How To Treat Depression In Teens

Depression is an umbrella term for all depressive disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). These conditions are some of the most common mental illnesses worldwide and can be experienced by people of any age, including children and teens. Because of the prevalence of adolescent depression, it can be essential to understand how this mental health condition is treated and what options are available to young people living with its symptoms.

Understanding teen depression 

A study by Johns Hopkins University found that clinical depression in teens increased by 37% from 2005 to 2014. In 2023, youth diagnosis of major depressive disorder (MDD) was at almost 3 million cases per year. Often, addressing adolescent depression begins with recognizing its causes and symptoms and the standard health care treatments available.

What is depression?

Depression can cause a prolonged low mood and loss of interest in activities once enjoyed. Depression can also lead to various emotional challenges, physical health problems, and a decrease in a person's ability to function at work, school, and home. Some activities, such as school, social gatherings, speaking to family members, or participating in daily activities, may become challenging for those experiencing child and adolescent depression. 

Although it is a symptom, depression is not the same as sadness. It impacts how a person thinks, feels, and behaves over two weeks or more. In some cases, depression can last years. Below are the depressive disorders that can be diagnosed in teens: 

• Disruptive mood dysregulation disorder
• Major depressive disorder (MDD)
• Persistent depressive disorder (dysthymia)
• Premenstrual dysphoric disorder
• Depressive disorder due to another condition
• Other specified depressive disorder
• Unspecified depressive disorder
• Seasonal affective disorder (SAD) 

What are the symptoms of depression in teens?

The symptoms of depression in adolescents are the same as those in adult depression in many cases. However, risk factors can look different. Parents and professionals working with children may benefit from looking for behavioral changes, mood swings, and physical symptoms when attempting to identify depression in a child. Below are a few symptoms associated with these depression risk factors. 

Social withdrawal

Teenagers with depression may withdraw from loved ones significantly. Although teens are often known for being moodier and withdrawn from their loved ones, a sudden change in social behavior is a risk factor. Look at whether the teen's isolation is accompanied by other symptoms of depression and significant irritability or anxiety. 

Lack of energy 

Lack of motivation, low energy, and fatigue are signs of depression to look out for. While it can be expected for teenagers to sleep more than adults, teens require at least eight to ten hours a night, look for signs of lethargy or difficulty staying awake during the day after a restful sleep. Insomnia can also be a sign of depression and related mental health conditions, and some teens may struggle to sleep. 

Difficulty making decisions 

Struggling to make decisions is another sign of depression. If your teenager seems to struggle more than average with their thought processes, consider talking to them about what they're experiencing. 

Changes in eating habits 

Changes in eating habits, such as loss of appetite or overeating, can also be a sign of depression. However, some changes in eating can be expected as teens go through puberty, as they may require more nutrients while growing and changing.  

Thoughts of worthlessness or hopelessness 

Like adults, teenagers experiencing depression may believe they are inadequate, worthless, lonely, or empty. They may have excessive amounts of guilt or shame. If you're a parent of a teen, look at what your child tells you about their emotions. It could indicate an underlying mental health condition like depression if they often express self-doubt or low self-esteem.

Severe symptoms of depression in teens can lead to substance use, thoughts of self-harm, or suicide. It's important to seek professional help if you or someone you know is experiencing these symptoms.

If you or a loved one is experiencing suicidal thoughts, reach out for help immediately. The 988 Suicide and Crisis Lifeline can be reached at 988 and is available 24/7.

Behavioral and physical changes 

Watch for behavioral and physical changes in your teen. These changes might include a drop in performance at school, athletics, or an after-school job. It could involve them engaging in reckless behavior, such as driving dangerously or misusing substances. They may also experience more irritability and stop putting as much effort into their appearance. 

Some teens with depression may have physical symptoms, such as digestive challenges, headaches, cramping, or pain. Anxiety can accompany these symptoms, which may cause a racing heart, high blood pressure, or hyperventilation. 

If you think your teenager is depressed, watch for any changes in their normal behavior and consider helping them reach out to a professional. 

What causes depression in teens?

The causes of depression in teens are the same as for adults. Depression is often considered a genetic connection, so a family history of depression can put teens at a 40% to 50% risk of depression, as well. If a teenager has a predisposition to depression and experiences a traumatic event, it could cause them to have an increased risk of depression. Traumatic events for teens could include bullying, abuse, losing a loved one, or unhealthy relationships, among others. 

