Teen moods: Angst or depression?

The hormone highs and lows that are associated with adolescence can cause mood highs and lows. Adolescence is a time of experimentation, changing relationships, and finding your own identity; sometimes this is accompanied by conflict (i.e. lots of family arguments).  How can you tell the difference between normal teen moodiness/angst and a more serious mental health disorder, like depression?

Depression can present in many different ways, and it may vary from how it presents in adults.  For example, recurrent ailments like headaches and stomachaches which have no physical cause can sometimes be the result of depression.  The official diagnosis of depression requires more than two weeks of depressed mood (sounds like most teens, eh?) or a loss of interest or pleasure in daily activities.  The key is that the mood represents a change from the person's baseline and causes significant impairment in function (either social, occupational, or educational). According to the Center for Disease Control and Prevention's national survey Youth Risk Behavior Surveillance (YRBS), 28.5% of high school students felt sad or hopeless almost every day for 2 or more weeks in a row so that they stopped doing some usual activities during the 12 months before the survey.

Other signs/symptoms that health care providers look for (and you can look for too) include change in weight or appetite, change in sleep, fatigue or loss of energy, feelings of worthlessness, and decreased concentration.  Some specific warning signs you should keep an eye out for and seek help immediately include:

• Withdrawing from family and friends, and spending a lot of time alone.

• Dangerous use of alcohol or other drugs.  Although experimentation is common, substance use in combination with mental health disorder can lead to increasing risk taking behaviors.

• Concerns about self-injury and suicide.  Specific things to look for include off-hand comments about death/suicide or giving away possessions.

A special note on suicide:  Suicide is the third leading cause of death of teenagers nationwide, behind unintentional injuries and homicide. According to the YRBS, 15.8% of high school students seriously considered attempting suicide, 12.8% made a plan about how they would attempt suicide, and 7.8% attempted suicide at least once in last year. Risk factors for suicide include: prior suicide attempt, family history of suicide, substance use, social isolation, and easy access to lethal methods like firearms. LGBTQ youth are also at high risk.

What's a parent to do?

Regularly ask your teen questions about their feelings, school, and activities.  If you notice a change in mood or behaviors, acknowledge it and ask if there is anything you can do to help.  Do not judge them if it is a small thing causing them distress.  Let the teen know that, no matter what, you are there to support them.

If you think your teen is having depression or another mental health disorder, contact his or her health care provider. If you are concerned about suicidal behavior, this is a medical emergency and you should go to the nearest emergency department.

Have you noticed changes in mood or behavior of your teen?