Depression Questions

1. What are the leading causes of depression in teenagers?

There is no one cause of depression in teenagers. Some of the issues that are suggested to play
a role are biological chemistry, hormones, inherited traits, early childhood trauma and
environmental factors (such as learned patterns of negative thinking, etc). Biological chemistry
refers to specific neurotransmitters in the train. Sometimes these are impaired or abnormal, or
the nerve receptors or systems are not working as they should be. This can lead to depression.
Similarly, changes in hormones occur often when people are teenagers. These changes could
lead to depressive symptoms. Depression is more common in people who have close blood
relatives that have depression or other mood and anxiety disorders. Further, traumatic events
in childhood has been suggested to potentially cause changes in the brain that could make
someone more susceptible to depression. In addition to the biological components, teens learn
from their parents and other caregivers around them how to cope with challenging situations
and how to interpret an event. When parents model negative thinking, and learned
helplessness, children can learn this as well. Practicing this type of thinking for years can make
someone more susceptible to depression when they are a teenager.

2. What are the differences between depression in teens and depression in adults?
Depression looks different in teenagers and adults. For example, teenagers who are depressed typically
present as angry or irritable in comparison to adults who may display sadness. In addition, teens
typically complain of physical ailments, such as their head hurting, or a stomach ache. Obviously, one
would want to conduct a medical examination to rule out any other causes, but it could be determined
as part of depression. Depressed teens also may be incredibly sensitive to criticism, rejection and failure.
Teenagers who are depressed might also tend to withdraw from some people, and not all. They may
even resort to a different crowd of teens. Adults tend to isolate themselves in general.

3. How common is depression in teens?

According to the NIMH, in 2015, approximately 3 million adolescents (ages 12-17) in the US had
at least one major depressive episode in the past year. That is approximately 12.5% of the
population. For more information about this statistic you can visit:
https://www.nimh.nih.gov/health/statistics/prevalence/major-depression-among-adolescents.
shtml

4. Is there a difference between depression in teenage girls and teenage boys?

Yes, girls are more than twice as likely as boys to be diagnosed with a mood disorder by the age
of 15. According to WebMD, one in 10 girls are depressed. In one study, ​depression among girls
was found to have caused stronger feelings of guilt, self-blame, failure, and even negative body
image. Teen girls are also more susceptible to health problems as a result of depression than
boys. Girls suffering from depression may withdraw from family and friends, cry frequently,
suffer from low self-esteem, feel hopeless about the future, and show changes in sleeping
patterns. For boys with depression, some symptoms differ. Depressed boys show higher rates
of depressed morning mood and morning fatigue. Instead of withdrawing, teenage boys may
exhibit overt physical and emotional changes. “Teenage males tend to act out and get in
trouble or may appear more irritable,” explains adolescent expert Mike Dow, PsyD.
https://highfocuscenters.pyramidhealthcarepa.com/how-to-recognize-depression-symptom-dif
ferences-in-teen-boys-and-girls/

5. How does the teenage mind/brain work during depression? ​During adolescence, the brain
goes through several changes. During early- and mid-adolescence, the brain undergoes
considerable ​neural​ growth and pruning which create changes of connectivity within and
between various brain regions. This transition is riddled with many potential minefields and
booby traps for most teenagers. Teenage brain structure, connectivity, and behavior are all
intertwined. The most widely studied changes in the teenage brain take place in the prefrontal
cortex, which is the area behind the forehead and associated with planning, problem-solving,
and other 'executive functions.' Teenage stress appears to raise cortisol and lower dopamine
levels in the brain, both of which may contribute to changes in mood and depression. There are
several changes that may occur during depression and there does not appear to be one root
cause. The following article provides a thorough summary:
https://www.psychologytoday.com/blog/the-athletes-way/201312/why-is-the-teen-brain-so-v
ulnerable

6. What are the treatments used for depression in teens?

"Talk therapy": Cognitive Behavioral Therapy (CBT) and Interpersonal Therapy (IPT) have been
found to be effective for treating depression in teenagers. Treatment can be provided in
individual, group, and family formats.
Medication management: antidepressants, such as ​ Serotonin Specific Reuptake Inhibitors
(SSRIs) (e.g. Prozac, Zoloft) helps the brain correct the functioning of its emotional control
circuits.
Maintaining a regular routine, including regular bedtime, healthy diet, exercise, and scheduled
activity for fun activities, is important for teens with depression. Having a regular routine is
emphasized in CBT treatment.
School supports: Adaptations in school can assist a student in coping with and managing his or
her symptoms. For example, a student can receive individual or group counseling as part of
their Individualized Education Program. They can receive extra time on tests and take tests in
separate rooms if they are having difficulty concentrating.
Community supports: Community supports can include peer support groups for teenagers with
depression and for families.

