Depression in teenagers is a serious issue that can cause feelings of persistent sadness, hopelessness, and an overall lack of motivation. If you have a teenager who struggles with depression, it’s important to receive help immediately. The emotional toll can lead to physical and functional problems. If you’re not sure, you’ll want to know the signs of depression in teens.

What Causes Depression in Teens?

Researchers are still trying to figure out what causes depression and how it changes the brain. As of this time, we know:

• Brain Chemistry – Through neuroimaging, it’s been found that people with depression have impaired neurotransmitters. ¹

• Childhood Trauma – If a child experiences traumatic events (i.e. physical or emotional abuse, loss of a parent, etc.), they may be more susceptible to depression. ²

• Genetics – If a blood relative (i.e. parent or grandparent) struggles with depression, a teenager of that relative is more likely to develop it. ³

• Hormones – Teenagers experience extreme hormonal changes daily and sometimes these can cause depression. ⁴

• Negative Thinking Patterns – If a teenager isn’t taught how to feel capable or find solutions, they may learn negative thinking patterns (i.e. how to feel helpless) from their environment. ⁵

Still, more research is required to properly understand what causes depression in teens.

Risk Factors of Depression in Teens

Teenagers are more at risk of depression if they struggle with: ⁶

• Being the victim (or witnessing) of violence (i.e. physical or sexual abuse)
• Certain personality traits (i.e. being overly dependent, self-critical, etc.)
• Learning disabilities or attention-deficit/hyperactivity disorder (ADHD)
• Ongoing physical illness (i.e. cancer, diabetes, etc.) or chronic pain
• Other mental health conditions, such as an anxiety disorder
• Self-esteem issues (i.e. obesity, long-term bullying, academic problems, etc.)
• Substance use disorder (abusing alcohol, nicotine, or other drugs)

Furthermore, those involved in LGBTQ+ are also more likely to struggle with depression. ⁷

Signs of Depression in Teens: What to Look For

If your teen has recently revealed significant distress, problems at school or home, in social activities, and in other aspects of life, they may struggle with depression. To know for sure, you’ll want to look for these signs and symptoms of teenage depression: ⁸

Behavioral Changes

• Agitation or restlessness (i.e. pacing, inability to sit still, etc.)
• Appetite changes (either increased or decreased with weight gain or loss)
• Frequently experiencing body aches and/or headaches
• Insomnia or sleeping too much
• Loss of energy, tiredness
• Poor personal hygiene or appearance
• Self-harm (i.e. cutting, burning, etc.)
• Slowed thinking, speaking, or body movements
• Social isolation
• Substance abuse (using drugs or alcohol)
• Suicidal ideation
• Trouble with school performance or frequent absences

If your teenager struggles with suicidal thoughts or behavior, it’s important to seek help immediately. In cases of emergency, you should visit your local emergency room or call 911. In other cases, you can reach out to the 988 Suicide & Crisis Lifeline.

Emotional Changes

• Constantly talking about life and the future being grim or bleak
• Difficulty concentrating, making decisions, remembering things, and overall thinking
• Feeling guilty or worthless
• Feelings of sadness, hopelessness, and emptiness
• Frustration (even over small matters)
• Irritability or annoyed mood
• Lack of interest in (or conflict with) family and friends
• Loss of interest in activities they once enjoyed
• Low self-esteem
• Obsessed interest in past failures (exaggerated self-blame or self-criticism)
• Thoughts and discussions of death, dying, or suicide
• Very sensitive to rejection or failure (needs excessive reassurance)

When to Contact a Doctor

Admittedly, it isn’t always easy to tell whether or not your teenager struggles with depression. Sometimes, experiencing the occasional downs is just part of being a teenager. To get a better idea of how your teen is managing their feelings (and to figure out what’s going on inside them), it’s important to have a conversation.

However, if you notice the signs of depression continue, you may need to interfere in your teen’s life. Especially if their depression presents safety concerns to your teenager or others.

It’s unlikely your teen’s depression symptoms will go away on their own. Therefore, it’s important to contact a doctor or mental health professional to intervene.

One of the biggest concerns with teenagers is their risk of suicide. Even in teenagers where depression may not appear so severe, suicide remains an extreme risk.

How is Depression Diagnosed and Treated in Teenagers?

To diagnose your teenager with depression, a doctor must perform a physical exam, lab tests, and psychological evaluation to rule out other conditions. Once diagnosed, depression is typically treated in two ways: medication and psychotherapy.

