Normal Teenage Angst or Something Else?

The teenage years are fraught with intensity, the surge of hormones and the pitfalls of apathy. One is neither a child nor an adult. There are responsibilities and expectations but no real freedoms. The prefrontal cortex-which governs impulse control and decision making-won’t be fully developed until around age twenty-five, so teens are often erratic and impulsive. Their decisions are frequently rash and poorly made, which is to be expected, if not usually excused. They are at turns passionate and clever, childlike and abandoned, serious and contrite. Often frustrated; always unpredictable. Whatever it is that “smells like teen spirit” surely smells of angst.

Depression in Teenagers

Sometimes, however, teens encounter problems which cannot be explained away by the surge of estrogen, testosterone, or the lack of a fully functioning prefrontal lobe. It is estimated that one in five teens suffers from depression and that as high as 28% of adolescents may acquire major clinical depression. Depression should not be thought of simply as sadness or being “down in the dumps.” It is a serious mental condition which can lead to self-medication via substance use or abuse with alcohol and/or drugs, as well as to suicidal thoughts or actions.

Some signs of depression may include:

  • Persistent feelings of sadness, hopelessness, or “emptiness”
  • Withdrawal from family and friends
  • Decreased interest in appearance
  • Fatigue or lethargy
  • Changes in appetite or sleeping patterns
  • Persistent physical complaints (e.g., headache, stomachache, etc.) for which there are no medical causes*
  • Increased irritability, agitation, or hostility
  • Extreme restlessness
  • Difficulty concentrating
  • Drop in grades and/or diminished interest in school activities
  • Drop in interest in friends and/or regular activities which typically brought pleasure in the past
  • Sudden weight loss or weight gain
  • Substance use or abuse
  • Suicidal thoughts, feelings (e.g., “I wish I were dead.”), or behaviors
  • *Note: Depression is frequently accompanied by real somatic pain. It is unwise to invalidate your child’s pain even when there may appear to be no apparent medical cause.

Teens and Suicide

According to the CDC, suicide ranks as the third leading killer of teenagers in America. Approximately one in 10 teens ages 15-19 attempts suicide at least once every year, with 600,000 suicide attempts causing injury necessitating hospitalization. It is thought that at least 90% of teen suicide attempts are never revealed. It is also believed that approximately 90% of teenagers who died by suicide had a psychiatric illness, the majority of which exhibited symptoms one year prior to their deaths.

It is also believed that 50% of adults with mental illness were first symptomatic during their adolescence. Receiving a diagnosis and acquiring treatment earlier can drastically increase quality of life over the long term-improving relationships, increasing school attendance, high school and college graduation rates, and improved workplace experiences.

If you feel your teen may be experiencing depression or the possibility of any other mental condition, recognize that speaking to her may not be enough. If your teen is suffering, she may already feel misunderstood. You may receive non-answers such as “I don’t know,” “I’m fine,” or even “Leave me alone.” This is to be expected of many teens, but if your teenager is experiencing depression or any other mental or emotional issue, she is likely unable to advocate for herself. You will need to do that work on her behalf. Find a therapist, a guidance counselor, and/or a mental health group in your area with resources for teenagers. You may have to insist that your child go. Do it gently, but firmly.

Some Other Symptoms of Depression in Teens

Teenagers who suffer from depression may experience increased frustration and episodes of rage or even violent behavior. Boys are more likely to express violent tendencies, but girls may also reveal aggressive outbursts.

Depressed youth may also exhibit self-harming behavior. Cutting, bruising, burning (branding or friction burning as with eraser rubbing), hair pulling (trichotillomania), head banging, drinking chemicals, and the breaking of bones are some examples of examples of self-mutilating behaviors a severely depressed teenager may resort to. It is important to know that these behaviors can become addictive and should not be thought of merely as attention-seeking. Even if you feel the behaviors are in whole or in part intended to acquire attention, do not say this to your teenager or to anyone who will. Any child engaged in these behaviors, or in anorexic or bulimic behaviors (also forms of self-harm), needs help to stop and invalidating words may only escalate their behaviors.

Get Support for Yourself

Regardless of the degree of symptoms your child may be exhibiting, it can be painful and frightening for any parent. Find a supportive community, group, and/or therapist to speak to about any overwhelming feelings you may have about the difficulty of attending to a teen with these issues. You are not alone.

It can sometimes be difficult to tell when a young person is simply being a teenager-lazy, angst-filled, and disdainful of most everything-and when that teenager is experiencing a serious problem. Inside, he may feel overwhelmed: powerless, confused, and too despairing to ask for your help. And he may not know that help is even possible. So reach out. Don’t judge or react or allow him to see you fret. Do not trouble over whose fault his depression or other illness may be, or how this might have happened to your child. Look only toward what you can do to get help for your teen, and for your entire family, including yourself.