Depression in Teens: Signs, Causes, Prevention, and Treatment

It isn’t unusual for teens to feel anxious or sad throughout their developing years. However, depression among teens has become a global epidemic often requiring treatment or intervention. Without immediate attention, teen depression can cause severe and devastating consequences.

If you think your teen might suffer from depression, you’ve come to the right place to learn about the warning signs and options for treatment.

What is Teen Depression?

Teen depression is a mental health problem resulting in persistent feelings of sadness, anxiety, and a loss of interest in activities. Teenagers might develop feelings of worthlessness and inadequacy due to peer pressure, school performance, struggles with sexual orientation and gender identity, or family life.

Teen depression can cause significant consequences and may require professional intervention or medical treatment. How long teen depression lasts varies from person to person—it’s a complex mental health condition that improves with regular treatment and a healthy support system.

Signs of Depression in Teens

Teens often demonstrate noticeable changes in their thinking and behavior when they develop depression. While these symptoms vary in severity, they may include the following examples.

Emotional Signs

• Feeling sad for no apparent reason
• Feeling angry, even over small, seemingly insignificant matters
• Constantly irritable and annoyed mood
• Feeling hopeless and empty
• Feeling worthless or guilty
• Becoming extremely sensitive to rejection or failure
• Loss of interest in usual activities and neglecting friendships or familial relationships
• Trouble thinking, concentrating, and making decisions

Behavioral Signs

• Tiredness and loss of energy
• Insomnia and poor sleep quality or sleeping too much
• Decreased or increased appetite
• Slowed thinking and acting
• Poor school performance or frequent absences
• Risky sexual behavior
• Drug and alcohol use
• Agitation and restlessness
• Self-harm like cutting or burning
• Unexplained body aches and pains or headaches

Cognitive Signs

• Negative or pessimistic thoughts about themselves and their futures
• Difficulties remembering things
• Indecisiveness regarding everyday matters
• Feeling overwhelmed by simple cognitive tasks, even when they aren’t physically taxing

Common Types of Depression in Teens

Different types of depression can manifest in teenagers, each with unique symptoms and characteristics. Iterations of teen depression might include:

• Major Depressive Disorder (MDD). This is the most common type of depression. Teens with MDD experience persistent feelings of sadness or a loss of interest in activities they once enjoyed. Symptoms can interfere with daily life and last for weeks or longer.
• Bipolar Disorder. While less common, some teenagers experience bipolar disorder, which involves extreme mood swings that include emotional highs (mania or hypomania) and lows (depression) [*].
• Persistent Depressive Disorder (Dysthymia). Dysthymia is a milder but chronic form of depression. Teens with dysthymia might experience ongoing feelings of sadness, low self-esteem, and a lack of interest in activities for an extended period, typically lasting for at least two years.
• Seasonal Effective Disorder (SAD). Some teens experience depressive symptoms that occur seasonally, usually during the fall and winter months when there's less natural sunlight. Symptoms often improve during the spring and summer.
• Psychotic depression. Psychosis includes hallucinations or delusions. Teens with psychotic depression may have difficulty discerning what's real and what's not.

Causes of Teen Depression

There is no singular cause for teenage depression. However, it may result from the following factors.

Biological Causes

• Family history of depression or mood disorders
• Imbalances in neurotransmitters such as serotonin, dopamine, and norepinephrine
• Fluctuations in hormones like estrogen and testosterone
• Physical health issues and chronic illnesses
• Overreaction of the body’s stress response system or hypothalamic-pituitary-adrenal (HPA) axis

Environmental Causes

• Stress exposure during childhood
• Preterm birth and poor fetal growth
• Infections during gestation
• Maternal depression during childhood
• Social factors like bullying, social isolation, or difficulties in making and maintaining friendships
• High academic expectations and performance anxiety
• Poverty or other socioeconomic factors like financial stress and a lack of access to resources
• Cultural and societal influences like discrimination and stigmas surrounding mental health

Psychological Causes

• Persistent negative thinking patterns and self-criticism
• Low self-worth and self-esteem
• Perfectionism
• Personality factors like high levels of neuroticism or introversion
• Difficulties in forming secure attachments
• Trauma or past experiences
• Cognitive distortions like catastrophizing or black-and-white thinking

Risk Factors for Depression in Teens

Some teenagers are more likely to develop depression because of high-risk factors, including the following:

• Other existing mental health conditions like bipolar disorder, anxiety, personality disorders, anorexia, or bulimia
• Learning disabilities
• Neurodevelopmental disorders such as ADHD
• Ongoing pain from a chronic illness like cancer or significant physical trauma
• Abusing alcohol, prescription drugs, and illicit substances
• Struggles with gender identity and sexual orientation in an unsupportive environment
• Firsthand experiences with violence or sexual abuse

How is Teen Depression Diagnosed?

