Teen Depression: Signs, Causes, and Treatment

My heart aches for the multitude of teens who come through my door and self-report depression. Some are guarded and say very little, while others begin telling their story in an attempt to vomit all the trauma they have experienced in their short life. No matter the circumstance, if someone is consumed with sadness, they have the right to be treated with the utmost love, respect, and care.

I recently had a teen client share with me that one of her teachers explained to her that her depressive symptoms were invalid as he felt she lacked physical evidence of her pain.

What physical evidence did she require to prove to him she was depressed? Did she need to have self-harmed or attempted suicide in order for him to have empathized or referred her to the school counselor or community mental health resource?

While we, as a society, have made many strides toward helping those who experience challenges with their mental health, we still have a lot of work to do. It is when people, like my client’s teacher, are quick to judge and dismiss their student’s pleas for help that teens begin to feel hopeless and symptoms escalate.

This sense of desperation can lead to dangerous and horrific outcomes. If you are a teacher or frequently work with teens, please listen with an open mind, non-judgmental stance, and provide them with loving and compassionate care. Please use your resources to connect them with the support they need.

I hope you are one of the many extraordinary teachers who takes that extra step to not wait for teens to come to you. Instead, look for the many visible signs and immediately refer.

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Signs of Teen Depression

If some of you are unaware of these common signs of teen depression, they are as follows: sleeping more or less than normal, loss of appetite, loss of energy, poor hygiene, loss of interest in things they once were passionate about, quickness to anger, isolation, increase in crying, loss of purpose, hard time concentrating, statements of despair, homework not completed, and/or expressed or unexpressed thoughts of suicide.

Causes of Teen Depression

There are many reasons for teen depression. Some examples include a loss of a relationship, parental conflict, previous abuse, divorce, the suicide of loved one, loss of friendship, loss of support, loss of self-identity, loss of self-esteem, new family member, moving, bullying, school shooting, etc. The list is endless.

Treatment for Teen Depression

No matter the cause of their depression, seeking counseling is a must. If left untreated, teen depression can potentially lead to self-harming behaviors and/or attempts at suicide. According to the Centers for Disease Control and Prevention, suicide rates are up 77% for Caucasian children and teens between the ages of 10 and 17 and 70% for African American children and teens from the years 2006 to 2016.

If you are a parent who is reading this, you might be thinking, “Karina, my teen isn’t that depressed.” I am so happy to hear your teen isn’t at a state of hopelessness. At the same time, if there have been any changes in your lives or you notice a change in your teen’s behavior, please find help for them.

The National Prevention Suicide Hotline is 1-800-273-8255. If you live in Spokane, Washington, the First Call for Help crisis number is (509) 838-4428. Both are opened 24 hours a day. If your teen is in grave harm to themselves, please take them to the emergency room for further evaluation. You can also call me at (509) 869-2974.

An Open Letter to Depressed Teens

If you are a teenager battling depression, please read:

Dear Teen,

There is so much I want to say to you. First, though, I want to say I’m sorry. I’m sorry you’re hurting. I’m sorry you feel alone. I’m sorry you feel lost and without a purpose. I’m sorry you’ve had to fight back your tears. I’m sorry you feel ashamed of something you did or said or of something that happened to you. I’m sorry I can’t be there to hold you right now while you get rid of the many emotions that have built up within your heart.

I want to hear your story. There is no wrong way to tell it. I want to hear the good, the bad, and the ugly. I want to sit with you. I want to listen without interruption, without judgement, and with a caring, open and loving heart. I want you to know that I don’t want to hear your story to immediately solve your problems.

Hearing how various life experiences have affected your today will help me know where to start and how to intervene. While this is a hard step, I encourage you to release the pain. The faster you let your guard down, the quicker you will see results. I am certain you are tired of feeling this low.

Even though you feel that you don’t matter, you really do. You matter more than you know. Right now, as you sit in your darkness, think about the many roles you play in life. Are you a sister, brother, aunt, uncle, student, church member, employee, or athlete? If so, I promise you, that at least one person in these categories cares deeply about you.

I know it’s hard to believe right now, but with time, you will begin to feel a part of your world. Sometimes when we go down the dark tunnel of depression, we isolate or distance ourselves so that others can’t further hurt us.

