Adolescence is a time of great change in the body and the brain.
The parts of the brain that are responsible for our emotions are working harder than they do in either childhood or adulthood.
On top of that, our reproductive and stress hormones are undergoing rapid age-related changes.
But while our emotions and our hormones are in overdrive, the parts of the brain responsible for keeping our emotional impulses in check and making rational decisions, called the pre-frontal cortex, is still under construction.
These biological factors help to explain some of the behaviour that we all associate with adolescence – such as mood swings and risk taking behaviour.
And all of this is occurring at a time when teenagers are trying to undertake the developmental tasks of identity formation and individuating from their parents in preparation for moving into adulthood.
We all know the stereotypes of teenage behaviour – mood swings, crazy hair styles, dark taste in music, arguing with parents and spending lots of time alone in their room behind a closed door. But, sometimes the signs that we attribute to normal teenage development can also be signs of a major depressive disorder.
Teenagers and Depression: the Statistics
The Australian Government recently published a report entitled “The Mental Health of Children and Adolescents: Report on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing”. This document detailed the results of a survey of over 6 300 Australian families with children aged between 4 and 17.
The findings were quite concerning – 4.3% of males aged 12-17 years and 5.8% of females aged 12-17 years met criteria for major depressive disorder according to their own self-report. That’s at least one teenager in every class in every school in Australia.
The report also detailed the way that experiencing major depression in adolescence can impact on a teenager’s level of functioning. Two fifths of young people with major depression reported that the depression led to severe distress; one third reported that the symptoms of depression severely impacted on their schooling or work; and one quarter reported that the depression severely impacted on their friendships and family relationships.
Furthermore, young people with major depressive disorder missed an average of 23 days of school each year as a result of their symptoms. Overall, the impact of depression was found to be greater than other mental disorders.
Signs Your Teenager May Be Depressed
So, how do you know if your teenager’s mood swings, door slams, and penchant for black clothing are part of normal adolescent development – or a sign that they may be struggling with something more?
Signs to look out for include:
- Persistent changes in mood – your teen might seem sad and down a lot of the time, but teenage depression can also result in a grumpy or irritable mood.
- Loss of interest in activities – it’s normal for teenagers to lose interest in some of the things they loved to do as a child – they may no longer want to play soccer or take dance classes. However if these activities are not replaced by new pastimes, it might be a sign your teenager is struggling.
- Intense interest in only one activity – it’s pretty normal to be arguing with your adolescent over their use of electronic games or social media, but if your teen can only ever be found in front of a computer or device playing games or using social media, this might also be a sign that they are using these activities as a way of coping or as a distraction from deeper problems.
- Changes in concentration or motivation – these might be particularly obvious come report time, if your adolescent has a sudden dip in grades.
- Changes in sleep and eating – adolescence is usually a time of changes in sleeping patterns and appetite so these changes can be tricky to spot, but if your teenager is suddenly eating less, having trouble getting to sleep at night, or sleeping the whole day away, this can be an alarm bell.
- Withdrawing from family relationships and friendships – adolescence is a time when friendships are increasingly important, so if your teenager is spending more and more time alone, it can be a sign of depression.
- Expressing suicidal thoughts which might be passive thoughts such as wishing they were dead, or more active intentions of ending their life.
What should I do if I think my Teenager is Depressed?
First things first . . . talk to your adolescent. Pick a moment when you won’t be interrupted, such as driving in the car together. Gently let your teenager know that you’ve noticed they’re struggling and that they have your unconditional support. Don’t ask too many questions, listen carefully to them and be sure to validate any feelings that they express.
If your teenager expresses suicidal thoughts seek immediate help from your General Practitioner, a local mental health service, or your nearest hospital. If you are worried about your teenager’s immediate safety call 000.
Make an appointment with your General Practitioner and be guided by your teenager; they may want to see the doctor by themselves, or they may need your help to do it. Your doctor can discuss the treatment options with you, but here’s a breakdown of the evidence and the expert guidelines:
- Cognitive Behavioural Therapy (CBT) and Interpersonal Therapy (IPT) have been shown to be effective in treating adolescent major depression and should be considered as the first line of treatment.
- A group of antidepressant medications, called Selective Serotonin Reuptake Inhibitors (SSRIs), may be considered if the depression is severe, if psychological therapy has been ineffective or if psychological therapy is refused or unavailable.
- For severe depression, a combination of SSRIs and CBT can help reduce suicidal thinking and improve functioning.
Once you have seen your GP for an assessment and to discuss treatment options, a Clinical Psychologist can then discuss the type of evidence based talking therapy, such as CBT or IPT, that they can offer. With the right help and support your teen will be back to their door slamming, loud music loving self in no time!
Author: Emma Jury, B Sc (Hons), PG Dip Sc (Psych), M Sc (Psych), PG Dip Clin Psych, MAPS, MCCLP.
As a Clinical Psychologist, Emma is trained to provide evidence-based assessment and treatment of depression, anxiety and other forms of mental illness. Although Emma has worked with clients across the lifespan, she is particularly experienced in working with children, teenagers and their families.
- Lawrence D, Johnson S, Hafekost J, Boterhoven De Haan K, Sawyer M, Ainley J, Zubrick SR (2015) The Mental Health of Children and Adolescents. Report on the second Australian Child and Adolescent Survey of Mental Health and Wellbeing. Department of Health, Canberra.
- McDermott B, Baigent M, Chanen A, Fraser L, Graetz B, Hayman N, Newman L, Parikh N, Peirce B, Proimos J, Smalley T, Spence S; beyondblue Expert Working Committee (2010) Clinical practice guidelines: Depression in adolescents and young adults. Melbourne: beyondblue: the national depression initiative.
- National Institute of Mental Health (2011) The teen brain still under construction. http://www.nimh.nih.gov