Just Moody? Or Something More? Learn the Signs of Teen Depression

She can’t face Facebook, and her iPod and cell phone are gathering dust on a shelf. Her teacher wants to meet you about her failing math grades, and you just discovered she’s been late for clarinet practice for the past two months.

Is your teen just moody? Or could she have clinical depression?

“Because adolescence is filled with ups and downs, answering this question isn’t always easy,” says Charles Wibbelsman, MD, chair of the Teenage Clinic at Kaiser Permanente in San Francisco. “You need to know what signs to watch for—and to act on them immediately.”

One in five teens suffers from depression, reports the advocacy group Mental Health America (www.nmha.org). And though cases vary, your child may need treatment if she exhibits three or more of the following symptoms for more than two weeks straight:

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• • apathy
• • anger or rage
• • anxiety or restlessness
• • complaints of pains such as headaches or stomachaches
• • dramatic changes in eating or sleeping patterns
• • difficulty concentrating
• • indecision
• • hopelessness/sadness
• • irresponsible behavior (skipping chores or school)
• • loss of interest in activities that once brought pleasure
• • neglect of personal appearance (not showering or changing clothes)
• • rebellious behavior
• • a sudden drop in grades
• • use of alcohol, drugs, or promiscuous sexual activity
• • withdrawal from friends
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• “Behaviors like these can be triggered by humiliation on the sports field, the breakup of a relationship, worries about sexual orientation, or anything else that’s overwhelming,” says Wibbelsman. “Adolescents don’t have the life experience that allows them to shrug off setbacks. Mistaking temporary problems for permanent ones, they’re more vulnerable to depression than adults."

If your teen is depressed, he or she may not realize it or be able to express it in words. Approach him or her gently, ask what’s going on, and if it sounds serious, seek help from your family doctor, school counselor, or a therapist. Because depression subsides then flares up again, it’s vital to address it early, before it spirals out of control. Teen girls, who are twice as likely to be depressed as boys, attempt suicide more often. But boys are three times more likely to succeed in ending their lives. Resources like SuicidePreventionLifeline.org (800-273-8255) can help.

Cognitive behavioral therapy, which reverses negative patterns of thinking and behaving, eases teen depression in 30 percent of cases. Prescription drugs called selective serotonin reuptake inhibitors (SSRIs, including Prozac, Zoloft, Paxil, Luvox and Celexa) are 60 percent effective, though the Food and Drug Administration issued a 2004 warning about their potential to spur suicidal thinking in some teens. According to a recent National Institute of Mental Health study, the most effective treatment may be a combination of behavioral therapy and SSRIs, which beats teen depression in 75 percent of cases.