Speak to any parent who has a teen with depression, and most will tell you that somewhere along the way, there was a nagging feeling that they couldn’t shake: “Is this really normal?”

At first, the anger, moodiness, and withdrawal seemed like the typical growing pains of adolescence. But as time went on, that initial dip became a steeper decline: their teen seemed to lose their spark, instead becoming tired, unmotivated, and even more isolated.

Eventually, it was as if they weren’t totally present anymore — like they’d left parts of themselves outside the room.

But then there was a good afternoon, or a decent test grade, or a laugh on the phone with friends, and they thought, “I must be overreacting.”

The truth is, depression in teens can be complex. Adolescence is already a turbulent time, and it can leave you second-guessing if that persistent worry about your teen’s emotional well-being is misplaced.

It’s crucial to remember, however, that it’s better to be proactive with your teen’s mental health than to wait too long.

Read on to learn more about depression in teens, including the symptoms as well as the misconceptions that keep families from reaching out for support.

Symptoms of Depression in Teens

According to the American Academy of Child & Adolescent Psychiatry, the most common symptoms of depression in teens include:

Feeling sad, tearful, irritable, or down

This might look like: Crying spells, anger outbursts, “moping around,” being more argumentative.

No longer enjoying the things they used to

This might look like: Staying in bed, losing interest in hobbies or activities, not reacting when hearing news about a beloved TV series or celebrity, frequent complaining about boredom.

Spending less time with friends and/or after school activities

This might look like: Cancelling plans, dropping out of sports teams or missing practices, no longer talking about close friends, contemplating aloud quitting a club or activity

Changes in appetite and/or weight

This might look like: Not finishing their plate when they did previously, no longer getting excited about favorite foods, snacking frequently and more mindlessly, losing weight or gaining weight

Sleeping more or less than usual

This might look like: Struggling more to get out of bed on time, sleeping through or repeatedly snoozing an alarm, difficulty falling asleep, staying up much later than usual, never seeming rested or intense fatigue

Low self-esteem or excessive guilt/self-blame

This might look like: Making self-critical or mean comments about oneself, taking the blame even in situations when they aren’t at fault, ruminating about situations that are out of their control (“I should have…” “Why didn’t I…”).

Difficulty concentrating

This might look like: Straining to read or complete schoolwork that previously wasn’t challenging, zoning out during conversations, struggling to remember instructions or things they were told, difficulty focusing on television or activities that used to be enjoyed

Caring less about school or not doing as well in school

This might look like: “Phoning it in” for classes or subjects they used to like, their grades dropping without explanation, their teachers noticing they seem distracted or less engaged, not turning in homework or skipping classes.

Physical symptoms of stress or anxiety

This might look like: Frequent headaches, nausea or stomach aches, complaints of jaw tension, muscle aches or unexplained body pain, racing heart or heart palpitations.

Remember: Common doesn’t mean everyone.

Your teen could still have depression, even if they don’t present in the most “common” or typical way.

The only person who can accurately capture your teen’s internal experience is them, so if you suspect that your teen is feeling down, it’s best to ask them directly how they’ve been feeling and what they might be struggling with.

Severe Depression Symptoms in Teenagers

While any symptom of depression is worth taking seriously, there are some symptoms of depression that are particularly risky.

These include:

Having thoughts of suicide or wanting to die

This might look like: Suicide attempts or ideation, giving away prized possessions, dark or morbid humor (“I’d rather die,” “just kill me already”), despairing statements (“I can’t do this anymore,” “it’s never going to get better”), sentiments of feeling trapped or without options (“there’s no future for me,” “there’s no point anymore”).

Note: This can include sharing posts, internet memes, songs, or videos that express similar feelings or ideas.

Numbing or self-punishing behaviors

This might look like: Alcohol or drug use, self-injury (like cutting, burning, hitting oneself during or after arguments, etc), eating less food or drinking less water.

Decline in personal care

This might look like: Not showering or brushing one’s teeth (or doing so less often), not combing one’s hair and allowing it to tangle or mat, leaving moldy food or trash in one’s room when previously their room was somewhat maintained.

Careless behavior

This might look like: Not wearing a seatbelt, not wearing a winter coat when it’s cold outside, self-sabotage (like forgetting to submit their college applications), seeming to have a “passive death wish,” or not caring about the outcome of something that used to be important.

Your teen’s depression could be severe and hidden.

Even if your teen doesn’t seem to be exhibiting these more “severe” traits, it doesn’t mean their depression isn’t severe. Some teens will mask or hide their depressive symptoms, especially if they fear “getting in trouble” or being forced to get help.

Learn more: Depression in Teen Girls and Depression in Teen Boys may differ.

Symptoms of Bipolar Depression in Teens

In addition to the symptoms of depression, teens with bipolar disorder — a mood disorder that includes periods of depressive symptoms as well as manic or hypomanic symptoms — may experience additional symptoms, such as:

• Rage outbursts (temper tantrums)
• Rapid or fast speech
• Racing thoughts
• Uncharacteristically high energy levels
• Sleeping significantly less (only a few hours) but still seeming energetic
• Intense optimism or abrupt hopefulness
• Grandiosity, or exaggerated beliefs about one’s importance
• Impulsive behaviors such as spending sprees, reckless driving, hypersexuality
• Impatience and/or aggression
• Having lots of exciting ideas or projects
• Hearing voices
• Delusions (so, beliefs that are false, irrational, or illogical)

As a parent, it isn’t your job to diagnose your teen — rather, if you suspect something isn’t right, get in touch with a mental health professional as soon as possible. 

