Adolescent Depression

How To Know When Your Child Needs Help

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Being an adolescent is an exercise in wild mood fluctuations. Swinging from effusive gushing about the latest album to declarations that their lives have just been ruined in one five-minute conversation comes with the territory. Social media, with its faux visions of other people’s “perfect” lives, exacerbates their already built-in tendency to judge themselves harshly against others. So when your teenager is depressed, it can often be hard to determine that there is indeed a problem.

Mental health issues were prevalent in adolescents even before the COVID-19 pandemic, but the major upheaval of the last two years has changed how they attended school, participated in activities, saw their friends – virtually everything about their day-to-day lives. Combine that with the possibility of having lost a loved one or having their family face employment, housing, or economic challenges, and it is no wonder that the rate of teenage depression has increased twofold during the pandemic, according to a report by the Surgeon General.

So how does a parent decipher what is normal teenage drama and what is actually a mental illness in need of intervention? All of the parents of kids with depression with whom I spoke emphasized that this was the biggest challenge – determining whether the situation rose to the level of a mental health issue. Unlike other typical childhood challenges like sleeping through the night, potty training, and eating vegetables, these parents noted that admitting that your child is struggling to function in life is not something you discuss freely with other parents.

Healthcare worker and mother Mindy had years of experience working with mentally ill patients but still missed the signs in her own child until a routine pediatrician checkup revealed that he was suicidal. She knew what to watch for, but in her own child, whom she saw every day, it was harder to see the changes. Because depression can look different in adolescents compared to adults, it is important to know what to look for.

Signs Your Teen Might Be Depressed

  1. Sleeping more or less than usual.
  2. Changes in eating habits, losing or gaining weight.
  3. Loss of interest in social activities. Withdrawing from family life.
  4. Loss of interest in extracurricular activities.
  5. Difficulty concentrating, increased forgetfulness.
  6. Feelings of sadness or hopelessness, unexplained crying.
  7. Abusing alcohol or drugs, engaging in promiscuous sexual behavior.
  8. Doing worse than usual in school.
  9. Physical complaints such as stomach aches and headaches.
  10. Complaints of being bored.
  11. Anger, irritability, anxiety, overreaction to situations.

What Should Parents Do?When Holly’s son was first showing signs of depression, she had no idea what to do. She had a difficult time figuring out what was depression and what was normal teenage behavior. He was already struggling with gender identify issues and then with the onset of the pandemic, he started shutting down.

If you suspect your teen is depressed, start with reaching out to him. Try initiating a conversation about what you see happening. Avoid interrupting or finishing her sentences. Validate his feelings rather than minimizing them. Let her know that she can come to you for a judgment-free zone.

Encourage your child to reach out to friends as well. While their natural tendency might be to withdraw from social interactions, encouraging them to call a friend and even to get together can be helpful. Start with baby steps, though. Maybe just a brief visit rather than a big outing that can quickly become overwhelming.

Do not hesitate to reach out to your pediatrician. Waitlists for mental health providers can be long so you should also contact your insurance to get a list and get on some waitlists. You can always cancel the appointment if it turns out to be unnecessary. Many therapists do not accept insurance, but you might want to get on those lists, too. Often your insurance will reimburse you for a portion of your payment.

Medication can be helpful in treating depression. Psychiatrists can also have waitlists and do not necessarily take insurance. Often medication can make the patient feel well enough to allow talk therapy, and other interventions to work better or more quickly. It is important to watch teenagers carefully when they first start some mood stabilization medications as they can increase suicidal tendencies.

Mindy recommends that parents take notes about the changes they see in their children. Documenting the symptoms of decline and also documenting during treatment can help parents see minute changes.

Holly lamented that the mental health system is completely inadequate and that they had to pay out of pocket to receive the right therapy. It definitely can take a lot of work, and often a lot of money, to put together a support team, but it is imperative.

What Should Schools Do?
Parents should also reach out to the school to let them know their concerns. Teachers who know your child better might be able to confirm what you are seeing and share their own observations.

A student with depression might qualify for a 504 Plan, which is a formalized list of accommodations given to a student with a diagnosis that causes challenges in the school setting. However, a 504 Plan takes months to develop. In the meantime and as part of the 504 Plan, there are several steps that can be taken.

Schools should provide a professional at the school with whom the teen can speak. Students should have a designated safe space in which to calm down and regroup. Physical activities can help with mood regulation. Preferential seating in the classroom, whether it’s closer to the teacher or slightly removed from the group, might help the student feel more comfortable.

Students with depression might benefit from greater assistance in breaking down large tasks such as papers and projects. They might be less able to visualize how to start the assignment and complete it. Setting short-term goals can also help them feel accomplished when the work seems overwhelming. Reduced homework and extended deadlines can help them learn, while accommodating mood fluctuations. Assisting the teen with using a planner to keep track of assignments can help compensate for reduced concentration and distractedness.

Dawn feels strongly that her daughter Nora’s depression was due to the pandemic. Nora went from being an A student to struggling with online learning. Without the framework of school to hold her together, her executive functioning skills fell apart. She would leave work to the last minute and then struggle to complete it. Support from parents and the school were helpful, but it was not until the family employed an executive functioning coach that Nora was able to get back on track.

Watching your child struggle with depression can be devastating, but there is help. If you are worried, reach out to the professionals – you will not regret it.

E.V. Downey is an educational consultant with Downey School Consulting, a camp director at Busy Bees Camps, a flute teacher at Music on the Hill, and a tutor and behavioral therapist. A graduate of Duke Ellington School of the Arts, she has raised her two kids on Capitol Hill.