PAMF Health Blog

Be Well, Be Well Informed

A Parent’s Guide to Teen Depression

Posted on Dec 21, 2011


Although being moody and irritable is often normal for teenagers, depression is not simply a side effect of growing up. Depression is a serious medical condition that affects approximately one in five teens before they reach adulthood and is the leading cause of teen suicide. Parents often feel concerned and unsure of what to do when they think their teen may be depressed.  Talking with your teens regularly, listening to what they have to say, and keeping up with their activities, go a long way to preventing and identifying any depression they may be experiencing. In this blog post, Meg Durbin, M.D., an Internal Medicine doctor and pediatrician at the Palo Alto Medical Foundation, offers some insights into depression, and answers parents’ commonly asked questions on teen depression and how to help.

I think my teenage son may be depressed. What should I do?

Try to make your teen comfortable by asking questions in a nonjudgmental way.  Keep an open mind while listening to what he has to say. Consider asking questions such as: “How are you doing? Are you feeling stressed? Have you been feeling sad or down most of the time?” Helping your teen identify and figure out how to cope with stress (whether academics or peer relationships) is an important part of growing up and an important responsibility for parents. Sharing how you cope with stress can be helpful, too. For example, you could say: “You know, when I feel stressed out, I find that taking a stroll helps to clear my head and calm me down. Why don’t we take a walk together?”

My two teenagers are very moody. How can I tell if they are depressed?

Don’t be afraid to ask your teen about moodiness or changes in behavior. In addition, look for the following signs and symptoms that can indicate teen depression:

  • Persistent mood changes, especially irritability or sadness
  • Feeling hopeless, helpless or worthless
  • Increased anger, fighting and self-destructive behavior
  • Loss of interest in normal activities
  • Withdrawal from friends
  • Increase or decrease in sleep or appetite
  • Excessive or uncontrollable crying
  • Difficulty concentrating and making decisions
  • Preoccupation with thoughts of death
  • Drop in academic performance

My 15-year-old daughter seems depressed. I’m concerned about what she might do to herself. What should I do?

If you are really concerned that your daughter may have serious depression, it’s OK to ask whether she has had thoughts of harming herself. Direct questioning about self harm does not push people over the edge and drive them to attempt suicide. In fact, bringing such a discussion into the open can be a relief to someone who harbors such thoughts but hasn’t yet sought help. At the same time, don’t feel like you have to assume the role of a suicide counselor or therapist: seek help if you are concerned about your daughter’s mood or behavior.

My teens are so stressed out about getting into college – getting high grades and doing lots of extracurricular activities to build their resumes. How can I help?

It’s very important to help our teens to strike a healthy balance: finding their passions and then working to achieve their goals, while nurturing their emotional needs and self esteem. Colleges and employers are looking for happy, healthy, confident people who have a genuine joy of learning and independent spirit. So, high school is a great time to explore different interests. Colleges neither expect nor want only students who take tons of AP classes and participate in a dozen sports and hobbies. Parents and doctors should encourage teens to set reasonable limits on their commitments: in academics, sports, and other activities. Teens, like everyone else, need unstructured time, to hang out by themselves and with friends. It’s a fact that we all function better when we have adequate rest and recreation.

In addition, it’s a sign of maturity when anyone – teen or adult – can acknowledge what they really want and need, and learn to cope with pressures that may come from others’ expectations. Teens especially need guidance about what others really do expect from them, since they may assume that their parents or teachers only accept them if they are ‘perfect.’ The message must be that we respect and support our teens: our goal is to ensure that we help teens discover who they are and want to be – and that includes a priority on staying emotionally healthy. Your school’s guidance counselors and teachers/mentors understand these issues very well, and, in addition to parents and health care professionals, can help teens strike a good balance that nurtures their love of learning and paths to reach their goals.

I think my son is depressed but he won’t talk to me. What should I do?

If you sense your son is holding back or is exhibiting signs of depression, please ask his regular doctor to screen him for depression and other emotional concerns.

  • If mild depression is uncovered, your son’s physician may be able to manage this directly through supportive counseling and frequent follow-up. Your son’s doctor may also refer him to a therapist and/or a psychiatrist.
  • If moderate depression is uncovered, your doctor may begin treatment (including supportive counseling and possibly medications) but will typically also refer your son to a psychiatrist and licensed therapist for counseling.
  • If severe depression is present, or if milder depression occurs with other concerns (such as attention deficit disorder, eating disorders or severe anxiety), your son should be referred promptly to a psychiatrist.
  • If you feel your son is in immediate danger, for example, he is threatening self harm or suicide – call a crisis service organization, such as EMQ Families First at 1-408-379-9085 or 1-877-41-CRISIS, or call 911. You can also take your teen to a local emergency room for evaluation if necessary. Child and adolescent psychiatrists are on duty at several local facilities in the Bay Area, including Lucile Packard Children’s Hospital at Stanford in Palo Alto, Mills-Peninsula Medical Center in Burlingame, Children’s Hospital & Research Center Oakland, Fremont Hospital, Alta Bates Medical Center in Berkeley, and John Muir Behavioral Health Center in Concord.

Let me reassure you, though, that most teen depression is not life threatening and can be helped with relatively simple interventions by caring parents and your son’s doctor, along with support from therapists and psychiatrists when needed.

Meg Durbin, M.D., is a board-certified internist and pediatrician at the Palo Alto Medical Foundation, and contributed to this post.