Sometimes the signs of teen depression are easy to recognize. Your teen is sad most of the time. Their sleeping and eating habits change. They don’t care about their friends, hobbies, or much else anymore. Other times, the signs are harder to detect and can be easily confused with other issues.

Here are a few lesser known signs that might point to depression in your teen:

#1 Irritability or Anger

While depressed adults often feel sad or hopeless, irritability and anger are common symptoms of depression in teens. Teens tend to be moody, so how do you know when irritability signals depression? If your teen is grouchy most of the time, gets in trouble at school, lashes out at you or flies into a rage over even small annoyances, this can be a sign of teen depression.

#2 Risky or Addictive Behaviors

Teens may try to cope with depression symptoms by engaging in behaviors that seem to help in the short term but cause damage long term.

Does your child engage in any of the following?

• Drug use, smoking, or heavy drinking – Almost one-third of people with major depression misuse alcohol. The relationship between substance use and depression is complex. Some people drink or use to cope with depression. For others, substance use can trigger a depressive episode.
• Out-of-control shopping or spending – Compulsive buying can be a sign of major depression or the mania phase of bipolar disorder.
• Excessive use of video games or the internet – Depressed teens often withdraw from family, friends, and favorite activities. Some may turn to virtual interactions like gaming, social media, or pornography.
• Shoplifting – Studies link depression with stealing, an act that may temporarily help counter feelings of numbness and powerlessness.
• Risky sexual behavior – Some teens use sex, often in the form of sexual obsession, unsafe sex, or promiscuity, to cope with depression symptoms. This can be a sign of major depression, mania in bipolar disorder, or impulse control problems.
• Gambling – Teens sometimes find an escape in online gambling. Studies show problem gamblers are more likely than others to struggle with depression and substance abuse.

#3 Forgetfulness

Some teens experience memory loss related to depression. Stress raises the cortisol levels in the body, weakening areas of the brain associated with learning and memory.

#4 Aches and Pains

Does your teen complain about back pain, stomachaches or other types of physical pain that don’t have an obvious cause and don’t get better with treatment? Chemicals in the brain, such as serotonin and norepinephrine, are linked to both pain and depression. People often report only physical symptoms, which get confused for somatic issues. As a result, depression gets overlooked even though research shows people with physical symptoms are twice as likely to have a mood disorder.

#5 Poor Self-Care

Teens with depression may neglect basic hygiene needs such as brushing their teeth, showering, or putting on clean clothes. You may also notice they regularly take risks that suggest a disregard for life, like not buckling up in the car.

#6 Weight Changes

For some teens, major changes in weight – defined as either a gain or loss of more than 5 percent of body weight in a month – are a sign of depression. A University of Alabama study found that depressed young adults were more likely than their peers to struggle with weight gain.

#7 Indecisiveness

Depression can affect your teen’s concentration, decision-making and ability to complete tasks. Teens with depression may get stuck in a cycle of rumination, or constant thinking. Others struggle with rational reasoning, self-confidence, perfectionism, or trusting their intuition, all of which can make it difficult to make decisions. They may feel stuck, unable to make big decisions like which crowd to hang out with, as well as smaller decisions like what to eat or watch on TV.

#8 Feeling Too Much

When a depressed teen feels sad, guilty, irritated, or angry, they don’t just struggle for a bit and move on. They experience emotions intensely, often getting overwhelmed by them. You may notice sudden changes in behavior. For example, your teen may go from expressing little emotion to yelling or crying.

#9 Feeling Nothing at All

While some depressed teens feel overwhelmed by strong feelings, others feel empty, apathetic, or devoid of energy. Some parents interpret this as laziness or lack of motivation. Things they used to enjoy no longer bring them pleasure. They may feel misunderstood or alone, like they don’t matter to anyone. Some young people describe this as feeling underwater or having a wall between them and everyone else.

If You See Something, Say Something

Depression can take a while for others to notice. It may go beyond sadness, with symptoms that are mostly internal and easy to miss. It also comes in various forms, ranging from mild to severe, lasting anywhere from a couple weeks to a year or more. If you pick up on signs that something isn’t right with your teen, talk to them. If they don’t want to talk, share what you’re seeing with a therapist or counselor. Depression often emerges in adolescence and earlier treatment can help them manage the issue before it impedes their healthy development.