So it seems that more and more, I am seeing adolescents in clinic who are suffering from a pervasive mood disturbance that is affecting their everyday life. But what makes a mood disturbance more than just something passing and when should you be seeking help for your child/adolescent around this?
Everyone suffers from ups and downs, and our mood each day can be affected by many things, what we’ve been eating and drinking, how much sleep we’ve had, our personal relationships and recent interactions with family and friends and even sometimes the weather.
Depression however is more than just an everyday fluctuation in mood or a transient feeling of being sad. It is not something that someone can just “snap out of.” It has other symptoms affecting emotions, cognition, motivations and even our physical state of wellbeing and if left untreated can have serious long-term consequences for that person’s life. It is often accompanied or precipitated by high levels of stress or anxiety and in the worst case scenarios, suicide.
Depression in teens can look different to the way it appears in adults, however it is no different in a medical sense from adult depression. It is around three times more common in teenage girls than in adolescent boys and can often be very difficult for parents to distinguish from the typical feelings of puberty and teenage adjustment. In clinical terms, if your child/teenager is suffering from 5 or more of these symptoms, most or all days for a minimum period of 2 weeks, then they could be suffering from depression.
Depression in teenagers
- The feeling of being extremely down or depressed; or big swings in mood; appearing irritable a lot of the time or having temper outbursts
- A loss of interest and pleasure in most or all activities (anhedonia) including socially withdrawing from friends or extra-curricular activities.
- Significant weight gain/loss or changes in appetite
- Major changes in sleeping habits (insomnia or sleeping too much)
- Physical agitation and being unable to sit still (although in some people the opposite happens)
- Fatigue and low energy
- Feelings of worthlessness or guilt over everything
- Finding it difficult to concentrate or difficult to make decisions about things
- Feeling like life would be better if they were no longer alive.
Behaviours such as cutting or burning are a warning sign of a pervasive mood disorder. Usually these behaviours are not an attempt to end their life, but is a manifestation of the teenager deliberately hurting themselves to cope with painful or strong emotions.
Helping a child who is self-harming, will probably take another article in full itself to cover, but suffice to say, it is important to try to stay calm, not judge, listen and call for medical attention if you feel that they are further risk of harm to themselves or suicidal. In the longer term, it is important to seek professional support for your child where they can positive strategies to handle their strong emotions.
What causes depression?
Neurotransmitters are important chemicals in the brain that affect how brain cells transmit messages to one another. They play a vital role in the regulation of mood and behaviour. In depression (and indeed anxiety), the most important neurotransmitters to understand are serotonin, dopamine and noradrenaline. If the levels of these neurotransmitters are low, then this can contribute to depression.
Mental health conditions such as anxiety and depression can run in families, so we know that genetics definitely plays a role. There are many other factors that can contribute to the development of depression, and these can include can be stressful or traumatic events, illness, personality type and long term stressors like abusive relationships, bullying at school, exam stress and anxiety.
As we have discussed before in my past articles on childhood trauma, early childhood traumatic events can cause a lasting impact on children’s coping mechanisms and contribute to the development of depression. Early childhood traumatic events can include things like (but not limited to) the loss of a parent, physical, emotional or sexual abuse.
There are plenty of things that you can do or suggest for your teenager to make them feel better when they are feeling low. Things like,
- remembering to breathe
- meditation and mindfulness exercises
- being kind to yourself
- remembering to eat regular and nutritious meals
- getting outdoors for some regular physical activity
- making sure your child is getting enough good quality sleep
- allowing your child to make time to do the things they enjoy
- allowing your child to connect to people who care for them and will boost them up (friends, family)
These are all helpful ways to help elevate a low mood. However, if the low mood is persistent and interfering with your child’s ability to participate in life, then active intervention/treatment will need to be considered.
Finding the right treatment or combination of treatments for a child or teenager who has depression can often be a process of trial and error and a process you need to go through with your doctor. In younger children, it is generally recommended that psychotherapy (usually with a psychologist who is trained in an appropriate therapy method such as cognitive behavioural therapy or acceptance/commitment therapy) is trialled first.
In adolescents, the most effective treatment is usually a combination of both medication and psychotherapy. For more information about the most commonly used medication(s) that we use in children who have anxiety and depression, access an article I wrote some time ago on the blog HERE. I find with my teenage patients, it is really important to find the right professionals to provide their care. By this I mean, you not only need to find someone with the right qualifications and training to help your child, you also need to find someone who can build a real rapport with them also.
Your teenager is not going to talk to someone that they do not trust or feel comfortable with. You are not friends with everyone you know for a reason, and in the same way not every therapist (or doctor for that matter) is going to be your child’s “cup-of-tea.” I think it is important to give your therapist a chance, but usually after about the 4th or 5th session if you are still not getting anywhere or if no progress has yet been made, I think it is reasonable to look for a therapist that might be more suitable for your child. Anyone who works in this industry will know that there is no point persisting if a trusting relationship cannot be formed, and most reasonable therapists will understand if you feel you need to look elsewhere (so take home message is, don’t be afraid of offending people by wanting to change therapists).
Finally, I just want to remind you, that if your adolescent does not want to talk to YOU about what is making them sad, DO NOT TAKE THIS PERSONALLY. It is NOT a reflection of the kind of parent you are, or necessarily of the nature of your relationship with your child. Sometimes kids just find it HARD to talk to their (often very awesome) parents. This is where trained professionals are really helpful and help you to take a step back and be your child’s mum/dad, rather than their therapist.
I hope that this article has been helpful for you, and as always, make sure you LIKE and SHARE the post, so that we can help as many people as possible!