What Are the Signs of Depression in a Teenager?

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Many people think that depression can only affect adults. However, depression can affect anyone regardless of age, nationality, gender, or background. Depression can be a debilitating disorder that may cause some people to turn to substance misuse to cope. This is why it is so important for coaches, teachers, parents, and others to learn how to recognize the signs of depression in teenagers. 

Many people struggle in silence with mental health disorders like depression for years without seeking help. This can be a result of many different things. For instance, they may be worried about how they will be regarded by others if they seek help. It is also possible that they have reached out for help before but without success. Maybe they no longer believe that finding relief is possible for them. 

When someone feels as if they have tried everything they can to treat their depression but doesn't feel any better, they can quickly become extremely discouraged and hopeless. Depression and substance misuse is a dangerous mix and is known as a co-occurring disorder. At Pathways Recovery Center, we treat co-occurring disorders with the utmost seriousness and delicacy. Full recovery requires treatment for both disorders. 

Understanding Why Depression Happens

We may never have an exact answer as to why some people experience debilitating depression, and others may never encounter it during their lifetime. However, we do know that there are some factors that can certainly affect one's likelihood of developing it. Genetics are certainly believed to play a role. Those who have close family members with a history of mental health problems are more likely to experience depression than those who do not. 

Environmental factors and chemical imbalances can also play a significant role. In addition, life circumstances are often related to one's likelihood of experiencing depression. These life circumstances may or may not be under a person's control. 

In looking at life circumstances that may play a role in the likelihood of depression in a teenager, some of the following are likely: 

  • Experiencing bullying by peers 
  • Having parents who are going through a separation or divorce 
  • Losing a close loved one
  • Struggling to fit in at school 
  • Family financial problems 
  • Surviving a natural disaster
  • Being physically, mentally, verbally or sexually abused 
  • Having witnessed an act of violence 
  • Surviving an accident like a car wreck 
  • Academic problems 
  • Having friendship or relationship problems

For teenagers, depression is also often associated with how they view themselves. For example, they may struggle with poor self-esteem, problems with weight, self-comparison, or other issues related to confidence. 

In addition, many teenagers often associate their self-worth with how others view them. They may seek out validation from their peers. This could be verbal validation or even validation shown through social media. For example, validation may be shown through how many followers or likes they get. When they fail to get this validation, they may take it as a negative reflection of themselves and their self-worth. 

Signs of Depression: Behavioral Health

In the case of some teenagers, it may be easier to recognize the signs of depression than in others. Some teenagers who struggle with depression may hide it very well from those close to them. They may appear happy, motivated, and content with their life, but they could be struggling in silence. 

It is important to note that it doesn't matter if a teenager appears to have it all. It is still possible for them to be experiencing depression. They may have great grades, have lots of friends, and appear to have it all together, but still not be okay. This is part of why it is important to be able to recognize the signs of depression in teenagers, no matter how inconspicuous they may be.

In many cases, the signs of depression may present themselves through a teenager's behavioral health. An ordinarily well-behaved and easy-going teen may start talking back and lashing out against those closest to them. They may go from getting great grades to failing to turn in assignments or even getting in trouble at school. In some cases, they may isolate themselves from others and spend a lot of time hidden away in their room. 

Some teenagers may become angry or defensive if someone asks them about their behavior or mental health. This can make it difficult to have a productive conversation about what is bothering them or what can be done to address the problem. 

Signs of Depression: Physical Health and Hygiene

In other cases, the signs of depression in a teenager may present themselves in the form of changes in their personal hygiene, physical health, or overall outward appearance. For some teens, their depression may cause them to lose their usual motivation to take care of themselves. They may start to appear unkempt. For example, they may start skipping showers or avoid brushing their teeth or hair. 

In some cases, they may go to school in unwashed or wrinkled clothing. They may skip daily grooming and hygiene practices and become defensive or angry when confronted about it. 

Some teens may show signs of depression in other outward ways, such as sudden fluctuations in weight. This can be a result of changes in appetite due to poor mental health. Some people turn to food as a way of coping with depression, which can cause them to gain weight quickly. They may engage in binge eating and choose unhealthier options that can take a toll on their overall health and lead to obesity. 

Others may lose their appetite altogether, leading to dangerous drops in weight. They may become deficient in important vitamins and minerals since they are not eating the foods they need to sustain themselves. This can lead to other health problems like a decrease in organ function, weakened bones, brittle nails and teeth, and other issues. It is crucial to recognize these things in order to get the teenager help before further problems occur.

Signs of Depression: Substance Misuse

Many parents think that there is no way that their child would ever even consider turning to substance misuse. But the truth is that they simply can't know what sort of experiences their child will experience as they navigate adolescence. They may be placed in situations where they are bullied or pressured to drink alcohol or use drugs. Or, they may feel as if they have been pushed to that point after struggling with their mental health over an extended period of time. 

When a teenager is struggling with depression and substance misuse simultaneously, it can present itself in a lot of different ways. They may be willing to take desperate measures to obtain drugs or alcohol regardless of the consequences. This is often because they may fear that they cannot withstand the pain associated with their depression without using substances to mask it. 

There are some signs to look out for that could indicate a teenager is struggling with depression and substance misuse simultaneously. Some examples include: 

  • Sneaky or secretive behavior
  • Asking to borrow money 
  • Money going missing without any explanation 
  • Getting caught in lies
  • Decreased performance levels in class
  • Skipping school 
  • Changes in appetite 
  • Decreased levels of performance in sports 
  • Isolating oneself from others 
  • Unusually defensive, aggressive, or angry behavior 
  • Changes in sleeping patterns 
  • Getting into arguments with parents, teachers, or classmates 
  • Alcohol or prescription medication going missing from home without an explanation 

It can be scary to know that a teenager is battling both substance misuse and depression simultaneously. At Pathways Recovery, we can help by providing a dual diagnosis and effectively treating both disorders. 

