Teen depression is a serious condition that affects emotions, thought and behaviors. Although teen depression isn't medically different from depression in adults, teenagers often have unique challenges and symptoms. Issues such as peer pressure, academic expectations and changing bodies can bring a lot of ups and downs for teens. But, for some teens, the lows are more than just temporary feelings — they're a sign of depression.
Also called major depression and major depressive disorder, teen depression isn't a weakness or something that can be overcome with willpower. Like depression in adults, teen depression is a medical condition that can have serious consequences. However, for most teens, teen depression symptoms ease with treatment such as medication and psychological counseling.
©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
Teen depression symptoms include:
Teen depression often occurs along with behavior problems and other mental health conditions, such as anxiety or attention-deficit/hyperactivity disorder (ADHD).
What's normal and what's not
It can be difficult to tell the difference between the ups and downs that are just part of being a teenager and teen depression. Talk with your teen. Try to determine whether he or she seems capable of handling his or her feelings without help, or if life seems overwhelming. If teen depression symptoms persist or begin to interfere in multiple areas of your teen's life, talk to a doctor or a mental health professional trained to work with adolescents. Your teen's family doctor or pediatrician is a good place to start. Or, your teen's school may have a recommendation.
Warning signs that your teen could be struggling with depression:
When to see a doctor
If you suspect your teenager may be depressed, make a doctor's appointment as soon as you can. Depression symptoms may not get better on their own — and may get worse or lead to other problems if untreated. Teenagers who are depressed may be at risk of suicide, even if signs and symptoms don't appear to be severe.
If you're a teen and you think you may be depressed — or you have a friend who may be depressed — don't wait to get help. Talk to a health care professional such as your doctor or school nurse. Share your concerns with a parent, a close friend, a faith leader, a teacher or someone else you trust.
Suicidal thoughts
If your teen is having suicidal thoughts, get help right away. Here are some steps you can take:
When to get emergency help
If you think your teen is in immediate danger of self-harm or attempting suicide, call 911 or your local emergency number immediately. Make sure someone stays with him or her until help arrives.
©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
It's not known exactly what causes depression. As with many mental illnesses, it appears a variety of factors may be involved. These include:
©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
Although the precise cause of depression isn't known, factors that seem to increase the risk of developing or triggering teen depression include:
©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
Untreated depression can result in emotional, behavioral and health problems that affect every area of your teen's life. Complications associated with teen depression can include:
©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
You're likely to start by taking your teen to see his or her primary care doctor or pediatrician. However, when you call to set up an appointment, you may be referred directly to a psychiatrist or psychologist — mental health professionals who specialize in diagnosing and treating mental health conditions.
Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea for you and your teen to be well prepared for the appointment. Here's some information to help you get ready for your teen's appointment, and what to expect from the doctor.
What you can do
Your time with the doctor is limited, so preparing a list of questions ahead of time will help you and your teen make the most of your time. List your questions from most important to least important in case time runs out. For problems related to depression, some basic questions to ask the doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions at any time during your teen's appointment.
What to expect from your teen's doctor
The doctor is likely to ask your teen a number of questions. Making sure he or she is ready to answer them may reserve time to go over any points you or your teen wants to spend more time on. Your child's doctor may ask your teen:
©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
When a doctor suspects a teen has depression, he or she will generally ask a number of questions and may do medical and psychological tests. These can help rule out other problems that could be causing symptoms, pinpoint a diagnosis and also check for any related complications. These exams and tests generally include:
Diagnostic criteria for depression
To be diagnosed with depression, your teen must meet the symptom criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
For a diagnosis of major depression, your teen must have five or more of the following symptoms over a two-week period. At least one of the symptoms must be either a depressed mood or a loss of interest or pleasure. Symptoms can be based on your teen's feelings or may be based on the observations of someone else. They include:
To be considered major depression:
Other conditions that cause depression symptoms
There are several other conditions with symptoms that can include depression. It's important to get an accurate diagnosis so your teen can get the appropriate treatment. Your doctor or mental health provider's evaluation will help determine if the symptoms of depression are caused by one of the following conditions:
Make sure that you understand what type of depression your teen has so that you can learn more about his or her specific situation and its treatments.
©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
Numerous treatments are available. Medications and psychological counseling (psychotherapy) are very effective for most teens with depression.
In some cases, a primary care doctor can prescribe medications that relieve depression symptoms. However, many teens need to see a doctor who specializes in diagnosing and treating mental health conditions (psychiatrist or psychologist). Some teens with depression also benefit from seeing other mental health counselors.
If your teen has severe depression or is in danger of hurting himself or herself, he or she may need a hospital stay or may need to participate in an outpatient treatment program until symptoms improve.
Here's a closer look at depression treatment options.
Medications
A number of antidepressant medications are available to treat depression. There are several different types, categorized by how they affect the naturally occurring chemicals in the brain linked to mood.
Because studies on the effects of antidepressants in teens are limited, doctors rely mainly on adult research when prescribing medications. The Food and Drug Administration (FDA) has approved two medications for teen depression — fluoxetine (Prozac) and escitalopram (Lexapro). However, as with adults, other medications may be prescribed at the doctor's discretion (off label).
Types of antidepressants include:
Managing medications
Carefully monitor your teen's use of his or her medications. In order to work properly, antidepressants need to be taken consistently at the prescribed dose. Because overdose can be a risk for teens with depression, your teen's doctor may prescribe only small supplies of pills at a time, or recommend that you dole out your child's medication so that your teen does not have large amounts of pills available at once. Be especially careful if you think your teen is at risk of suicidal behavior and is taking a tricyclic antidepressant or an MAOI — these medications are more dangerous than other types of antidepressants when it comes to overdose.
