Dr. David Palmiter's Blog for Hectic Parents

According to the National Institute of Mental Health 9% of teens suffer from depression each year while 11% of youth suffer a depressive disorder by age 18. Moreover, suicide is the third leading cause of death among those aged 15 to 24. This entry will describe common symptoms and signs of depression in youth. (Please keep in mind that depression runs on a continuum; a kid may be suffering from depression, and need treatment, but only have some of the symptoms indicated below.)

Mood disturbance: Kids who are depressed have impairing sadness and/or irritability that is persistent (i.e., two weeks or longer). When a kid’s depression is manifested as irritability, it is easy to mistakenly conclude that primary problem is defiance.

Sleep disturbance: Not being able to get enough sleep or oversleeping are both signs of depression. What can make this tricky for teens is that school and extracurricular commitments can make it so that the teen doesn’t get to bed late anyway. Moreover, parents may retire before their teen and may not realize that s/he is struggling with sleep. (For guidelines on how much sleep is recommended, across age groups, enter the word “sleep” in the search bar above).

Appetite disturbance: Like sleep disturbance, depressed kids will tend to either over or under eat. Changes in weight and waistline are common.

Poor motivation: Most kids need help learning to do things when they don’t feel like it. But, kids who are depressed experience a steeper climb up that mountain.

Anhedonia: This is the clinical word for not being able to experience joy when engaging in activities that are typically pleasurable. This can be especially frustrating for parents who have endeavored to engineer a positive change in mood.

Concentration problems: Just about all kids who are depressed will experience some degree of concentration problem. (Sleep disturbance and concentration problems are to a child psychologist what fevers are to a pediatrician: there’s a problem there but it can be due to a number of different things.)

Suicidal thinking: This kind of thinking runs along a continuum. On the one end are having vague thoughts that it’d be okay to die without any specific plans or intent to take action. On the other end is generating a lethal, specific and doable suicide plan.

Here are two common myths about teen suicide: asking a kid whether s/he is having thoughts of self-harm promotes suicide (not true) and all kids who make a suicide attempt mean to die (not true also). For more information on suicide, and talking to a teen about this, use the search bar above.

Negative thinking: Youth who are depressed tend to think, “Everything sucks. It’s my fault and it can’t be changed.” This promotes what is called “learned helplessness,” meaning that a kid can become so overwhelmed that s/he won’t take obvious and straightforward steps to feel better. Feelings of hopelessness, worthlessness and guilt are also common in moderate to severe cases.

Various kinds of mental confusion: In addition to concentration problems, youth with severe depression can start confusing what is real and what is not. They can also start to form beliefs that are highly distorted.

Though not present on the diagnostic criteria there are a couple of other common indicators:

Parental burnout: Parenting a kid who is depressed can be exceptionally frustrating and difficult. Not only do intuitive interventions tend to not work (e.g., verbal reassurances), but they tend to make matters worse. This can cause a parent to feel helpless and incompetent.

Parental disputes: As most parents tend to have different parenting styles, it’s natural to believe that if only the other parent would do things differently, the kid’s depression would lift. For this reason, the youth’s depression takes a toll on the parents’ relationship. I’ve witnessed a number of marriages get better simply by effectively treating a kid’s mood disorder.

Running in the family: Depression typically results when stress activates a pre-existing genetic vulnerability. The more mood disorders run in the family, the less stress it may take to activate impairing symptoms.

Sadly, and sometimes tragically, most youth who are depressed do not get treatment for it, even though effective treatments are available (e.g., cognitive-behavioral therapy). If you are in doubt about whether your child or teen is suffering from depression, by all means treat that situation as you would if you were in doubt about the presence of a cavity. For databases of treatment providers near you, click here. Also, and as is the case across all service professions, the quality of mental health care varies. Sometimes adequately credentialed therapists are not prepared to evaluate and to treat juvenile depression in a manner that is informed by contemporary research findings. For this reason, parents do well to be informed consumers. To learn more about what constitutes effective mental health care for youth, see Chapter 10 of my parenting book or search the pages of this blog.