It is better to “overreact” to mental health symptoms than to delay or not react at all.

Why Do Teens Get Depressed?

“We never had any issues like that in our family. I don’t know where they got it from.”

There are many risk factors that can contribute to a teen developing depression. 

While family history can be one of them, there are countless others, including:

• Genetics (including an undiagnosed parent or relative)
• History of mental health struggles (other diagnoses like anxiety, ADHD, or substance use)
• Major life changes (like a divorce or move to a new city)
• Intense and prolonged stress
• Major physical illness or hospitalization
• Physical, emotional, or sexual abuse
• Physical or emotional neglect
• Domestic violence
• Generational trauma (like an incarcerated parent, or recent immigration)
• Experiencing bullying (including identity-based oppression, like homophobia or racism)
• Living in an unsafe environment (home, neighborhood, school)
• Experiencing economic hardship (housing or food insecurity)

Misconceptions About Depression in Teens

As a clinical team that specializes in adolescent mental health, we’ve spoken with countless parents who initially did not notice, believe, or take seriously what their teen was experiencing.

This is understandable, to an extent, because adolescence is a turbulent time, and it can be hard to tease apart the subtleties of teen depression from teen angst! 

That said, there are some common misconceptions parents tend to have that are worth clearing up:

“I know my child. I would know if my teen were depressed.”

Sadly, this isn’t always true. Some teens may hide their depression for fear of disappointing their parents or burdening them. Some teens may not realize they’re depressed, and may resist the idea of needing support altogether, causing them to conceal or minimize their symptoms.

“If my teen were depressed, they would tell me — they trust me.”

Teens may not always have the self-awareness to identify themselves as depressed, and therefore may not think to tell you. 

They may feel “sad all the time,” or have a much shorter fuse than they used to, but could easily rationalize that as stress, struggle to believe themselves, or blame themselves for not coping well (remember, self-blame and guilt can be a part of depression!).

“Their grades are fine, so they must be okay!”

Not all teens who struggle with depression end up struggling academically, at least not in ways that are obvious. 

Especially for teens who are highly intelligent, ambitious, or “gifted,” it’s possible they’re knowledgeable enough already to pass exams with minimal effort, or they may cope with their depression by burying themselves in their schoolwork (often at the expense of other areas in their life). 

This wouldn’t necessarily alarm a parent or teacher at first glance, but still doesn’t invalidate their experience of depression.

“They aren’t withdrawing from their friends — they’re just withdrawing from me.”

It can be tempting to personalize our teen’s behavior as a grudge against us, rather than a symptom of depression. However, for teens who are depressed, it’s not uncommon for them to lean on their peers rather than their parents, especially if they’re scared of seeking help or fear that you won’t understand their experience.

While a teen becoming more independent is developmentally appropriate, if you feel you’re being “iced out” or rejected, it could be a sign of something more.

“It’s their peers making them act this way; their friends are a bad influence.”

Teens and adults alike tend to gravitate towards friendships that make them feel seen and understood, or at the very least, that feel familiar.

If your teen is spending a lot of time with a friend group that concerns you, it should be regarded as a sign that they may be struggling and are leaning on peers who seem to empathize with those struggles — not that they’ve been influenced or “manipulated” into struggling.

“They’re just doing it for attention.”

Consider this: If your teen were doing something for attention, doesn’t that mean that they need your attention? 

It’s impossible to know with certainty the underlying motivation for a teen’s behavior, but you actually don’t need to. As a parent, it’s crucial to validate your teen’s painful emotions, and take any cry for help seriously — both so that they know you care, and so the behavior doesn’t escalate further.

If your teen is acting out for any reason, it means they have an unmet need. A mental health professional, like a therapist, can help untangle what might be at the root of that behavior, and how best to support both your teen and your family.

“If I talk about things like suicide or self-harm, it might give them ideas.”

Not talking about suicide or self-harm makes the subject taboo, and may increase the likelihood of your teen concealing their struggles out of fear or shame, and being more easily influenced by media or peers in harmful ways.

Tragically, suicide remains one of the leading causes of death for teenagers in the United States. Many parents whose lives have been touched by teen suicide often express shock and regret, wishing they had asked their teen directly rather than assuming they would reach out.

Creating a safe environment where a teen can talk openly about their struggles — including struggles with self-harm and suicidal thoughts — is essential. It’s better to confront misinformation head-on, and offer empathetic support, than leave your teen to rely on an internet search, TikTok, or a peer. 

Even if your teen doesn’t struggle with self-harm or suicide, chances are, they have a friend who does or will. Reminding them that help is available and that you are a safe person to confide in could save a life — if not their own, another teen’s.

Mental Health Treatment For Teens With Depression

The good news is, depression is treatable, and early intervention is linked to stronger mental health outcomes later in life.

While it’s crucial to connect with a mental health professional to ensure the treatment plan for your teen is adequate and safe, many teens find relief from some combination of:

• Lifestyle changes, including physical exercise (so long as an eating disorder is not present)
• Mental health therapy, including evidence-based treatments like Dialectical Behavior Therapy (DBT) and Acceptance and Commitment Therapy (ACT)
• Medication, which can include antidepressants and/or mood stabilizers
• Outpatient treatment centers (day programs) and/or inpatient treatment (hospitalization or residential)

You’re Not Alone

At Evolve, we offer personalized treatment for teens struggling with their mental health, including depression, on both an outpatient and inpatient basis. 

We know that the families we support and the teens we work with are unique, so the programs we offer emphasize individualized and holistic care, backed by decades of experience and clinical research.