Life as a teenager is quite similar to riding a rollercoaster.
No matter what, you're strapped in, unable to stop the ride once it begins. One minute you're riding comfortably, the next minute your whole world is upside down, confusing, yet exhilarating.
And like rollercoasters, adolescence has its share of ups, followed by downs. But for some teenagers, these “down” periods last much longer than a two-minute rollercoaster ride. Refer to adolescence developmental psychology for more information.
Teenage depression is a serious issue that affects nearly one in five teenagers during adolescence, according to statistics from the U.S. Centers for Disease Control and Prevention. By increasing awareness of the symptoms and reasons for teen depression, psychologists, parents, and counselors work with teens to defeat this crippling illness.
Symptoms of Depression
Because adolescence is a time of extreme physical, cognitive, and emotional changes, depression is especially difficult to spot in teenagers.
The National Alliance on Mental Illness (NAMI) provides a number of warning signs that indicate depression in teens:
Signs of Depression in Teens
- Trouble sleeping or sleeping too much
- Loss of interest or pleasure in activities teens once enjoyed
- Change in appetite
- Loss of energy
- Feelings of sadness or irritability
- Difficulty concentrating at school or home
- Guilty thoughts for no particular reason
- Suicidal thoughts or preoccupation with death
Some of these symptoms might seem like normal parts of adolescence. For example, just because a 14-year-old boy sleeps until noon each Saturday doesn't necessarily mean the boy has depression.
But when a teenager displays multiple symptoms, and these symptoms persist for longer than two weeks, it could indicate mild, moderate, or serious depression in the teen.
Major Depressive Disorder in Teenagers
Major Depressive Disorder (MDD) in teenagers is more serious than the minor depressive episodes often experienced in adolescence.
It's normal for a teenager to feel down when he or she fails an exam, doesn't make a sports team, or goes through a breakup. But when these experiences bring the teen's life to a screeching halt, causing the teen to develop negative thoughts about himself or herself, it indicates clinical depression in the teen.
Teenagers with MDD are more likely to attempt to run away from home, become suicidal, practice self-harm, and report frequent signs of physical illness, such as headaches or stomachaches. Additionally, episodes of major depression cause teenagers to shut down, interfering with schoolwork and extracurricular activities.
While treating MDD in adolescents is often successful, untreated MDD has a high recurrence rate throughout life.
In the “Natural Course of Adolescent Major Depressive Disorder: Continuity into Young Adulthood,” published in The American Journal of Psychiatry, 767 adolescents with MDD were assessed at age 19 and then again at age 24.
By examining the participants between these ages, researchers Peter M. Lewinsohn and colleagues hoped to determine which factors best explain why some teens experience depression between these ages.
Of the selected participants, 261 were diagnosed with adolescent MDD by age 19. By their 24th birthdays, 45% of this group had experienced another major depressive episode.
Lewinsohn found the greatest predictors of depression included a family history of major depression, higher emotional reliance on others, conflict with family members, and anti-social behavior. But these predictors often appear in early adolescence, before age 19, and affect the teen during his or her formative years. For more info, see causes of teen depression.
For example, consider a 15-year-old girl who has recently experienced a breakup with her first boyfriend. She and her boyfriend were very close. She confided to him many of her stressful difficulties and problems.
She had been experiencing fights at home with both of her siblings, and her parents were often away working, unable to give her any support. Her boyfriend was her only form of emotional support, and now she felt lost and without anyone to care or listen.
The strong emotional reliance she had placed on her boyfriend, combined with the bickering and fighting at home, causes her to feel unwanted in the lives of her loved ones, and she develops a case of depression.
When teens experience depression and don't know how to manage it, they develop ineffective coping techniques in an attempt to relieve the pain. But rather than help, these techniques end up hurting the teen in the long run.
Ineffective Coping Techniques for Depression
Depression introduces a confusing series of emotions to a teenager already confused by the physical and mental changes adolescence brings. Sometimes, teenagers don't understand they are experiencing depression at all, and they attempt to bring attention to their symptoms in unhealthy ways.
According to “The Functions of Deliberate Self-Injury: A Review of the Evidence,” published in The Clinical Psychology Review, self-injury is defined as “the intentional and direct injuring of one's body tissue without suicidal intent.”
Teenagers who self-injure often do so to manifest their depression physically, and find relief from their depressive thoughts. According to the article, cutting is the most common form of self-injury, appearing in 70% to 97% of individuals who harm themselves.
There are a number of reasons a teenager feels the need to self-injure. Often, self-injury is a response to generate physical and emotional sensations to “feel alive” for a depressed teenager.
Because depressed teenagers often crave the emotional support of loved ones, those who self-injure do so during their absence. For example, the 15-year-old girl who experienced the breakup might feel unable to handle the emotional turmoil of losing a loved one, and start cutting as a distraction to her feelings.
