Overview

Teen depression is a serious mental health problem that causes a persistent feeling of sadness and loss of interest in activities. It affects how your teenager thinks, feels and behaves, and it can cause emotional, functional and physical problems. Although depression can occur at any time in life, symptoms may be different between teens and adults.

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 symptom of depression.

Teen depression isn't a weakness or something that can be overcome with willpower — it can have serious consequences and requires long-term treatment. For most teens, depression symptoms ease with treatment such as medication and psychological counseling.

Symptoms

Teen depression signs and symptoms include a change from the teenager's previous attitude and behavior that can cause significant distress and problems at school or home, in social activities, or in other areas of life.

Depression symptoms can vary in severity, but changes in your teen's emotions and behavior may include the examples below.

Emotional changes

Be alert for emotional changes, such as:

  • Feelings of sadness, which can include crying spells for no apparent reason
  • Frustration or feelings of anger, even over small matters
  • Feeling hopeless or empty
  • Irritable or annoyed mood
  • Loss of interest or pleasure in usual activities
  • Loss of interest in, or conflict with, family and friends
  • Low self-esteem
  • Feelings of worthlessness or guilt
  • Fixation on past failures or exaggerated self-blame or self-criticism
  • Extreme sensitivity to rejection or failure, and the need for excessive reassurance
  • Trouble thinking, concentrating, making decisions and remembering things
  • Ongoing sense that life and the future are grim and bleak
  • Frequent thoughts of death, dying or suicide

Behavioral changes

Watch for changes in behavior, such as:

  • Tiredness and loss of energy
  • Insomnia or sleeping too much
  • Changes in appetite — decreased appetite and weight loss, or increased cravings for food and weight gain
  • Use of alcohol or drugs
  • Agitation or restlessness — for example, pacing, hand-wringing or an inability to sit still
  • Slowed thinking, speaking or body movements
  • Frequent complaints of unexplained body aches and headaches, which may include frequent visits to the school nurse
  • Social isolation
  • Poor school performance or frequent absences from school
  • Less attention to personal hygiene or appearance
  • Angry outbursts, disruptive or risky behavior, or other acting-out behaviors
  • Self-harm — for example, cutting, burning, or excessive piercing or tattooing
  • Making a suicide plan or a suicide attempt

What's normal and what's not

It can be difficult to tell the difference between 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 managing challenging feelings, or if life seems overwhelming.

When to see a doctor

If depression signs and symptoms continue, begin to interfere in your teen's life, or cause you to have concerns about suicide or your teen's safety, 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 recommend someone.

Depression symptoms likely won't get better on their own — and they may get worse or lead to other problems if untreated. Depressed teenagers 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 provider such as your doctor or school nurse. Share your concerns with a parent, a close friend, a spiritual leader, a teacher or someone else you trust.

When to get emergency help

Suicide is often associated with depression. If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.

Also consider these options if you're having suicidal thoughts:

  • Call your mental health professional.
  • Call a suicide hotline. In the U.S., call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) or use its webchat on suicidepreventionlifeline.org/chat.
  • Seek help from your primary care doctor or other health care provider.
  • Reach out to a close friend or loved one.
  • Contact a minister, spiritual leader or someone else in your faith community.

If a loved one or friend is in danger of attempting suicide or has made an attempt:

  • Make sure someone stays with that person.
  • Call 911 or your local emergency number immediately.
  • Or, if you can do so safely, take the person to the nearest hospital emergency room.

Never ignore comments or concerns about suicide. Always take action to get help.

Causes

It's not known exactly what causes depression, but a variety of issues may be involved. These include:

  • Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that carry signals to other parts of your brain and body. When these chemicals are abnormal or impaired, the function of nerve receptors and nerve systems changes, leading to depression.
  • Hormones. Changes in the body's balance of hormones may be involved in causing or triggering depression.
  • Inherited traits. Depression is more common in people whose blood relatives — such as a parent or grandparent — also have the condition.
  • Early childhood trauma. Traumatic events during childhood, such as physical or emotional abuse, or loss of a parent, may cause changes in the brain that make a person more susceptible to depression.
  • Learned patterns of negative thinking. Teen depression may be linked to learning to feel helpless — rather than learning to feel capable of finding solutions for life's challenges.

Risk factors

Many factors increase the risk of developing or triggering teen depression, including:

  • Having issues that negatively impact self-esteem, such as obesity, peer problems, long-term bullying or academic problems
  • Having been the victim or witness of violence, such as physical or sexual abuse
  • Having other mental health conditions, such as bipolar disorder, an anxiety disorder, a personality disorder, anorexia or bulimia
  • Having a learning disability or attention-deficit/hyperactivity disorder (ADHD)
  • Having ongoing pain or a chronic physical illness such as cancer, diabetes or asthma
  • Having certain personality traits, such as low self-esteem or being overly dependent, self-critical or pessimistic
  • Abusing alcohol, nicotine or other drugs
  • Being gay, lesbian, bisexual or transgender in an unsupportive environment

Family history and issues with family or others may also increase your teenager's risk of depression, such as:

  • Having a parent, grandparent or other blood relative with depression, bipolar disorder or alcohol use problems
  • Having a family member who died by suicide
  • Having a dysfunctional family and family conflict
  • Having experienced recent stressful life events, such as parental divorce, parental military service or the death of a loved one

Complications

Untreated depression can result in emotional, behavioral and health problems that affect every area of your teenager's life. Complications related to teen depression may include, for example:

