September is Suicide Awareness Month

LA CROSSE, Wis. – With many teens heading back to school, peer pressure and academic expectations are once again face to face. While for most teens the structure and socialization of school can help their mood, for others the added stress can be a tipping point during an already tumultuous time of life. For those teens, the low mood may be more than just temporary feelings. It could be symptoms of depression.

Major depressive disorder is one of the most commonly diagnosed mental disorders in children, according to the Centers for Disease Control and Prevention. The number of children diagnosed with depression and anxiety has increased from 5.4% in 2003 to 8.4% in 2011–2012. Among teens in 2018-2019 reporting on the past year, 15.1% had a major depressive episode.

Teen depression is a serious mental health problem,” says Chelsea Ale, PhD (Clinical Child Psychologist at Mayo Clinic Health System in La Crosse). “Depression can affect how teenagers behave, think, , and feel;, often showing up as emotional, functional and physical problems. Although depression can occur at any time in life, symptoms may look different between teens and adults.”

Signs and symptoms that a teen may be depressed include 1) changes in their previous attitude and behavior  and 2) these changes cause significant problems at school, at home, or in social activities. For example one symptom among other signs, could be a teen who used to love band, suddenly not wanting to attend practices, and dropping out of their commitments.

Be alert for several of the following emotional changes:

  • Feelings of sadness, which can include crying spells for no apparent reason.
  • Frustration or feelings of anger, even over small matters.
  • Feeling hopeless or empty.
  • Irritability or annoyed mood.
  • Loss of interest or pleasure in usual activities.
  • Loss of interest in, or conflict with, family and friends.
  • Low self-esteem.
  • Feelings of worthlessness or guilt.
  • Fixation on past failures, or exaggerated self-blame or self-criticism.
  • Extreme sensitivity to rejection or failure, and the need for excessive reassurance.
  • Trouble thinking, concentrating, making decisions and remembering things.
  • Ongoing sense that life and the future are grim and bleak.
  • Frequent thoughts of death, dying or suicide.

Watch for several of the following behavioral changes:

  • Tiredness and loss of energy.
  • Trouble sleeping or sleeping too much.
  • Changes in appetite, including decreased appetite and weight loss, or increased cravings for food and weight gain.
  • Use of alcohol or drugs.
  • Signs of agitation or restlessness, including pacing, hand-wringing or an inability to sit still.
  • Slowed thinking, speaking or body movements.
  • Frequent complaints of unexplained body aches and headaches, which may include frequent visits to the school nurse.
  • Social isolation.
  • Poor school performance or frequent absences from school.
  • Less attention to personal hygiene or appearance.
  • Angry outbursts, disruptive or risky behavior, or other acting-out behaviors.
  • Self-harm, including cutting or burning.
  • Making a suicide plan or a suicide attempt.

Depressive symptoms may can also be a sign of several other disorders, so connecting with your primary care doctor for a general health check and getting an accurate diagnosis is the key to appropriate treatment and recovery.

Treatment depends on the type and severity of a teenager’s depression symptoms. “For severe major depressive disorder,  the combination of cognitive behavioral therapy  and medication has been shown to be most effective,” explains Dr. Ale. For mild to moderate depression, starting with either CBT or medication may be enough. “CBT for teen depression involves families working together to make changes in their everyday life to help support the teen’s mood and fight against the isolation and avoidance that depression can cause.”

“If you’re concerned about your child’s mental health, consult your child’s healthcare provider. Describe the behaviors that concern you. Talk to your child’s teacher, close friends, relatives or other caregivers to see if they’ve noticed changes in your child’s behavior. Share this information with your child’s provider.

Connect with other parents and caregivers talking about kids, mental health issues like depression, and going back to school in the About Kids & Teens support group on Mayo Clinic Connect, an online patient community moderated by Mayo Clinic.

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