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Reviewed by the Faculty of Harvard Medical School

Adolescent Depression

Being a teen-ager means having lots of emotional "ups and downs." During these years, some difficult experiences may lead to a feeling of sadness in your adolescent. Typical examples include break-ups with boyfriends or girlfriends, arguments with friends, disagreements or tension with parents, and failure or problems in school. Indeed, since a major goal of all teens is to define their own identities by distancing themselves from family and taking on more adult responsibilities, there is an underlying sadness for both parents and adolescents.

While it is normal for adolescents to feel sad at various times during this developmental period, in some cases a teen's sadness goes beyond normal "blues" and turns into a problem — clinical depression. This happens when the sadness is severe, lasts for more than a few days, or makes it very hard for an adolescent to function at home, school, work or play. Adolescents who are depressed tend to do poorly at school, have a hard time with friendships and other relationships, act out aggressively, and show low self-esteem. In addition, depressed teens often use alcohol and other drugs to try to feel better. These teens only end up more depressed and are at high risk of all the dangers of alcohol and drug use. Most importantly, these teens, especially those that use alcohol or drugs at the same time, are at extremely high risk of trying to harm themselves (attempting suicide).

Depression is a very common problem in the adolescent years. Out of every 100 adolescents, five or six will be diagnosed with depression at some point during this period in their lives. Females are twice as likely as males to become clinically depressed. Teens who grow up in a household where someone suffers from depression (or another mood disorder) are more likely to develop depression themselves.

While for most teens depression follows a traumatic life event like the loss of a parent or other loved one, the break-up of a relationship, or a serious injury, there sometimes is no clear event that seems to have led to their sadness. Many adolescents recover completely from depression and do not go on to have problems with depression as adults. Unfortunately, others will be depressed again and go on to have other mood problems as they get older.

Although it can be challenging to figure out whether a teen has become too sad to be considered normal, it is important to identify possible depression and to then help a depressed teen deal with her sad mood. Doctors use the following symptoms to diagnose depression in adolescents:

  • Depressed mood or irritability (being extra-sensitive)
  • Decreased interest or pleasure in all or most activities
  • Weight change (up or down) or appetite disturbance (increase or decrease)
  • Insomnia (not able to sleep) or hypersomnia (sleeping too much)
  • Difficulty with psychomotor tasks (doing things very slowly)
  • Fatigue (tiredness) or lack of energy
  • Feeling worthless
  • Difficulty concentrating, thinking or making decisions

Parents should watch for warning signs that may signal that an adolescent's sadness has gone beyond the normal "blues." These include, but are not limited to:

  • Sudden behavior changes
  • Anger, agitation or irritability
  • Risk-taking
  • Giving away prized possessions
  • Withdrawal from social groups
  • Huge changes in dress and appearance
  • Constant boredom
  • Extreme sensitivity to being rejected or failing at something
  • Frequent complaints of physical symptoms (for example, stomachaches, headaches, sore throat) without a clear physical cause
  • Missing lots of school
  • Trying to run away from home
  • Having a hard time paying attention and concentrating

If you notice these or other concerning changes in your teen, it is best to seek medical attention as soon as possible. Call your teen's pediatrician first. The pediatrician can do a basic evaluation of your teen's mental health, and decide if she should speak with a mental-health specialist. If your teen ever expresses suicidal thoughts or feelings, TAKE IT SERIOUSLY AND SEE A PHYSICIAN IMMEDIATELY.

Last updated March 11, 2008