- Teen Depression
- What causes depression in teens?
- Which teens are at risk of depression?
- What are the symptoms of depression in teens?
- How is depression in teens diagnosed?
- How is depression in teens treated?
- Adolescent depression
- Causes, incidence, and risk factors
- Signs and tests
- Expectations (prognosis)
- Calling your health care provider
URL of this page: https://medlineplus.gov/teendepression.html
Teen depression is a serious medical illness. It's more than just a feeling of being sad or «blue» for a few days.
It is an intense feeling of sadness, hopelessness, and anger or frustration that lasts much longer. These feelings make it hard for you to function normally and do your usual activities. You may also have trouble focusing and have no motivation or energy.
Depression can make you feel it is hard to enjoy life or even get through the day.
What causes depression in teens?
Many factors may play a role in depression, including
- Genetics. Depression can run in families.
- Brain biology and chemistry.
- Hormones. Hormone changes can contribute to depression.
- Stressful childhood events such as trauma, the death of a loved one, bullying, and abuse.
Which teens are at risk of depression?
Depression can happen at any age, but often begins in the teens or early adulthood. Certain teens are at higher risk of depression, such as those who
What are the symptoms of depression in teens?
If you have depression, you have one or more of these symptoms most of the time:
- Feeling of emptiness
- Being angry, irritable, or frustrated, even at minor things
You also may also have other symptoms, such as
- No longer caring about things you used to enjoy
- Changes in weight — losing weight when you are not dieting or gaining weight from eating too much
- Changes in sleep — having trouble falling asleep or staying asleep, or sleeping much more than usual
- Feeling restless or having trouble sitting still
- Feeling very tired or not having energy
- Feeling worthless or very guilty
- Having trouble concentrating, remembering information, or making decisions
- Thinking about dying or suicide
How is depression in teens diagnosed?
If you think you might be depressed, tell someone that you trust, such as your
- Parents or guardian
- Teacher or counselor
The next step is to see your doctor for a checkup. Your doctor can first make sure that you do not have another health problem that is causing your depression. To do this, you may have a physical exam and lab tests.
If you don't have another health problem, you will get a psychological evaluation. Your doctor may do it, or you may be referred to a mental health professional to get one. You may be asked about things such as
- Your thoughts and feelings
- How you are doing at school
- Any changes in your eating, sleeping, or energy level
- Whether you are suicidal
- Whether you use alcohol or drugs
How is depression in teens treated?
Effective treatments for depression in teens include talk therapy, or a combination of talk therapy and medicines:
Talk therapy, also called psychotherapy or counseling, can help you understand and manage your moods and feelings. It involves going to see a therapist, such as a psychiatrist, a psychologist, a social worker, or counselor.
You can talk out your emotions to someone who understands and supports you. You can also learn how to stop thinking negatively and start to look at the positives in life.
This will help you build confidence and feel better about yourself.
There are many different types of talk therapy. Certain types have been shown to help teens deal with depression, including
- Cognitive behavioral therapy (CBT), which helps you to identify and change negative and unhelpful thoughts. It also helps you build coping skills and change behavioral patterns.
- Interpersonal therapy (IPT), which focuses on improving your relationships. It helps you understand and work through troubled relationships that may contribute to your depression. IPT may help you change behaviors that are causing problems. You also explore major issues that may add to your depression, such as grief or life changes.
In some cases, your doctor will suggest medicines along with talk therapy. There are a few antidepressants that have been widely studied and proven to help teens. If you are taking medicine for depression, it is important to see your doctor regularly.
It is also important to know that it will take some time for you to get relief from antidepressants:
- It can take 3 to 4 weeks until an antidepressant takes effect
- You may have to try more than one antidepressant to find one that works for you
- It can also take some time to find the right dose of an antidepressant
In some cases, teenagers may have an increase in suicidal thoughts or behavior when taking antidepressants. This risk is higher in the first few weeks after starting the medicine and when the dose is changed. Make sure to tell your parents or guardian if you start feeling worse or have thoughts of hurting yourself.
You should not stop taking the antidepressants on your own. You need to work with your doctor to slowly and safely decrease the dose before you stop.
