Moody, withdrawn, dejected. These words are often used by parents of teenagers. And young people may say that they feel very depressed about upcoming exams, or that the world is so depressing these days.
But how do you know if your teenager is experiencing what health professionals call severe depression? And when should you seek help?
First, let’s understand what this term means. Major depression is characterized by persistent low mood and/or irritability and loss of interest or pleasure in usual activities for at least two weeks. It also includes physical symptoms, such as sleep disturbances and fatigue, and cognitive symptoms, such as negative thoughts about themselves and the future, difficulty concentrating or making decisions.
Major depression is more than a brief sadness or an expected reaction to loss or a stressful event.
Although the diagnosis is the same for teens and adults, teens may be more likely to experience irritability and mood swings rather than the grumpiness typical of adults.
Increasing over time
There is evidence that depression is rising among young people, with an international study in 2021 estimating that 25% of children and adolescents experienced elevated depression symptoms, double pre-pandemic levels. Although Australia was not included in this study, a recent Australian study showed that psychological distress increased in Australian millennials (born between the early 1980s and late 1990s) and Generation Z Australians (born in the late from the 1990s to the beginning of the 2010s).
While the cause of this increase is unclear, it is likely due to multiple factors, such as financial pressures, social isolation and climate change, and made worse by the COVID pandemic.
Given the understandable distress experienced by many young people, how can parents or guardians know when to seek help?
Read more: How parents can play a key role in preventing and treating mental health issues in teens
Listen
Start by talking to your child. Let them know that you’ve noticed some changes and are concerned about them. If your child opens up about their struggles, listen carefully and validate their feelings. Being able to talk about difficulties and knowing that support is available if they need it may be enough for some teenagers.
Read about depression from trusted sources to be better equipped to understand and support a young person.
Try not to ignore your teen’s feelings or punish irritable behavior. It can be tempting to remind them of positives or offer solutions, but this can often backfire, leaving them feeling misunderstood. Although it may be difficult or uncomfortable to talk openly with your teen about their mental health, it is often a great relief for them.
Professional help may be needed if they are very distressed or if their difficulties are having a significant impact on their usual activities and relationships (this may include giving up many activities, avoiding school or avoiding friends and family much of the time).
Start with a general practitioner
The good news is that there are effective treatments available.
The first step in finding the right treatment will probably be helping your child see a family doctor. Again, simply talking about your concerns with your doctor can be very helpful. Your young person may prefer to discuss this matter with their GP without you.
Their family doctor may refer them to a mental health professional, such as a psychologist or psychiatrist.
Teenagers can also go directly to an organization like Headspace, which provides information, support and services to young people aged 12 to 25 and their families and friends through centers across Australia.
Read more: First sleep health program for First Nations teens could change lives
How is depression treated?
A recent review of the recognition and treatment of depression in adolescents examined clinical practice guidelines from Canada, Australia, the United Kingdom, the United States, and New Zealand and found that a comprehensive treatment approach is typically used.
Treatment may include:
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education about depression and its treatment
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lifestyle interventions (such as improving sleep, diet, and exercise)
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psychological therapy (often focused on understanding and changing unhelpful thought patterns)
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prescription of antidepressants when necessary.
Starting a teenager on antidepressant medication can be a difficult decision. It must be a collaborative decision involving the adolescent, their parents and health professionals.
Like all medications, antidepressants have side effects and potential risks. They are typically used in cases of severe depression or if psychological treatments have been unsuccessful. Suicidal thoughts or behavior are a possible side effect of antidepressants for a small proportion of adolescents and should be carefully monitored. However, untreated depression is also a risk factor for suicide, so the potential benefits and risks of antidepressant use in adolescents must be carefully considered.
Assessing the risk
Suicidal thoughts and self-harm are common in depression but can be treated effectively.
Assessing suicide risk is a critical part of any treatment for depression and should include developing a safety plan with the teen and their parents or guardians. Safety plans can be very useful in times of distress, listing useful coping strategies and contact details for family, friends and healthcare professionals.
If you are concerned that your teen may be at risk for suicide, take it seriously. Ask direct questions, such as Are you thinking about suicide? Get professional support as soon as possible and take the young person to the nearest A&E or call 000 if you are concerned about their immediate safety. You can also contact the Kids Helpline 24 hours a day on 1800 55 1800.
It is important to emphasize that you take care of yourself. Supporting a teenager with depression can be costly and cause significant strain on the family.
Find someone (other than your child) who you can trust. Make sure you rest, eat, and exercise. Seek professional support if you are having difficulties. Taking care of yourself means you are better equipped to support your child.
If this article has raised concerns for you, or if you are worried about someone you know, call Lifeline on 13 11 14 or Kids Helpline on 1800 55 1800.
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