7. Which treatment is found to be the most successful in teens?

Depending on the severity of the symptoms, a combination of therapy and medication is
usually the best approach. There are several kinds of psychotherapy (“talk therapy”) that can
help teens who are depressed. Cognitive behavioral therapy (CBT) and Dialectical Behavioral
Therapy (DBT) have been found to be particularly successful in treating symptoms of
depression. Through therapy, teens can learn how to change their negative thinking patterns
and behaviors and learn healthy coping skills to reduce symptoms of depression. In addition,
antidepressant medications, such as Lexapro and Prozac, are often prescribed by psychiatrists
to help treat severe symptoms of depression.

8. Is depression in teenagers increasing? If yes, why?

Yes, according to recent studies, teen depression is on the rise, particularly for girls. Between
2005 and 2015, there was a 37% increase in the number of teens who reported having a
depressive episode (this article describes the study
http://time.com/4572593/increase-depression-teens-teenage-mental-health/​). The exact cause
of this trend is unclear. While greater awareness and diagnosis of depression may partially
account for the increase, researchers believe that the ubiquity of technology (e.g. smart
phones) is also to blame. For example, social media use has been linked to low self-esteem,
depressed mood, and feelings of loneliness. Girls are particularly vulnerable to cyberbullying.
Unrealistic images of beauty as well as constant bombardment of news can also trigger feelings
of anxiety and depression. Here's an article that discusses the effects of social media on
adolescents:
https://www.npr.org/sections/health-shots/2017/02/13/514353285/depression-strikes-todays-
teen-girls-especially-hard.

9. What aspects of a teenager's life does depression effect?

Depression can affect many areas of a teen’s life, including their mood, self-esteem,
relationships with friends and family, school work, and hobbies. Teens who are depressed often
feel sad, hopeless, irritable, or lonely. They may have thoughts about wanting to hurt or kill
themselves. Often, they isolate themselves, withdrawing from friends, family, school, and other
activities. They might report that activities that they used to enjoy, such as playing sports,
listening to video games, or hanging out with their friends are no longer fun. Many teens who
are depressed report feeling like they have no energy or experience aches and pains in their
body. Another common symptom is difficulty concentrating or making decisions. Together,
these symptoms may result in teens not performing as well in school as they had before they
became depressed. It’s also very common for depressed teens to have difficulty sleeping; some
teens sleep too much and cannot get themselves out of bed in the morning, while others have
trouble falling asleep. Similarly, some people who are depressed find that their appetite
increases, while others have no appetite, leading to changes in weight. Finally, some teens
engage in risky behavior to cope with their depressed feelings, such as drinking alcohol or using
drugs.

10. What are the first symptoms of a depressed teenager?

The first symptom to notice for a depressed teen is withdrawal symptoms; the teen may stop
doing things he or she usually enjoys. In addition, other symptoms to notice include changes in
mood, such as sadness or irritability, and changes in behavior, including appetite, energy level,
sleep patterns and academic performance.
https://childmind.org/article/what-are-the-symptoms-of-depression-in-teenagers/

11. Do you think teenagers don’t know enough about depression to know if they have it?
Teenagers may not know enough about depression, making it difficult to know if they are
experience an episode. Adults may expect teens to act moody. In addition, teens may have
trouble understanding and expressing their feelings well. They may therefore not be aware of
their symptoms, as well as not be aware that their symptoms are symptoms of depression.
http://www.mentalhealthamerica.net/conditions/depression-teens

12. Do teenagers commonly tell an adult if they think they have depression? If no, what do
you think is holding them back from telling an adult?
Teenagers likely do not commonly tell adults if they have depression. This is likely the case for a number
of reasons:

1. They may not be aware they are experiencing a depressive episode

2. The teen may also be experiencing anxiety, and the teen may think that telling a parent or
asking for their help will be shaming.
3. They might think that parents are not able to help them.
4. Teenagers do not want to feel patronized, and they may believe that parents or other adults will
patronize them.

13. Are there stages of depression? If yes, what are they?

There are no “stages” of depression, per se, although depression can start off as mild and
become worse over time, especially if left untreated. Different people experience different
symptoms and to different degrees of severity. It’s important to seek treatment as soon as you
start experiencing symptoms of depression.

14. What can make depression in teenagers worse?

Risk ​factors that can trigger or exacerbate teen depression include:
Serious illness, chronic pain, or ​physical disability
Having other mental health conditions, such as anxiety, an eating disorder, ​learning
disorder​, or ADHD
Alcohol​ or drug abuse
Academic or family problems
Bullying
Trauma from violence or abuse
Recent stressful life experiences, such as ​parental divorce​ or the death of a loved one
Coping with your sexual identity in an unsupportive environment
Loneliness and lack of social support