  • Alcohol and drug misuse
  • Academic problems
  • Family conflicts and relationship difficulties
  • Involvement with the juvenile justice system
  • Suicide attempts or suicide

Prevention

There's no sure way to prevent depression. However, these strategies may help. Encourage your teenager to:

  • Take steps to control stress, increase resilience and boost self-esteem to help handle issues when they arise
  • Reach out for friendship and social support, especially in times of crisis
  • Get treatment at the earliest sign of a problem to help prevent depression from worsening
  • Maintain ongoing treatment, if recommended, even after symptoms let up, to help prevent a relapse of depression symptoms

Teen depression care at Mayo Clinic

Nov. 16, 2018
References
  1. Depressive disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://dsm.psychiatryonline.org. Accessed Aug. 20, 2018.
  2. Brown AY. Allscripts EPSi. Mayo Clinic, Rochester, Minn. July 7, 2018.
  3. Teen depression. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/teen-depression/index.shtml. Accessed Aug. 20, 2018.
  4. Depression in children and teens. American Academy of Child and Adolescent Psychiatry. https://www.aacap.org/aacap/Families_and_Youth/Facts_for_Families/FFF-Guide/The-Depressed-Child-004.aspx. Accessed Aug. 20, 2018.
  5. Psychotherapy for children and adolescents: Different types. American Academy of Child and Adolescent Psychiatry. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Psychotherapies-For-Children-And-Adolescents-086.aspx. Accessed Aug. 20, 2018.
  6. Psychiatric medications for children and adolescents: Part I ― How medications are used. American Academy of Child and Adolescent Psychiatry. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Psychiatric-Medication-For-Children-And-Adolescents-Part-I-How-Medications-Are-Used-021.aspx. Accessed Aug. 20, 2018.
  7. Psychiatric medications for children and adolescents: Part II ― Types of medications. American Academy of Child and Adolescent Psychiatry. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Psychiatric-Medication-For-Children-And-Adolescents-Part-II-Types-Of-Medications-029.aspx. Accessed Aug. 20, 2018.
  8. Depression. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/depression/index.shtml. Accessed Aug. 20, 2018.
  9. A family guide: What families need to know about adolescent depression. National Alliance on Mental Illness. https://www.nami.org/Press-Media/Press-Releases/2010/NAMI-Releases-Family-Guide-on-Adolescent-Depressio. Accessed Aug. 20, 2018.
  10. Bonin L, et al. Overview of prevention and treatment for pediatric depression. https://www.uptodate.com/contents/search. Accessed Aug. 20, 2018.
  11. Moreland CS, et al. Pediatric unipolar depression and pharmacotherapy: Choosing a medication. https://www.uptodate.com/contents/search. Accessed Aug. 20, 2018.
  12. Payne J. Psychopharmacology in pregnancy and breastfeeding. Psychiatric Clinics of North America. 2017;40:217.
  13. Zuckerbrot RA, et al. Guidelines for adolescent depression in primary care (GLAD-PC): Part I. Practice preparation, identification, assessment, and initial management. Pediatrics. 2018;141:e20174081.
  14. Cheung AH, et al. Guidelines for adolescent depression in primary care (GLAD-PC): Part II. Treatment and ongoing management. Pediatrics. 2018;141:e20174082.
  15. Haefner J. Complementary and integrative health practices for depression. Journal of Psychosocial Nursing and Mental Health Services. 2017;55:22.
  16. Rentala S, et al. Effectiveness of body-mind-spirit intervention on well-being, functional impairment and quality of life among depressed patients — A randomized controlled trial. Journal of Advanced Nursing. 2015;71:2153.
  17. Depression and complementary health approaches: What the science says. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/providers/digest/depression-science. Accessed Aug. 21, 2018.
  18. Stress and relaxation techniques: What the science says. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/providers/digest/relaxation-science. Accessed Aug. 21, 2018.
  19. Resilience guide for parents and teachers. American Psychological Association. http://www.apa.org/helpcenter/resilience.aspx. Accessed Sept. 11, 2018.
  20. Research report: Psychiatry and Psychology, 2016-2017. Mayo Clinic. https://www.mayo.edu/pmts/mc0700-mc0799/mc0710-11.pdf. Accessed Aug. 20, 2018.
  21. Centers of Excellence ― Mayo Clinic. National Network of Depression Centers. https://nndc.org/nndc-members/mayo-clinic/. Accessed Aug. 21, 2018.
  22. Get help. National Suicide Prevention Lifeline. https://suicidepreventionlifeline.org/chat/. Accessed Aug. 22, 2018.
  23. Bipolar and related disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://dsm.psychiatryonline.org. Accessed Sept. 11, 2018.
  24. Haynes PL, et al. Social rhythm therapies for mood disorders: An update. Current Psychiatry Reports. 2016;18:75.
  25. Frequently asked questions about pharmacogenomics. National Human Genome Research Institute. https://www.genome.gov/27530645/faq-about-pharmacogenomics/. Accessed Sept. 11, 2018.
  26. Peer support. Depression and Bipolar Support Alliance. https://secure2.convio.net/dabsa/site/SPageServer/?NONCE_TOKEN=F069DACE5CB2AF6445470F0879999D18&pagename=peer_landing. Accessed Sept. 11, 2018.
  27. Neavin DR, et al. Treatment of major depressive disorder in pediatric populations. Diseases. 2018;6:48.
  28. Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 25, 2018.
  29. McKean AJ (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 25, 2018.