Signs Your Teen Suffers Clinical Depression

By:   Jennifer Fink, RN, BSN
I’m just a loser who can’t get anything right…No wonder no one likes me!...The world would probably be better off without me…
The mind of a depressed teenager can be a lonely, bleak place. While all teens struggle with ups and downs, depressed teens see the world in a consistently negative light. It’s as if depression straps a pair of dirty, negative glasses on the child’s face. Instead of seeing sunshine and green grass, the depressed teen sees an overcast day and dying grass – despite the fact that sun is out and the grass is healthy.
Approximately eight percent of all teens are clinically depressed. Girls are twice as likely as boys to be affected, although some researchers now suggest that girls are simply more apt to be diagnosed. Teenaged girls tend to display the stereotypical signs of depression, such as crying jags and an outwardly depressed appearance, which may lead parents and medical professionals to identify, diagnose and treat and depression. Their male counterparts, on the other hand, may act out in school or exhibit extreme irritability -- behaviors that parents and teachers are likely to dismiss as simply rebellious, obnoxious or unruly.
So, identifying depression in teens is not always easy, because some of the behavioral characteristics -- moodiness, withdrawal and surliness -- can also be part of "normal" adolescent development. How do you tell the difference between depression and typical teen behavior?
Consider the context. A teen who cries every day after losing her grandparent to cancer is probably not clinically depressed; she’s grieving. But a teen who cries daily, despite the fact that her home and school life are both relatively stable, may well be depressed.
Consider the timeframe, too. Almost all teens occasionally exhibit one or more of the symptoms below, but if symptoms persist for two weeks or longer it’s time to get help.
Symptoms of Depression in Teens

1. Irritability, anger or hostility. People tend to think of depression as a pervasive feeling of sadness, so they expect tears. But depression really is a persistent feeling of hopelessness. Depressed teens feel bad inside, and they feel powerless to change their situation. That’s why many depressed teenagers react with anger and hostility to even seemingly innocent queries (“How was your day today?”). Irritability is often a major symptom of depression in teenage boys.
2. Extreme sensitivity to criticism. Depression brings with it feelings of guilt and worthlessness. A depressed teen is already beating herself up inside for not being perfect enough. External criticism – even a simple comment such as, “You have a stain on your shirt” – appears to validate the fact that she’ll never get anything right. If your teen reacts strongly to any kind of criticism, she might be depressed.
3. Withdrawal from friends and family. It’s perfectly normal for teens to spend more time with their friends and less time with their families as they grow. It’s not normal for your teen to sequester herself in her room for hours at a time. Pay attention if your teen has effectively removed herself from the family; pay close attention if she’s no longer interacting with her friends.
4. Unexplained aches and pains. Teens are more likely than adults to express their depression physically. If no physical cause can be found for your teen’s frequent headaches or stomachaches, depression may be the culprit. Pay a visit to your pediatrician to rule out (or in) a physical ailment. If none is found, ask about depression.
5. Loss of interest in activities. Does nothing strike your teen’s fancy? Kids who give up formerly beloved activities – or participate in them begrudgingly – are often depressed. If your sports-obsessed son hasn’t picked up a ball in months and won’t even watch the games on TV, he might be depressed.

Getting Help
If you suspect depression, talk to your teen’s doctor. He can check for any underlying medical conditions that might be causing or contributing to your teen’s behavior. He can also conduct a depression screening and refer you to a counselor, psychologist or psychiatrist for help.
Currently, only about one-third of teens with clinical depression receive treatment. While it can be difficult to find someone to work with you and your teen, it’s essential to keep pushing for help. Look for someone who has a history of working with teens with depression. You want someone who will listen carefully to your concerns and adequately assess your teen before issuing a diagnosis; you don’t want someone who whips out a prescription pad as soon as you mention “depression.”
Be patient. It can take time to find the proper treatment regimen for your teen, but your teen’s health and well-being is worth it.

Jennifer Fink, RN, BSN