Programs for severe depression
Some teens who have severe depression or are at risk of hurting themselves may need more intensive treatment. They may go into a psychiatric hospital or do a day program. Both offer counseling, group discussions, and activities with mental health professionals and other patients. Day programs may be full-day or half-day, and they often last for several weeks.
The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.
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- Research Studies
Adolescent depression is a disorder that affects teenagers. It leads to sadness, discouragement, and a loss of self-worth and interest in their usual activities.
- Bipolar disorder
- Major depression
Causes, incidence, and risk factors
Depression can be a response to many situations and stresses. In teenagers, depressed mood is common because of:
- The normal process of maturing and the stress that occurs with it
- The influence of sex hormones
- Independence conflicts with parents
It may also be a reaction to a disturbing event, such as:
- The death of a friend or relative
- A breakup with a boyfriend or girlfriend
- Failure at school
Teens who are most ly to become depressed when they experience stressful events:
- Have low self-esteem
- Are very critical of themselves
- Feel little control over negative events
Adolescent girls are twice as ly as boys to experience depression. A family history of depression also puts teenagers at greater risk.
The following events or situations can cause depression:
- Bullying or harassment at school or somewhere else
- Child abuse — both physical and sexual
- Lack of social skills
- Learning disabilities
- Long-term illness
- Poor parenting or caregiving
- Stressful life events, such as the loss of a parent to death or divorce
Many adolescents with depression may also have:
- Anxiety disorders
- Attention deficit hyperactivity disorder (ADHD)
- Bipolar disorder
- Eating disorders (bulimia and anorexia)
Depression can change the way teenagers see themselves, their lives, and the people around them. Teenagers who are depressed usually see everything more negatively. They can't imagine that any problem or situation can be solved in a positive way.
Some or all of these symptoms of depression may be present:
- Appetite changes (usually a loss of appetite but sometimes an increase)
- Difficulty concentrating
- Difficulty making decisions
- Episodes of memory loss
- Feeling upset, restless, and irritable
- Feeling worthless, hopeless, sad, or self-hatred
- Loss of interest or pleasure in activities that were once fun
- Thinking or talking about suicide or death
- Trouble sleeping, too much sleeping, or daytime sleepiness
Sometimes a person's behavior may change, or there may be problems at home or school without any symptoms of depression:
- Acting-out behaviors (missing curfews, unusual defiance)
- Criminal behavior (such as shoplifting)
- Irresponsible behavior
- Poor school performance, grades dropping
- Pulling away from family and friends, spending more time alone
- Use of alcohol or other illegal substances
If these symptoms last for at least 2 weeks and affect your mood or ability to function, get treatment.
Suicide is a risk for all teenagers with depression. See: Suicide and suicidal behavior for more information on how to recognize and treat suicidal feelings.
Signs and tests
True depression in teens is often difficult to diagnose, because normal teenagers have up and down moods. These moods may go back and forth over a period of hours or days.
Sometimes when children or adolescents are asked, they will say that they aren't happy or sad. Health care providers should always ask children or adolescents about symptoms of depression.
The health care provider will perform a physical examination and order blood tests to rule out medical causes for the symptoms. The doctor will also check for signs of substance abuse. The following can cause, or occur because of depression:
- Heavy drinking
- Regular marijuana (pot) smoking
- Other drug use
The health care provider will also check:
- The patient's history of sadness, irritability, and loss of interest and pleasure in normal activities
- Signs of other mental health problems, such as anxiety, mania, or schizophrenia
- Risks of suicide or homicide — whether the teen is a danger to him or herself or others
Information from family members or teachers can often help identify depression in teenagers.
Treatment options for adolescents with depression include:
- Supportive care from a medical provider
- Talk therapy
- Antidepressant medications (possibly)
Treatment should be tailored to the teenager, and the symptoms. Families often help in treating adolescent depression.
The first medication tried is usually a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI). Fluoxetine (Prozac) and escitalopram (Lexapro) are the only SSRIs approved for treating major depression in adolescents (ages 12 — 17). Fluoxetine is also approved for children age 8 and older.
NOTE: SSRIs and other antidepressants carry a warning that they may increase the risk of suicidal thoughts and actions in children and adolescents. Other evidence has not showed that these drugs increase suicide risk in children.
