Why Is My Teen Always so Tired? Do They Have Depression?

If you have a teen, you may  wonder why they always seem to be sleeping. Or tired. They might have a hard time getting up in the morning, and you’ve heard reports that they’re falling asleep in class. Or they may come straight home from school and take a nap.

True, school keeps them busy. And true, they may be involved in many extracurricular activities, which can keep them later after school. Plus, there’s all that homework to do at night; not to mention downtime and friends (late-night parties, anyone?). But there’s still that niggling voice in the back of your head, wondering if all this sleeping is really because they’re so overwhelmed by the day’s routine… or if there’s something else going on here.

Sleep Patterns and Teens

First, let’s look at the facts. Research has shown that adolescence brings with it a shift in biological sleep patterns. Thanks to changing circadian rhythms at this stage, teens naturally get tired later on at night. It’s also harder for their bodies to wake up in the mornings. Combine that with an early high school start time, and you can see why teens wake up so tired.

There are practical solutions that can help alleviate this problem, of course. Many mental health professionals encourage teens to go to sleep as early as they possibly can at night. Even if they’re not tired when they get ready to lay down, it’s better than falling into bed when they’re so exhausted they can barely keep their eyes open. Parents should also keep electronics out of the bedroom and institute a curfew for smartphones, as the bright light hampers teens’ sleep. Others advocate for later school start times. For example, California recently passed a bill that would prohibit public and charter schools from starting class anytime before 8am (or 8:30 am for high schools).

The motive of these California senators? All the research linking exhaustion with mental health and behavioral issues. Apparently, lack of sleep can cause cognitive defects, angry outbursts, negative mood, decreased attention, mental health issues, learning issues, and a host of other problems. According to the American Academy of Sleep Medicine (AASM), adolescents who don’t get enough sleep are also more likely to engage in self-injurious or suicidal behavior.

What does not enough sleep actually mean? According to AASM, teenagers should get eight to 10 hours of sleep per night. However, 75% of high school students sleep less than 8 hours a night, according to the CDC.

Mental Health Issues, Sleep Issues: Which Came First?

However, some wonder which came first: mental health issues or lack of sleep. Is exhaustion leading to mental health issues, or are their mental health issues causing fatigue?

Because the research goes the other way around, too. If a teen is struggling with depression, they are likely to be tired a lot. They may display fatigue all throughout the day. Teens with depression often have negative mood, angry outbursts, and passive affect. Their grades could be on the decline, and they could be losing interest in many of the activities that once brought them joy or satisfaction.

Same goes with anxiety. A teen with anxiety could be so nervous about certain things – school, natural disasters, friends – that he or she could have a hard time getting out of bed in the morning. It’s much easier to sleep the entire day than face their fears. However, on the surface, a parent could mistake this debilitating anxiety for exhaustion.

So how do you know whether your teen is just tired – plain and simple exhausted – or if they’re actually struggling with a deeper mental health or emotional issue that’s associated with fatigue?

My Teen is so Exhausted

There are several signs that indicate your teen may be struggling with fatigue that warrants medical attention.

Here are a few, from Dr. Craig Canapari, at the Yale Pediatric Sleep Center:

  1. It is very hard to wake your teen up in the morning; to the point that he often misses morning class.
  2. Their grades are declining.
  3. Teachers have complained about your teen falling asleep in class.
  4. Your teen commonly naps after school, and the naps are unusually long.
  5. During the weekend, they sleep excessively, and often wake up after noon or later.
  6. Your teen has had a car accident or near-miss car accident due to drowsiness.

In general, if your teen’s lack of energy stops them from participating fully throughout the day (being present and active at school, going about their daily activities), the fatigue is a serious problem. Your adolescent may be suffering from depression, anxiety, or another serious mental health problem. It may be time for teen mental health or dual diagnosis treatment.

Fatigue Could Also Be a Physical Health Issue

Note that fatigue could also be the result of a physical health issue, such as anemia, an underactive thyroid, Lyme disease, or even mononucleosis (aka mono). Teens with weight issues or an eating disorder could also be feeling exhausted. To rule out any somatic issues, visit the pediatrician.  (Keep in mind that some mental health issues are psychosomatic; meaning, they have effects on both the body and the mind. Anxiety, depression, trauma, high stress, and other emotional issues can cause fatigue and other physical and mental health symptoms.)

If your doctor cannot find a physical source for your teen’s fatigue, you may want to visit a mental health professional to see whether he or she can determine a diagnosis. If in fact your teen has depression, anxiety, psychosis, addiction, suicidal tendencies, self-harming behavior, or other mental health concerns, he or she may need treatment at an adolescent residential treatment center (RTC), partial hospitalization program (PHP), or intensive outpatient program (IOP). At a teen RTC, PHP or IOP, your adolescent will get help not only for their symptoms, but for the root of the emotional issues they’re struggling with.