Teenagers who use pain as a distraction from their depression often find temporary relief, but permanent relief is only brought about by correct psychological treatment. Yet similar to those who self-harm, some teenagers use drugs to take their minds off depression.
In “Adolescent Depression, Alcohol, and Drug Use,” published in The American Journal of Public Health, researchers examined 424 students aged 16 to 19 to determine the effect of drug use on depression.
Researchers Eva Y. Deykin and colleagues found that the initiation of substance use tends to follow rather than precede depression.
Deykin found that 79% of alcohol and drug abusers had depression or another psychiatric disorder before their abuse began. This suggests that teenagers who abuse alcohol or other drugs do so to self-medicate.
But the effectiveness self-medicating doesn’t work, according to psychologists and other health professionals. In fact, self-medicating through drug use, self-harm, or other means is likely to actually increase depressive symptoms.
In “Marijuana Use Worsens Depression,” published by the Office of National Drug Control Policy, statistics show that illicit drug use among depressed teens is significantly higher than those who are not depressed.
Facts from “Marijuana Use Worsens Depression”
Using figures from the 2007 National Survey on Drug Use and Health, researchers surveyed 68,736 teens about their mental heath and substance use, leading to some surprising revelations and statistics about the link between depression and drug use.
- 35% of depressed teens used drugs, while 18% of non-depressed teens used drugs.
- Teens who smoke marijuana at least once a month are three times more likely to have suicidal thoughts than non-users.
- Depressed teens are more likely to use drugs as a form of self-medication than depressed adults.
- A teen who has experienced depression in the last year is twice as likely as a non-depressed teenager to begin using marijuana.
Teenagers who self-medicate and use ineffective coping methods also put themselves at higher risk for the deadliest price of untreated depression – suicide.
According to “Adolescent Suicide and Suicide Behavior,” published in The Journal of Child Psychology and Psychiatry, suicide ideation is common among teenagers. For more info, see Suicide - Why does it occur? and Suicide Prevention.
The article, by researchers Jeffrey A. Bridge and others, examined the risk factors concerning adolescent suicide. Bridges found that approximately 15% to 25% of teens have thoughts of suicide through adolescence, from minor thoughts of death to actual suicide plans.
But while a large number of teens might experience suicidal thoughts at certain points, far fewer attempt it. Actual suicide attempts range from 1.3% to 3.8% in boys, and up to 10.1% in girls.
Similar to drug use and cutting, suicide is often thought of as an “escape” from symptoms of depression or problems plaguing the teenager. But unlike drug use and cutting, this escape is sought as a permanent solution.
According to the National Alliance on Mental Illness, suicide is the third leading cause of death for young people between ages 15 and 24. Teens who commit suicide often do so in response to a major conflict or disappointment in their lives, such as a breakup, family problems, or problems with social lives.
These teenagers are unable to see that they can turn their lives around with counseling and therapy, feeling they have nowhere to turn to. Fortunately, treatment options for depressed and suicidal teens do exist, and have proven highly effective. For more info, see Help for Teen Depression.
Helping Depressed Teenagers
The Link Between Cigarette Smoking and Depression
For some teenagers, it helps to reduce the stress of school. For others, it relaxes them, providing a temporary escape from family and relationship conflicts.
But despite the temporary relief it brings to its users, cigarette smoking instigates a host of serious physical and mental health problems in teenagers and young adults.
Today, approximately 3,450 adolescents aged 12 to 17 will smoke their first cigarette. Of those, roughly 850 will become daily smokers. And from those 850 smokers, a significant number will develop depression during their lives.
According to “Tobacco: The Smoking Gun,” a study conducted by Columbia University's National Center on Addiction and Substance Abuse, a statistical link exists between teenage cigarette smokers and the later onset of depression.
Using data from the National Survey of Drug Use and Health, researchers at the center found that among teens aged 12 to 17, twice as many smokers (16.8%) had major depressive episodes in a year compared to nonsmokers (7.7%).
The data suggests that cigarette smoking precedes depression, but the reasons for this are not widely understood. Researchers have examined the effects smoking has on the mental health of lab rats, and now believe smoking possibly affects brain development.
According to the study, researchers examined the effects of nicotine on adolescent lab rats, and found that it reduced serotonin – the brain chemical responsible for emotions like happiness. From this study, the researchers hypothesized that nicotine, the addictive chemical in tobacco, directly affects serotonin.
Researchers believe that nicotine similarly affects serotonin levels in teenagers.
For smokers who start at a young age and continue smoking throughout their youth, the threat of depression continues to increase. According to data from the U.S. Centers for Disease Control and prevention, of cigarette smokers over the age of 20, nearly 43% experience depressive episodes each year.
And with 80% of adult smokers starting before the age of 18, more preventive programs are needed to educate adolescents about the dangers of smoking.