While there are no specific medical tests for diagnosing depression, a healthcare professional will typically conduct interviews and psychological exams [*].

The interviewer will likely ask questions about your mood, feelings, and behaviors. They'll inquire about your medical history, including any past or present physical health conditions and medications you take. They might also ask about your family's medical and mental health history.

Then, a doctor may perform a physical exam in case the depression is associated with an underlying physical condition. Teenagers may also undergo lab tests for professionals to determine thyroid function.

Complications Related to Teen Depression

Teen depression can lead to various complications, affecting multiple aspects of a teenager's life. For instance, depressed teenagers may be more likely to engage in substance abuse to cope with depressive symptoms [*]. As a result, they may develop addiction or experience further mental health problems.

Depressed teens might also encounter social difficulties, isolating themselves and exacerbating feelings of loneliness. They might engage in risky behaviors such as reckless driving, unsafe sexual activity, or other impulsive actions that can have detrimental consequences.

As their mental health worsens, they may self-harm or start ideating suicide.

How to Prevent Teen Depression

Preventing teen depression involves fostering a supportive environment and equipping teens with coping skills. It’s best to start at home—promote open communication amongst family members, allowing teenagers to express themselves without judgment.

Encourage regular physical activity, healthy eating habits, and sufficient sleep by providing teenagers with supportive environments and facilitating regular check-ins. Avoid being too clinical about it—just hanging out may motivate them to talk.

Once you get your teenager talking, find ways to introduce discussions about mental health. Educate them regarding signs and reinforce that seeking help for mental health concerns is a strength, not a weakness.

Treatment Options for Teen Depression

How teen depression is treated depends on the type and severity. Combinations of talk therapy and medications are typically the most effective. Some options you can explore include the following:

• Medication. Currently, the two FDA-approved antidepressant drugs for teen depression are fluoxetine (Prozac) and escitalopram (Lexapro). Note that it takes several weeks or longer for antidepressants to become effective.
• Psychotherapy. Different forms of therapy, such as cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), or dialectical behavior therapy (DBT), help teens identify and change negative thought patterns and behaviors contributing to depression [*]. Through CBT and DBT, teens can set realistic goals, develop better coping mechanisms, adjust to current difficulties, and regain a sense of control.
• Support groups. Participating in support groups or group therapy sessions with peers facing similar challenges can provide a sense of community and understanding.
• Mindfulness and relaxation techniques. Practices like mindfulness, meditation, yoga, or deep breathing exercises can help reduce stress and promote relaxation, potentially alleviating symptoms of depression.
• Hospitalization. Occasionally, severe cases of depression may require in-hospital psychiatric treatment. Teens can eventually transition into day treatment programs.

The Bottom Line

If your child suffers from teen depression, learning more about their condition and seeking professional help can mitigate related risks. Practicing patience and offering support can go a long way in their recovery.

Learn more about the signs and symptoms of depression with our collection of depression worksheets.

Sources:

1. Salinger, J.M. et al. “Family communication with teens at clinical high-risk for psychosis or bipolar disorder.” American Psychological Association, 2018.
2. Mason M, Mennis J, Russell MA, Moore M, Brown A. “Adolescent Depression and Substance Use: the Protective Role of Prosocial Peer Behavior.” Journal of Abnormal Child Psychology, 2018.
3. Alshawwa IA, Elkahlout M, Hosni Qasim El-Mashharawi, Abu-Naser SS. “An Expert System for Depression Diagnosis.” Philpapers, 2019.
4. Vernon A. “Depression in Children and Adolescents: RE-CBT Approaches to Assessment and Treatment.” Springer eBooks, 2020.