If you are facing or witnessing abuse of any kind, the National Domestic Violence Hotline is available 24/7 for support. Call 1-800-799-SAFE (7233) or text "START" to 88788. You can also use the online chat.

If you're a teen or child experiencing or witnessing abuse of any kind from a family member or caregiver, reach out to the Child Help Hotline at 1-800-422-4453 or use the online chat feature.

Differences between teen and adult depression

While many causes of depression are the same between teens and adults, a few challenges impact teens differently. 

Social media and cyberbullying 

The use of social media in recent years has made it easier for teenagers to communicate with their peers but has also connected them with content advertised to adults. In addition, bullying is not confined to physical locations, as cyberbullying is often common in teen circles. Cyberbullying removes a teen's option to escape the treatment and can make rumors spread easier throughout school populations.

Social media also allows teens to compare themselves with others. This comparison can cause some teens to attempt to be someone they're not or to experience low self-esteem, leading to thoughts of inadequacy and worthlessness. Therapy may be a valuable resource for those going through these challenges. 

Generational differences 

Some people believe younger generations struggle with mood because they aren't taught how to cope with failure. They may be moved forward in school even if they aren't performing well and may receive rewards because other students have. Although it can be essential to include children in their social groups, it may not always relate to adult life, and their future expectations could be warped. 

Note that a child being included and not experiencing failure is not necessarily a risk factor for depression. However, as teens leave high school and enter college, they may face new challenges that could cause the onset of depression in late adolescence. 

How to treat depression in teens

Teens often have several options for treatment available to them, including options for low-income families. Some high schools and colleges offer free counseling for their students or discounted pricing. In addition, families may take part in family therapy to avoid paying for multiple sessions. Other depression treatment options include therapy, lifestyle changes, medication, and support groups. When treatment is started young, children may have a higher chance of recovery. 

Therapy  

Over 400 modalities of therapy exist, offering a wide range of options to families. However, one of the most recommended treatment modalities for teens with depression is cognitive-behavioral therapy (CBT). CBT teaches clients about the connections between thoughts, emotions, and behaviors. In session, they can learn techniques like mindfulness and meditation to reframe self-beliefs and find healthy coping strategies for depression. 

Therapists specializing in adolescent psychiatry can equip teens with coping skills and give them techniques to improve their mood. They can also assess whether your teen may benefit from an entire treatment team comprising a psychiatrist, doctor, and case manager. These resources can be helpful for those taking medication and attending therapy.  

Lifestyle changes 

Initial management plans created by a teen's therapist may focus on their lifestyle and habits. As teens age, they get more freedom of choice. For this reason, therapists and parents often benefit from teaching teens lifestyle adjustments that may help them as adults, such as self-care. Self-care can include maintaining a healthy diet, getting rest, and exercising. However, it can also include fun activities like journaling, meditation, or hobbies. 

Medication 

In some cases, teens may meet with a psychiatrist or doctor to discuss antidepressants. While some people don't like the idea of taking antidepressant medications, it can be an effective treatment while going through therapy to offset symptoms while the teen learns new skills. Medication does not need to be a permanent, ongoing management solution for depression. Consult a doctor, like a psychiatrist, before starting, stopping, or changing any medication. 

Support groups 

Teens often believe they are alone in their challenges, potentially due to bullying, a lack of peer representation, or difficulty finding mental health support in their social environments. In these cases, they may benefit from a support group with other teens living with mental illness. These support groups can be a place for them to make friends and see they're not alone.

Support options 

If you're a parent of a teen with depression seeking support, finding time for in-person therapy can sometimes be challenging. Both parents and teens can become stressed by busy schedules or financial instability, which may reduce one's chances of finding affordable and convenient care. In these cases, online therapy through a platform like BetterHelp for adults or TeenCounseling for teens aged 13 to 19 may be effective.

Online platforms allow clients to receive support from home or anywhere with an internet connection. Being a parent can be busy, but online therapy allows you to seek comfortable, cost-effective care. Through some platforms, clients can choose between phone, video, or live chat sessions and utilize features like group therapy.

For those living with depression, online therapy is often effective. In one study, researchers found that a multimodal digital psychotherapy intervention aimed at those with depression significantly reduced their symptom severity. These results were more pronounced for those who had never gone to therapy in the past.