Adolescent Male Depressionby Jerry Kennard, Ph.D. Medical Reviewer
So much of teen behavior is characterized by shifting moods, angst and dissatisfaction that it may be difficult to identify a time when this tips into something requiring treatment.
During my teen years the prevailing view amongst adults was that 'moods' were a normal passing phase: seen as one of several hurdles all young people have to jump on the way to adulthood. Such beliefs are alive and well today, often with good cause, but the unfortunate consequence is that it can desensitize us to the fact that some young people need help.
In fairness, adolescence is certainly a turbulent period. It's a process that can last several years and, in the normal state of affairs, involves separating from parents, identity formation, career choices, and issues of sexuality. Many young people do go through the grinder but seem to emerge as reasonably well-adjusted adults. Yet, the fact remains that many do not, and the evidence tells us that depression is occurring earlier now than ever before.
The National Institute of Mental Health (NIMH) points out that the scientific literature on the treatment of depression in children and adolescents is sparse. This can largely be attributed to the fact that only in the past 20 years or so has depression in young people been taken seriously. Now it has, it emerges depression is associated with an increased risk of suicidal behaviors in adolescent males. Conduct disorder, alcohol or substance abuse increases the risk. In 2002, suicide was the third leading cause of death of death in males age 15 to 24.
Many teenage boys find the prospect of being seen with their parents as embarrassing. It's a perfectly normal state of affairs and signals a desire to be viewed as mature or beyond parental influence. Within the family home, they may spend hours on computer games or surfing the net and become resentful when asked or told to attend to other things. All these things are quite normal so at what point should a parent become concerned?
I think parents need to become more focused when the overall pattern of behavior starts to change or becomes more extreme. In terms of language, for example, depressed teens will feel isolated and may complain that nobody understands them. Any comments about suicide or interest in suicidal practices need to be taken very seriously. Sometimes the signs are less obvious. Often the young man reveals a restless energy and general irritability. Communication becomes harder and harder, not just between the teen and their parents, but other adults too. Some take less care with their appearance and yet others obsess over it. The kind of music they listen to may be morbid and this may reflect in the books being read.
Reflecting on these last few points it becomes clear that many of these issues seem like normal adolescent male behavior. It can sometimes take a jolt, for example getting into fights at school or being caught stealing, that alerts people (parents) to the fact that something isn't right.
A moody adolescent male with behavior issues is one of the hardest people to reach out to. But, doing nothing in the hope things will pass is a high-risk strategy. Because so much of a depressed teenager's behavior is masked beneath the appearance of normal adolescence, it may be convenient to dismiss their behavior as on the 'extreme end' of normality for teens. Irritation and anger may indeed be common, but persistent anger, destructive and antisocial behaviors are not.
Of course not all depressed young men adopt antisocial behaviors and not all antisocial behaviors are signs of depression. We rely therefore on a number of things to help guide our perspectives. These may, for example, involve our knowledge of that person, the circumstances of their upbringing, the medical history of their family, or other elements that collectively tell us this person needs help.