Helping Teenagers Cope With Depression

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The myriad academic, social and physical changes during adolescence can be stressful for even the most adaptive teenager. Though depression is less common among adolescents than adults, 11 percent of adolescents are diagnosed with a depressive disorder by age 18, according to the adolescent supplement of the National Comorbidity Survey, which collected data on teens in two sample groups between 2001 and 2004.

A National Center for Children in Poverty fact sheet suggests that teenagers with depression may experience academic problems, unstable relationships, substance abuse, criminal activity, unsafe sexual behavior and even suicidal thoughts. There are, however, ways to help a teenager who is suffering from depression.

Causes of Adolescent Depression

The National Institute of Mental Health reports that the impact of genetics, environment and early life experiences are potential influences on one’s propensity for depression. However, Heather Thurston, a clinical psychologist practicing in Cary, says no definitive answer about its cause has been found.

“Certainly adolescence is a time when brain development is still happening,” Thurston says. “The questions remain of how, why and when does brain maturation jump off track to increase one’s vulnerability to depression.”

Though you cannot completely eliminate your teenager’s chances for depression, consider whether your child participates in physical and extracurricular activities, maintains a positive social life and understands how to cope with stress, suggests John Curry, professor of psychiatry and behavioral sciences at the Center for the Study of Suicide Prevention and Intervention at Duke University in Durham.

Signs to Watch For

Thurston cites the following signs that might indicate your teenager is experiencing a mood disorder such as depression:

–          Low mood

–          Changes in social activity, academic performance, hygiene or eating habits

–          Negativity

–          Irritability

–          Reckless behavior

–          Expressions of being misunderstood

Whereas it is true that most teenagers experience these periodically, their appearance for prolonged periods of time could indicate more than just teenage woes.

“A diagnosis of depression can be present when there is a clustering of multiple depressive symptoms (including low mood or loss of interest in usual activities) that are present most of the time for at least two weeks,” says David Goldston, director of the Duke Center for the Study of Suicide Prevention and Intervention in Durham and associate professor of psychiatry and behavioral sciences at Duke University. “For a diagnosis of depression, the group of depressive symptoms needs to be associated with significant distress or associated with some impairment (e.g. difficulties in school).”

Early intervention is crucial, Thurston says, noting that one depressive episode makes one at risk for another. If your teenager presents the signs listed above, Thurston recommends taking a “nonjudgmental stance” when speaking to him or her. Teenagers need to feel that you are available to talk to them — when they are ready. School guidance counselors, pediatricians and primary care physicians are able to provide help and recommendations for mental health professionals who work specifically with teenagers who are depressed.

“There’s more emphasis now and there will be more emphasis because of the Affordable Care Act [on] offering mental health services in primary care settings,” suggests Curry, who is about to start a clinical trial looking at the effects of cognitive behavior therapy for adolescents with depression and substance abuse problems.

You, your child and a mental health care professional will decide upon the best treatment plan. “Treatment for depression has a good success rate,” Thurston says. “It’s important that people understand they can get help and relief from their symptoms. Treatment options include psychotherapy, medication or a combination of both.”

Helping Teenagers Who Express Suicidal Tendencies

“A majority of people who have depression do not die by suicide; however, having major depression definitely increases the risk of suicide,” Thurston says, adding that another way of thinking about the relationship between depression and suicide is recognizing that more than half of people who die by suicide have had a mood disorder.

Although not all people who suffer from depression commit suicide, be vigilant. Some teenagers with depression do express suicidal thoughts. These situations warrant immediate action, Thurston advises. She says if your teenager exhibits feelings of hopelessness, talks about wanting to die, makes statements about being a burden to others, becomes increasingly isolated or reckless, or appears to have intense mood swings, seek the advice of a mental health professional.

In the event that you are concerned that a teenager is at imminent risk for harming himself or herself, do not leave him or her alone and get help immediately by calling 911 or taking the teen to an emergency room to be evaluated by a psychiatrist. Thurston also advises removing firearms and limiting access to other household items that could be used to commit suicide.

The National Suicide Prevention Hotline at 800-273-TALK or serves as a 24/7 resource for those in need or those who are trying to help someone in need.

Helping a Teenager Cope With a Peer’s Suicide

There are ways to help your child cope with the loss of a peer due to suicide. Helping your teenager understand that the reasons people commit suicide are complex and that there are no simple answers is important, Goldston says. Instead of dwelling on the methods or graphic details of a peer’s suicide, focus on how your child is coping with the loss. Teenagers need to understand that a peer’s death is not their fault and that they cannot control another person’s actions. Make your teenager aware that you and mental health professionals are available to help them get through this difficult time.

Be mindful that for people who are already depressed, abusing substances or have other risk factors, a peer’s suicide may increase his or her own risk for suicide. Be observant in the days and weeks after the peer’s suicide. Seek professional help from counselors, physicians or mental health professionals if your teenager exhibits signs of depression and/or suicide.

Disclaimer: This piece should not substitute for professional mental health advice.  

Kathryn Caprino is a freelance writer living in Chapel Hill.

Local Resources for Parents

The Unicorn Bereavement Center (part of Duke Hospice Bereavement):

The American Foundation for Suicide Prevention and the Suicide Prevention Resource Center’s “After a Suicide: A Toolkit for Schools”:

The Duke Child and Family Study Center:

Young Adult Literature Featuring Mental Illness and Suicide

Bibliophile and literacy graduate student Tara Anderson of Durham says young adult literature can facilitate discussions about depression and suicide. She recommends several titles:

Ned Vizzini’s “It’s Kind of a Funny Story” portrays Craig, a teenager with depression at the hands of academic stress, who spends times in a psychiatric ward.

Jay Asher’s “13 Reasons Why” depicts the reasons Hannah committed suicide.

Jennifer Brown’sHate List” showcases the depressed Valerie Leftman, who must deal with the fact that her boyfriend Nick, also depressed, committed a school shooting.

In A.S. King’s “Glory O’Brien’s History of the Future,” Glory has to deal with her mother’s suicide brought on by depression.

Matthew Quick’s “Forgive Me, Leonard Peacock” reveals the story of Leonard, who plans to kill his best friend and then himself.

Anderson cautions parents to select texts carefully.

“Not every book about teenage depression or suicide or mental illness is going to give the kind of message that you want the teenager to receive, especially if it’s something that they’re dealing with personally in their real life,” she says.

Librarians, school counselors and the Young Adult Association of the American Library Association are good resources for additional titles. The School Library Journal posted an article about bibliotherapy for teenagers at (search for “bibliotherapy for teenagers”).

These texts help humanize teenagers who are suffering from mental illnesses, Anderson says. More than just their “symptoms or manifestations of a mental illness,” their characters are “complex individuals that are not just purely defined by their illness.”  

Read Anderson’s blog at

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