Signs of Depression: Self-Harm

Unfortunately, many teenagers who struggle with depression also struggle with self-harm. This is an extremely difficult and painful situation to be faced with. It can be especially hard to know how to handle it when a parent has never dealt with compulsions to engage in self-harm themselves. There are a lot of reasons why someone may be compelled to engage in self-harm. 

Some people who self-harm do it in an attempt to release inner pain and turmoil. Others may do it because they truly may be having suicidal tendencies as a result of depression. This is an extremely serious situation that should not be overlooked. Some signs that a teen may be self-harming include:

  • Noticeable cuts on wrists, stomach, hands, legs, or other body parts of the teen
  • The teen may frequently wear long sleeves, jewelry, or other items to cover up cuts and scars
  • They may seemingly make excuses for how they sustained certain wounds on their body

If a parent believes that their teenager could be self-harming or having suicidal thoughts, they should contact the teen's doctor immediately for further guidance. 

Signs of Depression: Loss of Interest

When someone is struggling with depression, they may often seemingly lose their zest and excitement for life. The things that they were once most passionate about and enjoyed doing may become an afterthought. They might not have the same energy or the mental capacity to put toward these things that they once did. For example, they may no longer seem interested in their after-school sports, hobbies, and extracurriculars. 

In some cases, teens may even lose interest in spending time with their friends. They may seem to prefer spending time on their own instead. This can be particularly concerning because support from their peers is so important for teens during this time of their lives. They need to be able to have people that they are comfortable with to turn to and discuss things they are going through in life. 

Talking to a Teen About Their Mental Health

As difficult of a conversation as it may be, it is important for parents to talk to their kids about their mental health. This is especially the case if they believe they could be struggling with depression or other mental health disorders. Some parents may avoid this conversation because they don't want to start an argument. Nevertheless, it is so important to have an open dialogue that allows a teenager to share how they are feeling. 

When a parent is ready to have this conversation, they should do so in a quiet area where the teen is going to be comfortable. It should be a private place where they won't have to worry about being overheard. There should be as few distractions as possible. It's important that they are not looking at their phone but are fully present in the conversation. 

The parent should invite their teen to open up and encourage them to share how they are feeling. This can be done by asking simple questions that may open a conversation without becoming overly pushy. A teen should never feel pressured into sharing more than they are comfortable with. It is important that the parent remains calm and that they make it clear they are coming from a place of love and concern. 

Some teenagers may express feelings of hopelessness, worthlessness, or intense sadness. However, they might not be able to pinpoint a reason why they fell that way. It is essential that parents make it clear to them that there is nothing wrong with them. In addition, it is vital that they know that they don't have to continue living this way and there is help available. 

Treating Depression in Teenagers

Depression in teenagers can, unfortunately, be quite common. The good news is that there are a variety of different treatment methods that have been found to be effective. It can take time and patience to determine what treatment method will be the best fit for a particular teen, but working with their health care provider is a good place to start. 

Some medical professionals choose to prescribe medications known as selective serotonin reuptake inhibitors (SSRIs). These medications treat problems like depression and anxiety by raising the levels of serotonin in the brain. Serotonin is a neurotransmitter, but it also works as a hormone to promote happiness. This is why those who struggle with depression will often feel a boost in mood after taking this medication. 

In many cases, it will also be recommended that a teen attend regular therapy. Having an outsider to open up to can be helpful in working through their different emotions. A therapist can also help them try to get to the bottom of why they are feeling this way and identify different things they can do to find relief. This could include learning different stress management techniques. 

Lifestyle changes can also improve one's symptoms of depression. The following steps are a great place to start:

  • Limiting processed foods or foods that are high in sodium and sugar
  • Taking time away from technology and social media
  • Getting more exercise 
  • Spending time outdoors 
  • Getting more quality sleep each night 
  • Asking for extra help with academics
  • Cutting out certain extracurriculars if they are feeling overworked or overwhelmed 
  • Learning how to practice good self-care on a regular basis 
  • Eating more nutritious meals and making it a habit not to skip meal time 

All of these things combined can make a major difference in one's mental health and keep depression away. 

Practicing Self-Care as a Parent and Avoiding Self-Blame

If a parent finds out that their teen may be struggling with depression, substance use, or other problems, their first instinct may be to blame themselves. They may wonder if they did something wrong that caused this. But it is important to remember that in many cases, there was nothing anyone could have done to prevent it. It could likely be as simple as a chemical imbalance within the brain. 

This is why it is crucial for parents to avoid self-blame and remember to practice their own self-care. They cannot be the best parents they need to be for their children if they don't care for themselves first. 

Mental health and substance misuse often go hand in hand, regardless of age. It doesn't matter if someone seems to have it all together on the outside; they could be fighting their own battles in silence without anyone knowing. This is why it is important that we work to eradicate the stigma of both mental health and addiction. There is hope, and treatment is available. If you or someone you love is struggling with addiction, our team at Pathways Recovery can help. Don't hesitate to give us a call at (888) 771-0966 today, and a member of our team will be happy to answer any questions that you may have. 

Clinically reviewed by 

Moses Nasser
Dr. Moses Nasser, a double board-certified physician in Family Medicine and Addiction Medicine, with expertise in holistic healing, addiction medicine, and psychiatric care, holds an X-waiver to prescribe buprenorphine and has extensive experience in mindfulness-based customer service and medication-assisted treatment.

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