How to Help a Teen With Depression

By Arastou Aminzadeh, M.D., Founder, BNI Treatment Centers

Nothing is more painful for a parent than witnessing their teen struggle with depression. You keep hoping they will pull out of it, yet each day they seem to be sinking deeper into the gloom. Parents feel helpless, watching their teen lose interest in the things they once enjoyed and even pulling back socially. What should a parent do to help their teen with depression?

The good news is that you are aware of your teens mood state. By acknowledging that there is something wrong, you have already taken the first step toward helping them. Depression thrives on denial, so being proactive offers the best start for your teen’s recovery journey.

Do Not Ignore the Signs of Teen Depression

Teen depression affects 13.3% of young people between the ages of 13-17. This equates to about 3.2 million teens dealing with symptoms of depression on an annual basis. Rates are significantly higher among girls, possibly due to their hormonal fluctuations. 

Parents need to be aware of any persistent mood changes that do not resolve. One of the key symptoms of depression is the loss of interest in things once enjoyed. When a teen suddenly has no interest in activities he or she used to love, that could be a sign of depression. The symptoms of depression include:

• Feeling sad or hopeless most of the time
• Changes in eating habits leading to weight loss or gain in a short time frame
• Excessive fatigue
• Irritable
• Sleep problems, like sleeping too much or insomnia
• Slowed  or agitated movements and thinking
• Self-harming behaviors
• Anger or hostility
• Loss of interest in the hobbies or activities once enjoyed
• Avoiding social situations, skipping school
• Feelings of irrational guilt or shame
• Decline in grades
• Trouble concentrating or making decisions
• Thoughts of death or suicide

If your teen is exhibiting a cluster of these symptoms that lasts for more than two weeks, they should have a doctor assess them. If there is no physical reason for the symptoms, the teen will be referred to a mental health professional for evaluation. 

What Causes Teen Depression?

There are several conditions or events that could initiate a depressive episode in a teenager. Teens today are under a great deal of pressure to map out their college plans and futures. School demands and expectations can become very stressful, and prolonged stress is a risk factor for depression. 

Social struggles are also common during the teen years. This phase of life is transitional, where they have one foot in childhood and the other in adulthood. Navigating the more adult types of social challenges and accompanying drama can be overwhelming for these young people.

Some teens wrestle with gender identity, which can also cause depression. Gender identity is scary and confusing to teens, leaving some to feel like outsiders in their peer group. A teen feeling they don’t fit in can also lead to sadness and despair.

The sheer number of hours that teens spend online on social media platforms is concerning. Social media bullying is, unfortunately, rampant in this age group. If they aren’t being shamed or bullied online, they may be struggling with feelings of inferiority when comparing themselves to the people they follow.

Recognized risk factors for teen depression include:

• Hormones. Puberty causes hormone changes in young teens. The hormonal fluctuations can trigger symptoms of depression.

• Genes. When a parent or grandparent struggles with depression there is a greater chance of the teen also developing depressive disorder.

• Trauma. A childhood history of physical or sexual abuse, neglect or abandonment, or any trauma they have lived through can be a factor for depression.

• Undeveloped coping skills. Some teens have not yet acquired the skills to help them manage stress, frustrations, or disappointment in a mature manner.

• Brain chemistry. Some teens may have a brain chemistry imbalance.

• Personality traits. Some teens are more passive by nature, some are more assertive. Each child has unique personality traits and temperament. These affect how the teen responds to stressors or negative life events.

Are There Signs of Substance Use?

In order to get an accurate diagnosis, the teen will be asked if they are experimenting with drugs or alcohol. Parents may suspect substance use, as you might have noticed your teen acting differently, not like their usual self. You may be worried about your teen hanging out with a different crowd of kids lately. Your teen might be acting sneaky or isolating themselves in their room. 

All of these signs could point to possible substance use. Some other signs of substance use include:

• Their clothing smells of alcohol or weed
• You notice money missing from your wallet
• Your teen has been truant from school
• You notice their pupils are constricted
• Your teen has been dishonest with you, telling lies about their whereabouts
• Pills missing from the bathroom medicine cabinet
• The teen comes home displaying signs of intoxication
• You find items in their room, like drugs, alcohol, pipes, foil, and other paraphernalia

If a parent suspects substance abuse they should have the teen examined by a doctor so lab work can be ordered. These blood tests can reveal any drugs in their system or elevated liver enzymes. If they are found to be using a substance, along with showing signs of depression, there are teen dual diagnosis treatment programs available.

Helping Your Depressed Teen

So, what does a parent do if the teen isn’t responding to the help of a local therapist or school counselor? Residential treatment is the appropriate level of care for teens that have not had relief from depression through outpatient efforts. These teens may have only seen their mental health declining, not improving. Because of the worsening symptoms, they have impaired functioning, social problems, poor grades, and increased social withdrawal. Deepening depression also increases the risk for suicide attempts.

The residential mental health program offers a customized treatment plan for your teen. 

These teen treatment programs are designed specifically for this particular age group. Many of the therapeutic activities involve the teen’s active engagement, which increases their role in discovering new ways to cope. Daily activities include:

• Psychotherapy sessions
• Peer group therapy sessions
• Family-focused therapy sessions
• Experiential activities, such as outdoor sports and outings, and art and music therapy
• Holistic therapies, such as yoga and practicing mindfulness
• Academic support
• Medication if needed
• Medical detox if needed

Teens who struggle with depression will find this setting provides a chance to take a break from their daily life. This way they can devote their energy and time to treatment. 

If you recognize the warning signs of depression in your teen, it is best not to delay starting a conversation with them about their mood state. The next step is to have their condition evaluated by a mental health provider so treatment solutions can be initiated.

About the Author

Dr. Arastou Aminzadeh is a triple board certified physician in psychiatry, child and adolescent psychiatry, and addiction medicine, and is the co-founder of BNI Treatment Centers in Agoura Hills, California.  Dr. Aminzadeh is a fellow of the American Society of Addiction Medicine and also a fellow of the American Psychiatric Association.  A well respected leader in the field, he also holds an adjunct faculty position at the University of Southern California, Keck School of Medicine, where he completed his residency and fellowship.