How to Identify and Treat Teen Depression

It's normal for teenagers to have bouts of irritability, sleepiness, and sadness. But when symptoms last for two weeks or more, it could signal depression.

"It's generally stated that one in five young people will develop depression before they reach age 25," says Susan Weinstein, co-executive director of programs and operations at Families for Depression Awareness.

Read on to learn more about teen depression statistics, then understand the causes, risk factors, and how you can help as a parent.

Teen Depression Statistics

According to the National Institute of Mental Health (NIMH), 17% of adolescents aged 12 to 17 had at least one major depressive episode in 2020. That equates to 4.1 million American teens. What’s more, 12% of adolescents experienced at least one instance of “severe impairment” that interfered with life.

Unfortunately, rates of teenage depression have risen over the years, says Jennifer Rothman, senior manager of youth and young adult initiatives at the National Alliance on Mental Illness (NAMI). More than a million more teens experienced depression in 2020 compared to 2017.

The Centers for Disease Control and Prevention (CDC) notes the following worsening trends in mental health in adolescents as of 2021:

• 42% of students felt persistently sad or hopeless
• 29% experienced poor mental health
• 22% considered suicide
• 10% attempted suicide

According to the CDC, certain adolescent populations are more affected, including LGBTQIA students, females, and marginalized racial and ethnic groups. In fact, almost half of LGBTQIA students considered suicide, and Black students were more likely to attempt suicide than teens of other races and ethnicities.

Causes of the trend

While the trend in adolescent mental health got worse during the COVID-19 pandemic, the situation was dire even before. In the ten years leading up to the pandemic, health officials saw an increase of 40% in feelings of hopelessness and suicidal thoughts.

In addition to pandemic-related causes, like social isolation and academic disruption, the American Psychological Association (APA) points to the following contributors to the trend:

• Social media
• Mass violence
• Natural disasters
• Climate change
• Political polarization
• Normal ups and downs of childhood and adolescence

While more research needs to be done, Rothman also hypothesizes that the increasing pressure of school work and bullying are contributors. For example, cyberbullying that “doesn’t end with the school day” is especially problematic.

“We’re seeing mental health issues more and more,” says Rothman. “People are becoming more aware of the warning signs and seeking help. The earlier depression is recognized, the better the outcomes for the future.”

What Causes Depression in Teens?

Depression may be caused by several different factors, according to Rachel Busman, Psy.D., a board-certified child and adolescent psychologist and senior director of the Anxiety Disorders Center at the Child Mind Institute.

Genetics and Biology

For starters, she says, "kids can have a biological predisposition toward anxiety or depression, which sets the stage for the condition." In other words, having a parent with depression makes children and teens more likely to develop depression themselves. That's partly because kids learn from their parent's behavior and tend to imitate their actions. But that's not the whole story.

Researchers hypothesize that maternal depression could cause transmission to children and that parental depression could impact fetal development. In addition, researchers believe genetic and environmental factors contribute to the development of depression.

Adverse childhood experiences (ACEs)

Depression may also be triggered by adverse childhood experiences (ACEs) like neglect, trauma, abuse, or parental divorce. According to the CDC, ACEs occur during childhood and can be potentially traumatic. Examples of ACEs include:

• Experiencing violence, abuse, or neglect
• Witnessing violence at home or in the community
• Having a family member attempt or die by suicide

Research has found that the more ACEs a person experiences, the greater the likelihood they will experience negative health outcomes.

Stressful life events

Another risk factor is being forced into stressful life events—like dealing with a family death or starting college—without sufficient coping strategies or a support network. What’s more, Rothman says kids who have a hard time in school, such as those with learning disabilities, could develop depression if they’re falling behind in their classes and grades.

Having anxiety

Finally, there may be a link between childhood depression and anxiety. According to a 2016 Journal of Psychiatric Practice systematic review, anxiety and depression commonly co-occur in adolescents and is likely underestimated. Teens with both anxiety and depression have greater symptom severity and experience greater treatment resistance compared with those who have anxiety or depression alone. So, quickly identifying co-occurring illnesses is critical.

