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Depression - adolescents; Teenage depression
Adolescent depression is a disorder that affects teenagers. It leads to sadness, discouragement, and a loss of self-worth and interest in their usual activities.
Depression can be a response to many situations and stresses. In teenagers, depressed mood is common because of:
It may also be a reaction to a disturbing event, such as:
Teens who are most likely to become depressed when they experience stressful events:
Adolescent girls are twice as likely as boys to experience depression. A family history of depression also puts teenagers at greater risk.
The following events or situations can cause depression:
Many adolescents with depression may also have:
Depression can change the way teenagers see themselves, their lives, and the people around them. Teenagers who are depressed usually see everything more negatively. They can't imagine that any problem or situation can be solved in a positive way.
Some or all of these symptoms of depression may be present:
Sometimes a person's behavior may change, or there may be problems at home or school without any symptoms of depression:
If these symptoms last for at least 2 weeks and affect your mood or ability to function, get treatment.
Suicide is a risk for all teenagers with depression. See: Suicide and suicidal behavior for more information on how to recognize and treat suicidal feelings.
True depression in teens is often difficult to diagnose, because normal teenagers have up and down moods. These moods may go back and forth over a period of hours or days.
Sometimes when children or adolescents are asked, they will say that they aren't happy or sad. Health care providers should always ask children or adolescents about symptoms of depression.
The health care provider will perform a physical examination and order blood tests to rule out medical causes for the symptoms. The doctor will also check for signs of substance abuse. The following can cause, or occur because of depression:
The health care provider will also check:
Information from family members or teachers can often help identify depression in teenagers.
Treatment options for adolescents with depression include:
Treatment should be tailored to the teenager, and the symptoms. Families often help in treating adolescent depression.
The first medication tried is usually a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI). Fluoxetine (Prozac) and escitalopram (Lexapro) are the only SSRIs approved for treating major depression in adolescents (ages 12 - 17). Fluoxetine is also approved for children age 8 and older.
NOTE: SSRIs and other antidepressants carry a warning that they may increase the risk of suicidal thoughts and actions in children and adolescents. Other evidence has not showed that these drugs increase suicide risk in children.
Doctors are still prescribing SSRIs and other antidepressant medications to adolescents with depression. Several important facts about taking any antidepressants include:
Not all antidepressants are approved for use in children and teens. For example, tricyclic antidepressants are not approved for use in teens.
Almost all adolescents with depression benefit from some type of talk therapy. Talk therapy is a good place to talk about their feelings and concerns, and to learn ways to deal with them.
Types of talk therapy include:
Sometimes people with severe depression, or those who are suicide risks may need to stay in the hospital for treatment.
Adolescents with depression should learn to:
Depression usually responds to treatment. Getting the right treatment as early as possible may prevent further episodes. However, about half of very depressed teens will keep having problems with depression as adults.
Adolescents with other mental health problems usually need longer and more intensive treatment.
There are numbers you can call from anywhere in the United States, 24 hours a day, 7 days a week: 1-800-SUICIDE or 1-800-999-9999.
Call your health care provider right away if you notice one or more of these suicide warning signs:
See: Suicide and suicidal behavior for more information
Call your health care provider if you notice:
NEVER IGNORE A SUICIDE THREAT OR ATTEMPT!
Most teenagers feel down sometimes. Having support and good coping skills can help prevent these periods of sadness from leading to more severe depression. Talking openly with your teen can help identify depression early.
Make sure your teen gets professional help to deal with periods of low mood. Identifying and treating depression early may prevent or delay episodes.
In homes with adolescents:
US Preventive Services Task Force. Screening and treatment for major depressive disorder in children and adolescents: US Preventive Services Task Force Recommendation Statement. Pediatrics. 2009;123:1223-1228.
Zuckerbrot RA, Cheung AH, Jenson PS, Stein REK. Identification, assessment, and initial management guidelines for adolescent depression in primary care. Pediatrics. 2007;120:e1299-e1312.
Cheung AH, Zuckerbrot RA, Jenson PS, Ghalib K. Treatment and ongoing management guidelines for adolescent depression in primary care. Pediatrics. 2007;120:e1313-e1326.
Bostic JQ, Prince JB. Child and adolescent psychiatric disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier;2008:chap 69.
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