Finding the right medication
Everyone's different, so finding the right medication or dose of medication for your teen may take some trial and error. This requires patience, as some medications need eight weeks or longer to take full effect and for side effects to ease as the body adjusts. If your teen has bothersome side effects, he or she shouldn't stop taking an antidepressant without talking to the doctor first. Some antidepressants can cause withdrawal symptoms unless the dose is slowly tapered down. Quitting suddenly may cause a sudden worsening of depression.
If antidepressant treatment doesn't seem to be working, your teen's doctor may recommend a blood test to check for specific genes that affect how his or her body processes antidepressants. The cytochrome P450 (CYP450) genotyping test is one example of this type of exam. Genetic testing of this kind can help predict how well the body can or can't process (metabolize) a medication. This may help identify which antidepressant might be a good choice for your teen. These genetic tests aren't widely available, so they're an option only for people who have access to a clinic that offers them.
Antidepressants and pregnancy
If your teen is pregnant or breast-feeding, some antidepressants may pose a health risk to her unborn child or nursing child. If your teen becomes pregnant, make certain she talks to her doctor about antidepressant medications and managing depression during pregnancy.
Antidepressants and increased suicide risk
Although antidepressants are generally safe when taken as directed, the Food and Drug Administration (FDA) warns that in some cases, children, adolescents and young adults ages 18 to 24 may have an increase in suicidal thoughts or behavior when taking antidepressants. This risk may be highest in the first few weeks after starting an antidepressant or when the dose is changed. Because of this risk, people in these age groups must be closely monitored by while taking antidepressants.
While this warning may seem alarming, for most teens the benefits of taking an antidepressant generally outweigh any possible risks. In the long run, antidepressants are likely to reduce suicidal thinking or behavior.
If your teen has suicidal thoughts when taking an antidepressant, immediately contact his or her doctor or get emergency help.
Again, make sure you understand the risks of the various antidepressants. Working together, you and your doctor can explore options to get depression symptoms under control.
Psychotherapy
Psychological counseling (psychotherapy) is another key depression treatment. Psychotherapy is a general term for a way of treating depression by talking about depression and related issues with a mental health provider. Psychotherapy is also known as therapy, talk therapy, counseling or psychosocial therapy. Psychotherapy may be done one-on-one, with family members or in a group format.
Through these regular sessions, your teen can learn about the causes of depression so that he or she can better understand it. He or she will also learn how to identify and make changes in unhealthy behaviors or thoughts, explore relationships and experiences, find better ways to cope and solve problems, and set realistic goals. Psychotherapy can help your teen regain a sense of happiness and control and help ease depression symptoms such as hopelessness and anger. It may also help your teen adjust to a crisis or other current difficulty.
Cognitive behavioral therapy is one of the most commonly used therapies for teen depression. It helps a person identify negative beliefs and behaviors and replace them with healthy, positive ones. It's based on the idea that your own thoughts — not other people or situations — determine how you feel or behave. Even if an unwanted situation doesn't change, you can change the way you think and behave in a positive way. Interpersonal therapy and psychodynamic psychotherapy are other examples of counseling commonly used to treat depression. There are a number of additional types of psychotherapy that can be effective. Many therapists use a combination of approaches.
Hospitalization and residential treatment programs
In some teens, depression is so severe that a hospital stay is needed. Inpatient hospitalization may be necessary if your teen is in danger of self-harm or hurting someone else. Getting psychiatric treatment at a hospital can help keep your teen calm and safe until his or her mood improves. Partial hospitalization or day treatment programs also are helpful for some teens. These programs provide the support and counseling needed while your teen gets depression symptoms under control.
©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
Depression generally isn't an illness that you can treat on your own. But there are some steps you and your teen can take that may help:
©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
Alternative medicine strategies for depression include supplements and mind-body techniques. Here are some common alternative treatments for depression.
Herbal remedies and supplements
A number of herbal remedies and supplements have been used for depression. Examples include:
Some supplements — including St. John's wort and SAMe — can interfere with antidepressants.
Mind-body connections
The connection between mind and body has been studied for centuries. Complementary and alternative medicine practitioners believe the mind and body must be in harmony for you to stay healthy.
Mind-body techniques used to improve depression symptoms include:
As with dietary supplements, take care in using these techniques.
Make certain you understand risks as well as possible benefits before pursuing any therapy for your teen. To be safe, talk to your teen's doctor before he or she takes any herbal or dietary supplements — particularly St. John's wort or SAMe. Keep in mind, alternative treatments aren't a replacement for conventional medical treatment or psychotherapy.
©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
Showing interest and the desire to understand your teen's feelings lets him or her know you care. You may not understand why your teen feels that things are hopeless or why he or she has a sense of loss or failure. Listen to your teen without judging and try to put yourself in his or her position. Help build your teen's self-esteem by recognizing small successes and offering praise about his or her competence.
Encourage your teen to:
©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.
There's no sure way to prevent depression. However, making sure your teen takes steps to control stress, to increase resilience and to boost low self-esteem can help. Friendship and social support, especially in times of crisis, can help your teen cope. In addition, treatment at the earliest sign of a problem can help prevent depression from worsening. Some teens need to continue taking medications even after symptoms let up, or have regular therapy sessions to help prevent a relapse of depression symptoms.
©1998-2012 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.
Read this article on Mayoclinic.com.

Want to know more about this article or other health related issues? Ask your question and we'll post some each week for CNN.com reader to discuss or for our experts to weight in.

| Most Viewed | Most Emailed |
