Recognizing Depression in Teenagers

Patient Expert

Teenagers are mysterious creatures. Even though we've all been teenagers, somehow that experience doesn't amount to a hill of beans when we're trying to understand our own (speaking as the stepmother to one current and two former teenage stepchildren).

Most of the time this inability to understand teenagers is simply a reason to smack your forehead with your hand and mutter something under your breath. But what if you're concerned that a teenager you know is depressed? Not just experiencing hormone-ridden mood swings, but clinical depression?

I suffered from depression throughout my teenage years. I can tell you that I was very different from my non-depressed friends, even though we were sharing the same adolescent journey. Unfortunately, in the seventies even medical professionals didn't subscribe to the idea that children could be depressed, so while my parents knew something was wrong, they had no way of finding out what it was.

The danger is that depressive behavior in an adolescent might be written off as normal teenager behavior. What make this possible is that beahviors that would signal depression in an adult are normal for teenagers. For instance, the everpresent iPods are just the most recent version of using music to ignore adults (and bratty younger siblings). While it might be considered rude and isolating in an adult, it's just par for the course in a teenager, so we don't get concerned.

So how do you tell the difference between normal behavior and depression in a teen? While normal teenage behavior might seem at first glance to be very similar to depression, these similarities are fairly superficial. It is possible to separate the two. Let's look at the behavior a non-depressed teenager might exhibit:

  • Mood swings
  • Mildly rebellious behavior (breaking curfew, taking car without asking, etc.)
  • Listening to angst-ridden music that grownups can't possibly understand
  • Dressing strangely (at least as far as adults are concerned)
  • Sleeping late
  • General unwillingness to let parents into his/her life

This is all normal behavior for teens. Much of it is explained by the natural process of separating from your parents and establishing your own identity. It may be frustrating, but it's not depression.

Depression is an altogether different animal. A depressed teenager might:

  • Lose interest in activities that he or she previously enjoyed. Has she quit playing soccer after years of enjoying it? Did she have a good reason (new part-time job or greater focus on schoolwork) or was the explanation somehow lacking?
  • Stop hanging out with friends.
  • Exhibit changes in appetite or sleep patterns. Obviously, chances are pretty good that a teenager is going to need more sleep - it's purely biological. But when they are either sleeping all the time or having trouble sleeping, that's not normal. When his appetite drops off or suddenly increases beyond what's normal for a teenager, it needs to be looked at.
  • Express feelings of sadness and/or hopelessness. Don't write off a statement like, "I hate myself" or "I'm never going to be able to (fill in the blank)" as teenage dramatics. It might not be.
  • Think and talk about death and suicide. This is a big blinking neon sign, obviously. Don't hope it will go away and/or be afraid to ask the young person about these thoughts. Depression can make suicide seem like a perfectly natural solution, even to adults. That's the kind of thought process that urgently needs to be addressed.

One of the most important signs overall is change. Don't just brush off any change in behavior as a normal part of growing up. Some change is normal, obviously, but when the changes are all negative, that should tell you something.

If you're finding that you're not able to get any helpful answers from your child about what is going on, you might want to enlist the aid of a school counselor, teacher, coach or spiritual adviser. Sometimes teenagers are more comfortable talking about their problems to someone other than their parents.

Even if your child seems to resent your concern, don't be afraid to keep pushing until you're satisfied that things are fine with him or her. Remember, deep down a teenager doesn't really resent your "interference." Even if they're grouchy on the outside, they're secretly happy that you care enough to worry.