem to be more protected from developing the illness when the parent is able to demonstrate a commitment to parenting and to relationships. Youth of depressed parents have also been found to benefit from being part of a support group that uses cognitive therapy as the management approach.

Role of family

Family members and friends are advised to seek and encourage the depressed teen to receive mental health evaluation and treatment. Family members may consult with the teen’s primary care doctor or seek mental health services by contacting one of the resources identified below. Friends of the depression sufferer sometimes think that they would be betraying their friend’s confidence by notifying the depressed teen’s parents, teachers, school counselor, or other school personnel about their friend’s troubles. The potential risk of their friend’s sadness worsening and leading to their becoming suicidal or homicidal far outweighs the risk of the depressed teen feeling betrayed.

Once the depressed youth is in treatment, family members can help encourage good mental health by gently encouraging him or her to adopt a healthy lifestyle. Examples of that include encouraging the teen to drink plenty of water, maintain a healthy diet, get adequate sleep, participate in regular exercise, and engage in appropriate stress-management activities. Friends can encourage the depressed peer to remain socially active rather than becoming isolated. Both family and friends can be helpful to the depressed teen by discouraging their loved one from using alcohol or other drugs or otherwise engaging in risky behaviors.

Depression is an illness that can easily be treated if diagnosed at the right time. However, not many people are aware about it. To know more about depression.