Here’s how to know if the problem is more than just moodiness.
You have a teenager who sleeps until noon, spends most of his time in his room, and barely speaks (except when he’s snapping at you). After a few weeks of this, you start to wonder: Is he just being a teenager, or could he be depressed?
If you’ve read the statistics, you know how common teen depression is: In 2014 approximately 11.4 percent of 12- to 17-year-olds (that’s 2.8 million) experienced at least one major episode of depression, according to the National Institute on Mental Health. Depression and bipolar disorders are the third most common mental health diagnosis in kids 18 and under, according to the Child Mind Institute.
But how do you know when to worry—and whether your child needs help? “It’s perfectly normal for teenagers to be moody and irritable, and not all moody teens are depressed,” says Stephanie Dowd, Psy.D., clinical psychologist in the Anxiety and Mood Disorders Center at the Child Mind Institute in New York City. “But there are some specific symptoms that could be red flags.” Here are eight to watch for:
Your child is down or moody more often than he’s not.
The general standard Dowd and other experts apply is that the teen is sad, irritable, or both for most of the day on most days of the week for at least two weeks or longer. Her inclusion of irritability in addition to sadness is crucial. Many adults expect depressed teens to feel down and lack energy—and that does happen. “But it’s also common for depression to be exhibited in an irritable mood,” Dowd says. “Kids are really on edge, they’re grumpy, and it doesn’t take much for them to be set off.”
Your child has lost interest in things she normally loves to do.
Maybe she no longer wants to play guitar or soccer. The clinical name for this is anhedonia and it’s a warning sign, Dowd says.
Your child withdraws from people.
He doesn’t want to hang out with friends and family—even those he would normally find interesting or fun to be with.
Your child’s feelings are starting to have a major effect on his life.
“Grades may go down, he may be getting into more arguments than usual, his relationships may be falling apart,” says Dowd. “His life is being affected in a significant, consistent way.”
Your child’s eating or sleeping habits change.
Your teen might be more or less hungry—and it has nothing to do with trying to lose weight. She may have more trouble falling or staying asleep than before. Or she may be very tired and have very little energy and low motivation no matter how much she sleeps.
Your child does not feel good about himself.
“He feels worthless or hopeless and guilty about things that are not his fault,” says Dowd.
Your child is engaging in high-risk behavior.
Think substance abuse or promiscuous sex. “It’s normal to experiment with drugs, drinking, and sex at this age,” Dowd says. “But if there’s a stark change in your teen’s behavior or it’s done in an extreme way, particularly with an attitude indicating that she doesn’t care about life, that’s a red flag that should be paid attention to.”
Your child expresses thoughts about harming himself.
This is a very serious warning that your child needs to be evaluated by a qualified mental health expert immediately, Dowd says.
What should you do if your child shows any of these signs? Here’s Dowd’s advice:
- Talk to your teen. “It’s fairly common for teenagers to shut down and not want to talk, even if they aren’t depressed,” she says, “so it’s important for parents to be creative in finding an environment and situation when the teen will open up.” She suggests talking on a car ride or when you’re doing an activity together, like throwing a baseball around or playing video games. “If you can get kids out of the house or out of the bedroom, they may feel freer to talk.” How to start the conversation? “Honey, it seems as though you’ve been really down lately. You’ve been sleeping a lot, and you haven’t wanted to play soccer as much. I’m wondering if you’re feeling sad. Is that true?”
- Just listen. Be supportive, don’t lecture, and make it clear you’re not judging or placing blame. Say, “I just want to listen, and if there’s anything you want to share with me I’m all ears.”
- Don’t try to fix the problem. If your teen says, “Yeah, Simon and I haven’t hung out lately,” for example, don’t say, “Why don’t you give him a call?” Instead, validate what your child is saying: “Wow, I can imagine that must be difficult for you.” Then keep the conversation going: “How are you feeling in general?”
- Suggest therapy. You can say, “I can tell you’re having a hard time, and I have some ideas for things that could help. I think we should see a therapist.” If your child resists, ask why she’s resisting and ask her think it over: “I want you to know that I hear you and I want to help. You can come to me when you’re ready.” Keep the door open and allow your child to make the decision. (The exception: If your teen is having thoughts of suicide or engaging in high-risk behavior, it’s time to be more firm: “You don’t have a choice. We have to see a therapist.”)
- Offer options. After asking your pediatrician and family friends for recommendations and doing your own research about licensed mental health professionals in your area, come up with two or three names. Then, once your child has agreed to see a therapist, present the options and say, “I’d like you to meet with these specialists to see which one you fit with best.” It’s important for teens to have a voice in who they’re seeing, Dr. Dowd says: “It should be a good fit and a trusting relationship.”
- Know what to expect. The professional will do a thorough evaluation of your child and suggest a course of treatment. Research shows that certain types of therapy tend to be most effective in treating teens: cognitive behavioral therapy (CBT), behavioral activation, dialectical behavior therapy (DBT), and interpersonal psychotherapy. For mild or moderate depression, therapy alone has been found to be effective. For moderate to severe depression, therapy plus medication works best. Find more information about getting the right care for your child here.