Helping Teens with Depression: A Guide for Parents

“I’m so depressed,” your 16-year-old says as she gets into your car after school. Your ears perk up as you prepare to home in on what you hope will follow—a conversation about her day. As she talks, you listen for clues to help you understand her current mood. Did the math test she stayed up late to prep for go badly? Has a friend disappointed her?

You might be especially alert if you’ve read the recent New York Times story about the prevalence of depression in teenagers—especially girls. “Nearly three in five teenage girls felt persistent sadness in 2021, double the rate of boys, and one in three girls seriously considered attempting suicide,” the article notes, citing recent data released by the Centers for Disease Control and Prevention.

Esse Health Pediatrics has noted, over the past decade, an increase in the number of kids we see who are struggling with anxiety and depression. Health experts point to a few factors that may be responsible for this uptick—from isolation during the pandemic to the increasing prevalence of social media in our children’s lives, and number of other changes in ways today’s teens experience life in the 21st century.

As society works to identify and modify the factors contributing to this concerning trend, we all—parents, teachers, doctors, friends, family members—owe it to our teens to be watchful and at the ready to help if the time comes.

Depression: a definition

We all have down days; teens perhaps especially so. A good night’s sleep, a change in circumstances, and that sense of blue lifts. We’re back on track. True depression, however, is an illness that can be dangerous if left untreated. So how can you tell the difference between teen angst and true depression?

• If the following symptoms, or a combination of them, persist for more than two weeks, depression may be the cause.
• Low mood or irritability
• Loss of interest in sports, activities or friends
• Changes in sleep patterns, including difficulty falling asleep or staying asleep
• Changes in appetite, whether an increase or decrease
• Decreased energy or fatigue
• Difficulty concentrating, which can affect school performance
• Feelings of guilt or low self-esteem

Again, it’s important to stress that many teens will have short periods of low mood that go away on their own.

Keep in mind that children and teenagers with depression may not exhibit the typical depressed mood that you think of as depression; they may instead be irritable or angry. Boys, especially, may display anger and irritability as symptoms of depression. Other symptoms, including headache, stomachache, and muscular pain, may also be present in depressed teens.

Depression is more common in girls than boys and in those with family history of depression or anxiety. Often there is no identifiable cause, but stressful events like the death of a loved one or the breakup of a relationship can trigger an episode of depression.

How to respond

If you think your teen may have depression, the next step is to schedule an evaluation for your child with your pediatrician. Often, your pediatrician will be able to manage the illness—and will refer you to a specialist if one is needed. As part of the evaluation process, your pediatrician will want to talk with your teen and with you. She may also want feedback from teachers or others involved in your child’s daily life. Your child may need a physical evaluation as well, to rule out other illnesses that may be involved.

Suicidal thoughts or other thoughts of self-harm can accompany depression. It is important to contact your pediatrician if your teen shows or expresses intent to hurt themselves or has a plan to do so. Don’t leave your teen alone; seek emergency care to keep them safe.

Additionally, you can get immediate help using your cell phone to contact one of these services:

• National Suicide Prevention Lifeline: call or text 988
• Crisis Text Line: text TALK to 7417413

Treating depression in teens

A consistent schedule—for children in general and teens with depression in particular—helps support a healthy life. You can help your child by seeing that they:

• Maintain a regular sleep schedule that includes at least eight hours a night
• Eat balanced, nutritious meals
• Drink plenty of water
• Exercise regularly

Both cognitive behavioral therapy and interpersonal therapy have been shown in studies to be helpful for teens with depression. You can help this process by encouraging your teen to be open to the process of therapy. Some may find that thinking of their therapist as a life coach—someone who can help them develop tools and strategies for dealing with stress and other problems—helps dispel the stigma that too often is attached therapy.

Your pediatrician or psychiatrist may also recommend medication for depression, depending on how severe the symptoms are and how much they are interfering with school and family life. SSRIs (selective serotonin reuptake inhibitors) are the most common class of medications prescribed for depression and include Prozac and Lexapro.

These medications are generally well-tolerated and considered to be safe. However, they are not a quick fix. It takes four to six weeks to see full effect at any given dose. Once started, they are usually continued for a minimum of six to nine months, at which time their use is reevaluated.

Depression is common and can be effectively treated. If left untreated, depression can be dangerous. If you have concerns about your teen, don’t hesitate to contact your pediatrician.

Board certified pediatricians like Dr. Theodore Kremer, who has a special interest in well-child care, ADHD, and autism spectrum disorder, are just a text or phone call away. Esse Health Pediatrics offers six locations to make pediatric visits as easy as possible for you and your family.