A Parent’s Guide to Teenage DEPRESSION

Priory’s Group Associate Medical Director and Child and Adolescent Psychiatrist Dr Hayley van Zwanenberg explains the common causes of depression, the signs that your teenager may be suffering and what can you do to help them.

DEPRESSION isn’t exclusive to adults – it can affect anyone.

The persistent and long-lasting unhappiness characterising depression can have an enormous impact on how a young person thinks, behaves and feels.

When combined with the hormonal changes, academic expectations and peer pressure that teenagers typically experience, it can make day-to-day life a real struggle.

If you are worried that your teenager may be dealing with depression, Dr Hayley van Zwanenberg – Child and Adolescent Psychiatrist at Priory Wellbeing Centre Oxford – has outlined the warning signs to look out for.

She has also highlighted what depression can feel like for a teenager, helping you understand what they may be going through.

You will also find information on the steps to take if you think your teen has depression, and how you can help them on their journey to recovery.

What does DEPRESSION feel like for a teenager?

It is as if you have a sieve in your head.

You let any positive information through to wash down the sink.

Anything you can turn into a negative, you catch in the sieve where you then focus on it and magnify it to help reinforce all your negative thoughts. You will try and put a brave face on to cover up how you feel in front of your friends. You think you'll be a burden to others if you show your true mood.

Putting on a mask like this is exhausting. By the time you come home you cannot keep it up and the family are often the ones to see the true picture. Depression is not a pleasant illness to experience and many young people describe it as feeling like being tortured in their head.

Anything that you hear gets turned into a negative by your brain.

Even when a specialist says that depression is treatable, your brain tells you "you'll be the only one this doctor can't get better.

What can cause their DEPRESSION?

Depression in teenagers can have obvious triggers such as:

A relationship ending

Losing someone they love

Not passing something that is important to them

But many teenagers develop symptoms of depression and cannot identify any reasons for them. When this happens, a family history of depression and genetics might be coming into play.

What behaviours, thoughts and symptoms can DEPRESSION cause?

Symptom Thoughts

Low mood

Thoughts of self harm

Suicidal thoughts

Changes in sleep pattern

Lack of energy

Loss of motivation towards activities they use to enjoy

Poor concentration

Feeling hopeless

Feeling guilty about little things

Changes in appetite

Behaviour

Isolating themselves

Self harm

Preoccupied, as they try to distract themselves from these thoughts or make plans to act on them.

Struggling to get to sleep, waking up a lot in the night or waking very early. The opposite can happen where they want to sleep all the time.

Struggling to do anything other than the minimum they have to do each day.

Stopping clubs and hobbies.

Decrease in academic performance.

Struggling to think about the future or look forward to anything.

Avoiding people to try not to upset anyone.

Either not hungry or comfort eating.

“No one really likes me. Everyone has fun without me being there. No one really cares about me”

“I’m rubbish, I deserve to suffer, I cannot take this anymore”

 “People would be better off without me. They wouldn’t be upset for long”

“I’m so rubbish, I’m never going to achieve anything”

  “I don’t achieve anything, I’m a waste of space”

“I’m a boring person and rubbish at everything”

 “I’m going to let everyone down”

“Nothing will ever get better. I will never succeed”

 “Everything that goes wrong is all my fault”

“I can’t be bothered to make any food for myself”

 What to do if you think your teenager has DEPRESSION?

Listen, listen, listen  (and don’t judge)

If you are concerned about your child, sit down calmly with them and explain that you are worried as they do not seem themselves.

Be careful that the young person does not take this as criticism. As seen in the sieve image above, positive information they receive will wash away and anything that can be turned into a negative will be focused on and magnified to help reinforce their negative thoughts.

Help in a way they are comfortable with.

If the young person is struggling, calmly explain to them that they might be depressed. Let them know that depression is treatable, but you understand it is a horrible place to be when you are suffering with it.

Give them statistics such as ‘one in 10 young people have a diagnosable mental illness at any one time’ and explain that depression is common so that they don’t feel different or unusual - and repeat it is treatable.

Advise them that it would be worth taking them to a doctor to find out if they are unwell with depression, and if so, to get them the right support.

They need to be able to place their trust in doctors and adults who have always cared for them.

Explain that if they see a doctor, the doctor does not have to share everything with you if they want to talk in confidence. However, explain you are willing to listen too, and will not get upset and are willing to help in any way they feel comfortable

with. A GP should be able to refer you to a Child and Adolescent Psychiatrist who can make the right diagnosis and recommend a treatment plan.

Reduce risks

Give them the phone numbers for Samaritans and ChildLine. If they have self-harming or suicidal thoughts, ask them to share those thoughts with you in a way that they feel OK with, so you can help keep them safe. They could text you, write their thoughts down,

or talk to you about them when feeling calm and perhaps distracted with an activity.

Things you can do to reduce risks include locking away tablets and asking the young person what websites they are accessing online, and talking through whether these are really helpful to them or not.

Ask how they would like you to support them; they may just want hugs, a distraction such as watching a film with you or not to be left alone at night time.

Give them useful apps to look at such as Headspace or Calm Harm.

Stay calm

Stay calm and help your child feel that it is safe to talk to you. If you need to discuss what they tell you with another family member or friend for your own support, ensure they do not feel their confidence is being broken or that you are telling everyone about them.

Most importantly, get them professional help. Depression is a horrible illness that causes risks to the young person but is treatable, and the earlier treatment is accessed the better.

How to support their journey through RECOVERY

Keep lines of communication open

It is so important to help them communicate their risks while they are getting better, as recovering from depression is a journey that can take two to three months or more.

Many young people prefer communicating their risks by text, where they use single words such as red to mean they are having thoughts that could be dangerous to them. There needs to be an agreement about how you will react if they tell you their risks, so they feel safe to do so.

Managing everyone’s expectations

Depression is treatable with professional help, but it is a journey with its ups and downs. As a teenager starts to recover, they will have better moments, and then better days, which will increase in frequency to the point where they feel they have recovered sufficiently.

During the journey, there will be dips to a lower state of mind. When this happens, the drop between moods may seem significant, as it is a bigger change in mood from when they were low all the time. It is important to inform them that this happens as part of recovery so they do not feel like they are back at square one.

The dips will gradually become less severe and less frequent until they stop and their mood fluctuations reach their healthy range again.

Understanding early warning signs

Once a young person is better, it is important to allow therapists to help them understand what their early warning signs of becoming unwell would be. These are different for everyone.

If your child and family can understand the early warning signs of relapse, they can get access to support quickly and use strategies given by therapists to prevent themselves from becoming unwell again.

For further help go to https://www.nhft.nhs.uk/camhslive