Cedars-Sinai Blog

Recognizing and Coping with Teen Depression

teen, depression, what to watch out for, getting treatment

Teens are faced with big challenges socially, emotionally, and mentally. There's pressure to fit in with peers, pressure to look a certain way, and pressure to succeed academically. It's no wonder that teen depression is a problem many teens and parents face. In 2015, an estimated 3 million teens ages 12-17 experienced at least one major depressive episode, according the National Institutes of Health.

How can you tell if your teen is depressed or just displaying typical teenage moodiness?

If you think your teen is depressed, what should you do?

How can you help your kids address mental health challenges?

We sat down with Dr. Rebecca Hedrick, child psychiatrist and assistant professor in the Cedars-Sinai Department of Psychiatry to get her advice.

If a parent is concerned about their child, what are some of signs and symptoms of depression they should look for?

Dr. Hedrick: Teens are known for their moodiness, which is a natural consequence of development. Teen depression goes beyond the occasional bouts of moodiness and evolves into a more severe and unrelenting unhappiness with pervasive negative mood, thoughts, and behavior.

Some behaviors to look for may include:

  • Sadness
  • Hopelessness
  • Worthlessness
  • Guilt
  • Frequent crying
  • Isolating oneself from friends and family
  • Falling grades
  • Dramatic changes in sleeping and eating habits

Not all depressed teens look or feel sad. Instead they may appear irritable, angry, or easily frustrated. Teens struggling with depression may also develop unexplained aches and pains and other physical symptoms. They may begin to engage in harmful risk-taking behavior with drug and alcohol abuse, promiscuity, and reckless driving.

What are the most severe signs of depression?

Dr. Hedrick: The most devastating outcome of teenage depression is suicide. It is the second leading cause of death for those younger than 25 years old. It is important to watch for warning signs of suicide.

These include:

  • Talking or joking about suicide (including in social media)
  • Writing poems or stories about death or suicide
  • Giving away possessions
  • Saying goodbye as if for the last time
  • Drastic changes in appearance
  • Increasing accidents resulting in injury
  • Romanticizing suicide
  • Making statements like "I bet if I were dead they would miss me."
  • Engaging in self-harm behavior such as cutting or burning themselves

Suicidal thoughts, behaviors, and self-harm should never be ignored or minimized by parents and should be taken very seriously. If there is any suspicion of depression or suicidal thoughts, it is best to remove any guns from the home. It also important to limit access to prescription drugs and over-the-counter medicines containing Tylenol as well as access to knives, scissors, razors, and sharps. You may want to consider increasing supervision by banning closed doors.

If a parent suspects their teen might be suffering, what should they do?

Dr. Hedrick: The first step is to open the lines of communication with the teen. Let them know you are concerned.

  • Talk to your teen in a non-blaming, non-judgmental way.
  • Do not try to talk them out of depression, this will likely to shut down the conversation.
  • Let your teen know you understand their pain and that you are there for them.
  • Ask questions but avoid rapid-fire questions that would lead them to feel they're getting the third degree.
  • Do not hesitate to seek professional help. Even those who are brought "kicking and screaming" to a psychologist or psychiatrist often do eventually open up and feel they are helped.

What is the number one thing you want parents to understand about depression?
Dr. Hedrick: Depression is treatable.

What are the biggest misconceptions people have about teen depression?

Dr. Hedrick: The biggest misconception is that depression means you must feel sad. Many teens and others do not feel sad, but instead experience apathy, boredom, lack of pleasure, irritability, anger, or temper tantrums as the pervasive symptom.

Another one that comes to mind is that suicide threats are just "attention seeking" and that if they really wanted to kill themselves they would just do it: Most teens who die by suicide or who attempt suicide have given clear warning signs or made threats.

Lastly, one of the misconceptions that brings me the most concern is that antidepressants are dangerous in teens and young adults. The National Institute of Mental Health funded an analysis of multiple studies and found that the benefits of antidepressants outweigh the risks. It is understood among child and adolescent psychiatrists and pediatricians that antidepressants save lives and prevent suicides for the majority of those who take them.

What is the number one thing you want parents to understand about depression?

Dr. Hedrick: Depression is treatable.

If you or your teen are considering self-harm or need to talk, there are resources available to help. Call the National Suicide Prevention Lifeline at 1-800-273-TALK or Teen Line at 1-800-TLC-TEEN.