“An untreated anxiety disorder in a child is one of the top predictors of developing depression by the time you hit adolescence,” says Lynn Lyons, licensed clinical social worker, psychotherapist, speaker, and co-author of Anxious Kids, Anxious Parents. “If you have an anxiety issue and don’t learn the skills to help, your odds of becoming depressed are pretty high.”

Symptoms of Teen Depression

According to the American Academy of Child and Adolescent Psychiatry, common symptoms of depression in teens include:

• Sadness, tearfulness
• Irritability
• Not enjoying things they previously enjoyed
• Spending less time with friends or in extracurriculars
• Changes in appetite
• Weight loss
• Sleeping more or less than usual
• Fatigue
• Loss of energy
• Feeling like a failure
• Trouble concentrating
• Struggling in school
• Having thoughts of suicide or wanting to die

In addition, some teens may experience physical symptoms like headaches or stomach aches. It's also not uncommon for teens to use substances to try to feel better.

How to Help a Teen with Depression

If you think your teen has depression, don’t panic. “Remember that depression is a treatable disorder. It’s not permanent,” says Lyons.

However, seeking treatment sooner rather than later is essential since depression can come with a host of negative consequences. According to Weinstein, these include:

• Academic failure
• Substance misuse
• Impaired interpersonal relationships with family and peers
• Eating disorders
• Increased severity of health conditions
• Crime
• Suicidal behaviors

Moreover, Rothman adds that kids with depression won’t live life to the fullest.

Talk to your child

Lyons says the first step a parent should take is to seek accurate information from people specializing in treating depression. Then you should approach your teen with openness and acceptance.

Don't be afraid to call out symptoms you've noticed (for example, spending excess time alone or dwindling grades) and ask their opinion about treatment options. "Parents always want to give opinions and advice, but they don't always take the time to listen to children's needs and feelings," says Rothman. "Parents need to make their children feel heard and make them a part of the solution."

Seek professional help

After speaking with your child, it’s time to seek professional help. Dr. Busman says many parents visit a trusted pediatrician. You could also find a psychologist or psychiatrist on websites like the Anxiety and Depression Association of America (ADAA) and the Association for Behavioral and Cognitive Therapies (ABCT). The National Alliance on Mental Illness can also connect teens with local support.

“Look for a mental health provider who has specialization in children and adolescents and who practices evidence-based care,” Dr. Busman suggests. It’s important to note that you should seek help immediately if your child has suicidal thoughts or behaviors.

How Teen Depression Is Treated

Clinicians often treat teen depression with medication or talk therapy (psychotherapy). According to the Anxiety and Depression Association of America, the first-line treatment for moderate depression is psychotherapy—specifically cognitive behavioral therapy (CBT), an evidence-based approach that helps people change how they think and behave.

More severe depression usually improves best with a combination of therapy and medication. The most commonly used drug is selective serotonin reuptake inhibitors (SSRIs). These medications are a type of antidepressant that increases the availability of serotonin, a neurotransmitter that helps regulate your mood.

Weinstein also recommends three lifestyle factors that can manage symptoms of depression:

• Adequate sleep
• Balanced eating
• Exercise

While some people, including adolescents, will be resistant to treatment, SSRIs and evidence-based psychotherapy are effective treatments for teens with depression.

For example, a 2019 European Psychiatry study found that after receiving CBT, adolescents with depression had a 45% greater chance of being in remission and a 36% greater chance of recovery than control groups.

With regard to medication, a 2019 Current Psychiatry article points out that in one study, 80% of adolescents prescribed SSRIs improved over nine months. However, SSRIs can take up to eight weeks to work, so patience is key before ruling out a specific medication too early.

The Bottom Line

Teen depression is on the rise and the statistics are sobering. It's understandable if you feel a sense of despair if you suspect your child may be experiencing symptoms of depression. But, rest assured that you are helping them just by being aware of the situation. The good news is with evidence-based treatment, which may include psychotherapy, medication, or both, remission or recovery is likely.