However, it’s important to note that the type of depression will have a major influence on the treatment path your doctor chooses. These are the most common depression types:

• Anxious Distress – Displays characteristics of unusual restlessness and worry about losing control or possible events. ⁹

• Atypical Features – A form of depression that allows momentary happiness in certain instances (i.e. a happy event). ¹⁰

• Melancholic Features – A form of severe depression that makes teens less likely to enjoy activities they once found pleasure in, an overall worsened mood, and major changes to their appetite. ¹¹

Medications

As of this time, the Food & Drug Administration (FDA) has approved two medications for teenage depression: ¹²

• Escitalopram (Lexapro)
• Fluoxetine (Prozac)

However, not all teens benefit from medication due to the significant side effects they can cause. Instead, some teenagers may benefit more from holistic medicinal approaches to depression.

Psychotherapy

Psychological counseling is likely the best option for your teenager. It will give them a chance to talk about their depression in an open environment while finding solutions for the condition.

Psychotherapy can be done one-on-one, with family members, or in a group setting where others struggle with depression. Through these sessions, your teenager will learn how to identify unhealthy behaviors and thoughts and develop better coping mechanisms to address them.

Final Word

Depression is NOT easy to overcome. Your teenager will likely need some time before fully recovering from symptoms and signs. However, with the right treatment path, they can get better.

The earlier you identify and treat depression, the better chance your child has at overcoming it. The longer you let depression continue, the more of a chance it has of engulfing your teenager’s identity.

References

¹ Nutt DJ. Relationship of neurotransmitters to the symptoms of major depressive disorder. J Clin Psychiatry. 2008;69 Suppl E1:4-7. PMID: 18494537.

² Negele A, Kaufhold J, Kallenbach L, Leuzinger-Bohleber M. Childhood Trauma and Its Relation to Chronic Depression in Adulthood. Depress Res Treat. 2015;2015:650804. doi: 10.1155/2015/650804. Epub 2015 Nov 29. PMID: 26693349; PMCID: PMC4677006.

³ Lohoff FW. Overview of the genetics of major depressive disorder. Curr Psychiatry Rep. 2010 Dec;12(6):539-46. doi: 10.1007/s11920-010-0150-6. PMID: 20848240; PMCID: PMC3077049.

⁴ Angold A, Costello EJ, Erkanli A, Worthman CM. Pubertal changes in hormone levels and depression in girls. Psychol Med. 1999 Sep;29(5):1043-53. doi: 10.1017/s0033291799008946. PMID: 10576297.

⁵ Rood L, Roelofs J, Bögels SM, Alloy LB. Dimensions of Negative Thinking and the Relations with Symptoms of Depression and Anxiety in Children and Adolescents. Cognit Ther Res. 2010 Aug;34(4):333-342. doi: 10.1007/s10608-009-9261-y. Epub 2009 Jul 29. PMID: 20676215; PMCID: PMC2899011.

⁶ Wells VE, Deykin EY, Klerman GL. Risk factors for depression in adolescence. Psychiatr Dev. 1985 Spring;3(1):83-108. PMID: 3889900.

⁷ Russell ST, Fish JN. Mental Health in Lesbian, Gay, Bisexual, and Transgender (LGBT) Youth. Annu Rev Clin Psychol. 2016;12:465-87. doi: 10.1146/annurev-clinpsy-021815-093153. Epub 2016 Jan 14. PMID: 26772206; PMCID: PMC4887282.

⁸ Chand SP, Arif H. Depression. 2023 Jul 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 28613597.

⁹ Almas A, Forsell Y, Iqbal R, Janszky I, Moller J. Severity of Depression, Anxious Distress and the Risk of Cardiovascular Disease in a Swedish Population-Based Cohort. PLoS One. 2015 Oct 15;10(10):e0140742. doi: 10.1371/journal.pone.0140742. PMID: 26469703; PMCID: PMC4607409.

¹⁰ Quitkin FM. Depression With Atypical Features: Diagnostic Validity, Prevalence, and Treatment. Prim Care Companion J Clin Psychiatry. 2002 Jun;4(3):94-99. doi: 10.4088/pcc.v04n0302. PMID: 15014736; PMCID: PMC181236.

¹¹ Gili M, Roca M, Armengol S, Asensio D, Garcia-Campayo J, Parker G. Clinical patterns and treatment outcome in patients with melancholic, atypical and non-melancholic depressions. PLoS One. 2012;7(10):e48200. doi: 10.1371/journal.pone.0048200. Epub 2012 Oct 26. PMID: 23110213; PMCID: PMC3482206.

¹² Kovich H, Kim W, Quaste AM. Pharmacologic Treatment of Depression. Am Fam Physician. 2023 Feb;107(2):173-181. PMID: 36791444.