Moody, withdrawn and down are words often used by parents of teens. Photo / 123rf
Moody, withdrawn and down are words often used by parents of teens. Photo / 123rf
Moody, withdrawn, down. These words are often used by parents of teens. And young people may say they feel so “depressed” about upcoming exams, or that the world is “just so depressing” these days.
But how do you know if your teen is experiencing what health professionals call “major depression”? And when should you seek help?
Major depression is characterised by persistent low mood and/or irritability and loss of interest or pleasure in usual activities for at least two weeks. It also includes physical symptoms, such as sleep disturbance and fatigue, and cognitive symptoms, such as negative thoughts about themselves and the future, difficulty concentrating or making decisions.
Physical symptoms of major depression include sleep disturbance and fatigue. Photo / 123rf
Major depression is more than brief sadness, or an expected reaction to loss or a stressful event.
While the diagnosis is the same for adolescents and adults, teens may be more likely to present with irritability and mood changes rather than the low mood typical of adults.
Increasing over time
There is evidence depression is increasing among young people, with an international study in 2021 estimating that 25 per cent of children and adolescents experienced elevated depression symptoms – double pre-pandemic levels. While the cause of this increase is unclear, it is likely due to multiple factors, such as financial pressures, social isolation and climate change, and made worse by the Covid-19 pandemic.
Given the understandable distress experienced by many young people, how can parents or carers know when to seek help?
Listen
Begin by talking to your child. Let them know you have noticed changes and you are concerned about them. If your child opens up about their difficulties, listen carefully and validate their feelings. Being able to talk about difficulties, and knowing support is there if they need may be enough for some teens.
Talk to your child about the changes you noticed and tell them you're concerned. Photo / Inna Reznik
Read up on depression from reputable sources, so you are better equipped to understand and support a young person.
Try not to dismiss a teen’s feelings or punish irritable behaviour. It can be tempting to remind them of positives or offer solutions – but this can often backfire, leaving them feeling misunderstood. While it might be difficult or uncomfortable to talk openly with your teen about their mental health, it is often a huge relief for them.
Professional help may be needed if they are highly distressed, or if their difficulties are having a significant impact on their usual activities and relationships - this may include withdrawing from many activities, avoiding school, or avoiding friends and family most of the time.
Start with a GP
The good news is, effective treatments are available.
The first step to finding appropriate treatment will likely be supporting your teen to see a GP. Again, simply talking through their concerns with the doctor may be very helpful. Your young person might prefer to discuss this with the GP without you.
The GP may refer them to a mental health professional, such as a psychologist or psychiatrist.
Teens can also go directly to an organisation like Youthline or What’s Up, who provide information, support and services specifically for young people.
The first step to finding appropriate treatment will likely be supporting your teen to see a general practitioner. Photo / 123rf
What does depression treatment look like?
A recent review on recognising and managing teen depression examined clinical practice guidelines from Canada, Australia, the United Kingdom, the United States and New Zealand, found a comprehensive treatment approach is typically used.
Treatment can include:
education about depression and its treatment
lifestyle interventions (such as improving sleep, diet and exercise)
psychological therapy (often focused on understanding and changing unhelpful thinking patterns)
Whether to start a teen on antidepressant medication can be a difficult decision. It should be a collaborative decision involving the teen, their parents and health professionals.
Antidepressants are typically used in cases of severe depression, or if psychological treatments have been unsuccessful. Photo / 123rf
Like all medications, antidepressants have side effects and potential risks. They are typically used in cases of severe depression, or if psychological treatments have been unsuccessful. Suicidal thoughts or behaviour are a possible side effect of antidepressants for a small proportion of adolescents and should be carefully monitored. However, untreated depression is also a risk factor for suicide, so the potential benefits and risks of antidepressant use by teens need to be carefully considered.
Assessing risk
Suicidal thoughts and self-harm are common in depression but can be effectively treated.
Suicide risk assessment is a critical part of any treatment for depression, and should include the development of a safety plan with the teen and their parents or carers. Safety plans can be very helpful in times of distress, listing helpful coping strategies and contact details for family, friends and health professionals.
If you are concerned your teen might be at risk of suicide, take it seriously. Ask them direct questions, such as “Are you thinking about suicide?”. Get professional support as soon as possible and take the young person to the nearest emergency department or call 111 if you are worried about their immediate safety. You can also contact Lifeline on 0800 543 354 or text HELP to 4357.
Importantly, look after yourself. Supporting a teen with depression can take a toll and lead to significant tension in a household.
Find someone - other than your child - you can confide in. Make sure you’re getting rest, nutrition and exercise. Seek professional support if you find yourself struggling. Taking care of yourself means you are better equipped to support your child.
Safe to talk (sexual harm): Call 0800 044 334 or text 4334
All services are free and available 24/7 unless otherwise specified.
For more information and support, talk to your local doctor, hauora, community mental health team or counselling service. The Mental Health Foundation has more helplines and service contacts on its website.
