Sadness, frustration, anger and boredom are part of a normal array of emotions at any stage of life. However, these feelings can become overwhelming. If they are interfering with day-to-day life, causing significant distress and not going away, they may signal depression. Adolescent depression is a mental illness that affects teenagers. Depressed mood, behaviour and ability to function occur in episodes and may last weeks to month. An untreated episode of major depression in a teenage lasts on average seven to nine months, perhaps even as long as two years and may repeat.

What causes it?

Significant psychological turmoil affects about two of every ten teenagers aged 13 to 19.

Adolescent depression may be brought on by stress at home, school, work, or at extracurricular activities. Depression has a genetic link. Teens who have blood relatives diagnosed with depression are more likely to develop it. Those already diagnosed with anxiety, Attention Deficit Hyperactivity Disorder (ADHD), learning disability or chronic debilitating illness are more at risk. So are teens living in a dysfunctional home environment, experiencing physical, emotional or sexual abuse.

How many teenagers suffer from depression?

According to recent research, significant psychological turmoil affects about two of every ten teenagers ages 13 to 19. Previously we thought that emotional instability in adolescence was a natural stage in behaviour development. However, today we know that around 20 per cent of teens experience a major depressive disorder. Twice as many girls experience depression as boys. This trend continues into adulthood. Many researchers believe that adults diagnosed with depression may have had first signs and symptoms in their teenage years.

How can I tell if someone I know is depressed?

To diagnose depression in adolescents, doctors look for clues. Symptoms will fit set criteria of a major depressive episode. Depressed and irritable mood or loss of interest and pleasure must be one of the symptoms. This should be present most of the day, nearly every day, for at least two weeks. Other symptoms may appear at the same time. Someone with depression might experience the following symptoms:

Negative thoughts and feelings

Depressed mood most of the time
Temper, feeling annoyed by everything and everyone
Low self-esteem
Feeling sad and worthless
Thoughts or a plan of suicide
Obsessive thoughts of death
Excessive worrying

Decline in day-to-day function

Trouble sleeping or excessive sleep
Feeling tired and unmotivated almost all of the time
Trouble with concentration
Difficulty making decisions
Decline in usual school performance – dropping grades
Loss of interest in favourite activities – quitting teams or regular extracurricular activities
Overeating or loss of interest in food
Unintended weight gain or loss

Negative behaviour

Sudden irresponsibility
Difficulty in relationships with parents and peers – picking fights, outbursts of anger with little cause
Unusual acting-out – missing curfews, skipping school, disrespecting authority
Risky or criminal behaviour – shoplifting, associating with gangs
Risky sexual behaviour – having sex with many partners without using a condom or birth control
Smoking cigarettes
Using illegal drugs and alcohol

I think that I may be depressed.

Now what?

If you think you are depressed, see your medical doctor. Symptoms of depression can also indicate other illnesses, such as thyroid dysfunction, vitamin B12 deficiency, mononucleosis, HIV infection, post-concussive syndrome or lupus. If your doctor suspects illness is causing your symptoms, blood tests can make the diagnosis. However, no blood test can confirm depression. A medical professional can tell the difference between illness and depression and treat you appropriately.

Depending on your particular case, treatment may include:

counselling
interpersonal psychotherapy, where you learn how your depression influences and is affected by relationships with others
cognitive-behavioural therapy, where you learn how your thoughts can affect your depression, and how to change problematic ways of thinking
family or group therapy
medication
frequent visits with your doctor to monitor progress.

If you have life threatening complications such as a strong urge to commit suicide, a failed suicide attempt or severe mental distress despite treatment, you may need to go to hospital.

Your parents or guardians usually play an important part in diagnosis and treatment, as they are your main support system. Medical professionals encourage family to get involved whenever possible. Their involvement may improve your chance of recovery.

Chances are that your family doctor will be the one to diagnose depression. At this time, you will get advice on the best combination of treatment, which may include a referral to a psychiatrist, psychologist, therapist or a counsellor. Major depression can also be a part of a different mental illness, such as bipolar mood disorder or schizophrenia. These conditions may require additional medication and referrals to a specialist.

If this is your first episode of major depression, treatment may last anywhere from nine to 12 months. Unfortunately, even with medical help you have a high chance of experiencing another episode within the next five years.

Why treat depression?

Only a fraction of teenagers who experience symptoms of depression are identified and given proper help. It can be very difficult for parents and peers to recognize subtle clues of depression. The stigma around mental illness may stop teens from recognizing the problem and getting help.

However, ignoring depression has the potential to affect your whole life. Academic failure, social withdrawal, failed relationships, addiction to various substances, criminal convictions and permanent injury or death can all be linked to untreated depression.

Many teens and their families actually feel relief after diagnosis. Their symptoms have an explanation, and they are not alone in their illness and the journey back to good mental health.

A variety of mental health resources are available on the internet. The American Academy of Child and Adolescent Psychiatry website (www.aacap.org) is one reliable source for anyone wanting to know more. As with any problem, getting the information you need can make your experience easier.

The bottom line about adolescent depression

Teens with depression suffer greatly, sometimes silently. Often they are without proper medical help. In extreme cases, depression can be a death sentence. Although there are no quick fixes, many treatment options are available for this chronic disease. Help is only a doctor’s visit away. If you see symptoms of depression, please don’t wait. The price of ignoring or missing depression in a teen is just too great.

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What is adolescent depression?