Depression is common in adolescence and is often underrecognized.  As a parent it can be hard for us to think about our little ones having depression symptoms, but it is important to check in with teens to see if they are feeling depressed. Signs of depression can sometimes be different in teens compared to adults.  In my family medicine practice, I always make sure to screen for teen depression because of safety concerns as it is an important contributor to adolescent suicidal thoughts, self-harm, and suicide attempts.  I want to make sure that the teens I am treating are as safe as possible, so I screen regularly if they are feeling depressed. 

Teen depression is surprisingly common and it affects about 1 in every 10 teens aged 12-17 years old. The illness is important to treat because your teen’s brain is still growing and developing.  A depressive episode can result in school avoidance, academic failure, social withdrawal, and conflicts with their parents, peers, or teachers. Depression symptoms in teens are similar to the symptoms in adulthood, however some signs of depression may be slightly different. 

If your teen is feeling like their mood is down, low, or sad nearly all day, nearly every day – they could be suffering from depression.  Sometimes teens do not articulate what their mood is, so another symptom to look out for is if they don’t seem like they are getting the same enjoyment out of activities that they once loved.  Other symptoms of teen depression include:

Low or irritable moods are a sign of depression

Signs of depression in teens may include overly irritable moods.  Although typical depression symptoms include low moods, it is actually not uncommon for teens to seem more irritable when they are depressed.  They might be feeling more annoyed, grouchy, or bothered easily. 

Diminished interest or pleasure in activities they once loved

Some teens experience hobbies, activities, and interests as less fun and interesting, or more boring, stupid, and lame than they once found them.  They may lose interest in close friends, and withdraw from social activities. 

Changes in appetite or weight

In teen depression, they may lose their appetite, or on the other end may have a great increase in appetite.  This can result in weight loss, or failure to gain weight normally as they grow, or it can also result in weight gain. 

Lack of sleep, sleeping too much, or a change in sleep pattern

Adolescents might experience depression symptoms that interfere with their sleep.  They may have difficulty falling asleep, staying asleep, waking up in the middle of the night, or waking up much too early and not being able to fall back asleep.  They might also have day-night reversal where they are staying up late at night and sleeping throughout the day. 

Feeling worthless, hopeless, or guilty

They may be stricken with strong feelings of inadequacy, feeling like they are a failure or they let their parents down, or feeling like they are inferior to other kids their age.  They might not verbalize these thoughts to you, so some things to look out for are:

• Is your child criticizing themselves a lot?
• Does your child feel excessively guilty about events and outcomes that weren’t their fault?
• Do they feel preoccupied with what other kids think about them, or with the success of other children compared to their own?
• Does your child have difficulty complimenting themselves or taking a compliment and noticing their positive attributes?
• Do they think they deserve to be punished or shunned by other people or their peers? 
• They might be reluctant to engage in activities or join peers because “what’s the point” or believe they will just fail. 

Difficulty focusing in school or making decisions: 

While this may be a symptom of Attention Deficit Hyperactive Disorder (ADHD), people with depression often have difficulty making decisions or focusing.  If your child has a new onset of difficulty with decision-making, their grades have dropped in school, they cannot follow through with tasks or homework, or they forget things – this might be a symptom of depression. 

When concentration difficulties are caused by depression, the difficulties usually start with the onset, or shortly after the onset, of the change in mood (compared to ADHD – concentration and focus difficulties usually have gone on longer and are not associated with low moods).

Recurrent thoughts of death or not wanting to be around anymore, or thoughts of suicide:

One rather common symptom of depression in all age groups is thoughts of death, not wanting to be around anymore, or wanting to end their life.  This is a very important symptom because this is a safety concern. 

If your child is having thoughts of not wanting to be around anymore, it is important to seek medical attention promptly.  Safety is the number one priority when treating depression. 

Having low energy or feeling fatigued and tired very often

Children and adolescents with depression may lack of energy, they may look very tired, exhausted, or unmotivated.  They may start needing to sleep in the middle of the day, or not have the motivation or energy to do things they once did. 

So as a parent, what is important know about depression in childhood and adolescence and how can you help your child?  It’s important to know that if your child or teen is truly depressed, it is crucial not to scold them for it or tell them to “snap out of it.”  Conflicts between parents and teens can result when parents believe their child is being lazy, oppositional, or avoiding responsibilities.  If your child is truly depressed, it is important to take them to their doctor or a psychologist to start the process of getting them help. 

This post was co-authored by Suzanne Black, MD, BSc and Stephanie Liu, MD, MSc, CCFP, BHSc.

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