How to help a Depressed Teenager

As a parent, knowing that your teenager is depressed can be a frightening experience and trying to help them can be equally frustrating. Adolescence is characterized by turbulence, especially in today’s society. Hormones, bodily changes, relationships with friends, romantic relationships, and struggling towards independence all contribute to the emotional intensity of adolescence. No other stage of life is punctuated my the numerous physical and emotional changes that occur between childhood and adulthood. Although emotions tend to run high during the teen years, true depression must be distinguished from normal adolescent behavior.

So how do you know if your teenager’s moods are just par for the course or true depression? The DSM IV, which is the standard tool used in diagnosing all mental/emotional disorders, gives the following diagnostic criteria for a major depressive episode:

A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either
(1) depressed mood or
(2) loss of interest or pleasure.
Note: Do not include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.
(1) depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.
(2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)
(3) significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.
(4) Insomnia or Hypersomnia nearly every day
(5) psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
(6) fatigue or loss of energy nearly every day
(7) feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
(8) diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
(9) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
B. The symptoms do not meet criteria for a Mixed Episode (see p. 335).
C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
D. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).
E. The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

It is imperative that if you think your teenager is depressed you do not attempt to diagnose or treat the problem on your own. A licensed psychologist or psychiatrist is the only one who can accurately make a clinical diagnosis and develop a subsequent treatment plan. If you are worried that your child may be suffering from depression, seek professional help as soon as possible, especially if you have any concern that your teen may be suicidal.

Treatment will involve counseling sessions where any number of topics may be explored, possibly in combination with prescription medication. However, parents should be aware that anti-depressants have sometimes had adverse reactions in children and adolescents, including worsening depression and suicidal thoughts.

There is no one size fits all solution to helping a teenager through depression. Although professional help is necessary, the role of the parents is still of primary importance. Parents should try to b supportive and understanding. Talk to your child and LISTEN to what your child is saying. Even if you find some of what you are being told upsetting, do not judge or criticize. Just be there for your teenager. However, try not to smother your child. Instead, try to find a happy medium between loving concern and suffocation.

Dealing with a depressed teen can be frustrating and can take a great deal of energy. It is important to remember to take care of yourself and the other members of your family as well. Depression is difficult for all those involved and can cause a great deal of stress within a family. If necessary, you may find that professional support may benefit you as well and help you learn how to deal with the situation you are facing.