However, in isolating from the good people in our lives, we end up hurting ourselves even more. Please let me be the first person you let in or confide in a person you trust. You are good. You are enough. It is unbelievable how enough you are. You are so deserving of love, forgiveness, and acceptance.

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Sometimes when we hurt this much, we want others to hurt just as much. However, when we hurt others, a lot of guilt and shame shortly come trolling in. This begins our self-destructive behaviors: self-harming behaviors; screaming; hitting others; throwing or destroying things; yelling hurtful thins; self-sabotaging; freaking out; self-hating, or attempting suicide.

Our feelings and thoughts that life is not worth living; that no one loves us; that we are a waste of space; that we are horrible people because we hurt the ones who care most about us keep this self-hate cycle going. Understand that as we lose all sense of hope it’s easy to become angry.

Sometimes, when we feel angry about circumstances beyond our control, we react in ways we wish we didn’t. But baby, that is all that it is – hurt, fear, and anger. Your core self is completely different than your behaviors. Behaviors can be changed, your core self does not (meaning you are still good).

You’ve just gotten accustomed to reacting before someone else hurts you, that is all. Understand that despite how you’re reacting to your pain, it does not define you. No matter what you may think right now, you are worthy, lovable, and valuable.

I know you don’t feel in control of your life right now, but you are. You can control how you see and react to your world. You can control whether or not you decide to smile, do something nice for someone, you hug an animal when down, you call a friend when in need, or you go for a walk to get a new perspective.

Sometimes it’s difficult to do those things because we become afraid to hold on to any sort of hope because by now it has become comfortable or because people have continuously let you down. Let me in so I can help you handle all your pain.

It’s tiring clinging to the wrong people; distrusting, rejecting and arguing with others to keep people far away so they can’t hurt us anymore; feeling numb, empty, and alone; reliving traumatic events over and over in your head; and self-hating, self-blaming, and self-doubting. Oftentimes, we feel responsible for holding the darkness. But this is too much to bear.

We are not meant to sit in the gloom. We are made to cherish every minute of our lives, even difficult times. Sometimes our challenging moments last too long; but, when they are done, we are so grateful we almost forget about them. These minutes slowly add up to longer moments.

I want to help you identify this power that resides within you. I want to teach you how to be a beautiful you, how to set healthy boundaries for yourself and others, how to take care of yourself, calming skills to keep you mentally and physically healthy, and how to assertively communicate your needs and wants. In other words, I want to empower you.

Faith

Right now, you are in a dark hole. You are reading the latter part of my letter and are thinking this is impossible. How do I know this? Because I too have been there. I have been down that tunnel multitudes of times. There was a time in my life where I hid in that tunnel and seldom came up for air.

It took me a long time to figure out that my comfort in the hole was unhealthy. Each time I frequented the hole, I stopped living and in many ways rejected those who loved me most. This is why I became a therapist. I wanted to help others climb out of this hole.

I hated who I became, how I reacted to my fears, and I wanted to stop hurting those who I loved. My level of empathy for those who feel this amount of pain is immense. Please let me help you so you no longer have to live this type of life.

There were many moments in my aloneness that I felt a higher power. Whether He sent a new friend or some resource, I knew He was right beside me. While most times I rejected Him, I’ve come to accept Him in every aspect of my life. This is quite the change from being angry at Him for everything that happened to me as a child.

At times, the only time I reached out to Him was when I needed His help. If you are like I was, you probably don’t believe in God or are angry at Him. That is okay. When we go through so much pain over and over again, it’s easy to surmise we are alone and that there is no God. I’ve met so many teens who have expressed similar feelings and in turn, feeling guilty for losing hope and no longer asking Him for guidance. This is something that can be easily changed.

Why would you want to seek Him? Because God created you. He knows everything about you; and yet, he loves and accepts every bit of you unconditionally. He knows your pain, thoughts, fears, and tears. He knows everything you’ve done that has been wrong and good. Despite this, He still sees us as valuable, worthy, and enough. He even considers us precious.

My favorite part about having Him in my life is that I can ask Him to sit with me anytime I need him. Whether it’s in the middle of the night or during the day, when I’ve become overwhelmed, He is within reach. He encourages me to act with my heart to do kind things for others.

This leaves me feeling self-less and like I have a secret I’m holding with God. Oftentimes, I giggle with excitement and will share the good deed with my immediate family because I can’t contain myself. Other than that, I don’t tell anyone else, as I’d rather get His praise than anyone else’s.