Doctors are still prescribing SSRIs and other antidepressant medications to adolescents with depression. Several important facts about taking any antidepressants include:
- Children and adolescents who take medications should be followed by a doctor for side effects. Parents or caregivers should watch for suicidal thoughts or behaviors, nervousness, irritability, moodiness, or sleeplessness that is getting worse. Get medical help for these symptoms right away.
- Do not stop taking medications without talking to your health care provider first.
Not all antidepressants are approved for use in children and teens. For example, tricyclic antidepressants are not approved for use in teens.
Almost all adolescents with depression benefit from some type of talk therapy. Talk therapy is a good place to talk about their feelings and concerns, and to learn ways to deal with them.
Types of talk therapy include:
- Cognitive-behavioral therapy teaches depressed people ways of fighting negative thoughts. It makes people more aware of their symptoms, helps them learn what makes their depression worse, and teaches them problem-solving skills.
- Family therapy may be helpful if family conflict is contributing to the depression. Support from family or teachers may help with school problems.
- Talk therapy (psychotherapy) can help adolescents understand issues that may be causing their behavior, thoughts, or feelings.
- Joining a support group of people who are experiencing problems yours can also help. Ask your therapist or doctor for recommendations.
Sometimes people with severe depression, or those who are suicide risks may need to stay in the hospital for treatment.
Adolescents with depression should learn to:
- Take medications correctly and manage their side effects
- Watch for early signs that depression is getting worse, and react when it happens
- Exercise more and seek out other activities that they enjoy
- Avoid alcohol and drugs (whether or not they have been prescribed). These substances affect the brain and make the depression worse over time. They may also affect judgment about suicide.
- When you are struggling, talk to someone you trust about how you are feeling. Try to be around people who are caring and positive.
Depression usually responds to treatment. Getting the right treatment as early as possible may prevent further episodes. However, about half of very depressed teens will keep having problems with depression as adults.
- Drug, alcohol, and tobacco abuse
- Effects on school performance and relationships
- Other mental health problems, such as anxiety disorders
- Teenage suicide
- Violence and reckless behavior
Adolescents with other mental health problems usually need longer and more intensive treatment.
Calling your health care provider
There are numbers you can call from anywhere in the United States, 24 hours a day, 7 days a week: 1-800-SUICIDE or 1-800-999-9999.
Call your health care provider right away if you notice one or more of these suicide warning signs:
- Giving possessions to others
- Personality change
- Risk taking behavior
- Threat of suicide or plans to hurt yourself
- Withdrawal, urge to be alone, isolation
See: Suicide and suicidal behavior for more information
Call your health care provider if you notice:
- Depression that is not improving or is getting worse
- Nervousness, irritability, moodiness, or sleeplessness that is new or getting worse
- Side effects of medications
NEVER IGNORE A SUICIDE THREAT OR ATTEMPT!
Most teenagers feel down sometimes. Having support and good coping skills can help prevent these periods of sadness from leading to more severe depression. Talking openly with your teen can help identify depression early.
Make sure your teen gets professional help to deal with periods of low mood. Identifying and treating depression early may prevent or delay episodes.
In homes with adolescents:
- Do not keep alcohol in the home or keep it securely locked
- Lock all guns and keep ammunition separate
- Lock up all prescription medications
Depression in children
US Preventive Services Task Force. Screening and treatment for major depressive disorder in children and adolescents: US Preventive Services Task Force Recommendation Statement. Pediatrics. 2009;123:1223-1228.
Zuckerbrot RA, Cheung AH, Jenson PS, Stein REK. Identification, assessment, and initial management guidelines for adolescent depression in primary care. Pediatrics. 2007;120:e1299-e1312.
Cheung AH, Zuckerbrot RA, Jenson PS, Ghalib K. Treatment and ongoing management guidelines for adolescent depression in primary care. Pediatrics. 2007;120:e1313-e1326.
Bostic JQ, Prince JB. Child and adolescent psychiatric disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier;2008:chap 69.
Antidepressant Medications for Children and Adolescents: Information for Parents and Caregivers. National Institute of Mental Health (NIMH). January 13, 2010. Accessed January 13, 2010.
Fred K. Berger, MD, Addiction and Forensic Psychiatrist, Scripps Memorial Hospital, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.