Signs of Depression

What is depression?

Most people have felt sad or depressed at times. Feeling depressed can be a normal reaction to loss, life's struggles, or an injured self-esteem.

But when feelings of intense sadness — including feeling helpless, hopeless, and worthless — last for days to weeks and keep you from functioning normally, your depression (link opens new window) may be something more than sadness. It may be clinical depression — a more serious condition.

Depression is a treatable medical illness involving an imbalance of brain chemicals called neurotransmitters and neuropeptides. It's not a character flaw or a sign of personal weakness. Just like you can't “wish away” diabetes, heart disease, or any other physical illness, you can't make depression go away by trying to “snap out of it.”

Episodes of depression often follow stressful events. People who have recurrent episodes of major depression are sometimes said to have "unipolar depression”, because they only experience periods of low, or depressed mood (unlike someone with bipolar disorder who goes through periods of both low and high mood).

While depression sometimes runs in families, many people with the illness have no family history of depression. The exact causes of depression still are not clear. What we do know is that both genetics and a stressful environment, or life situation, contribute to its cause. Usually, it's not one or the other, but a combination of both.

Like other conditions, depression is easier to manage if it is caught and treated early. For most people, the right treatment, consistently used, works.

Common Symptoms of Depression in Adolescents:

Emotional Symptoms:

  • Flat, empty mood, prolonged sadness, weepiness
  • Listlessness; lack of motivation, bored, as if “going through the motions”
  • Loss of sense of humor
  • Feelings of hopelessness: “Nothing I do matters” or “I'll never be happy”
  • Increased anger, annoyance, irritability or outburst of temper
  • Frequent mood changes
  • Feeling unloved

Changes in Ways of Thinking:

  • Difficulty with concentration
  • Persistent negativism: “I can't do anything right”
  • Excessive guilt and self-blame for problems; out of proportion to the circumstances
  • Preoccupation with death: Verbal or written references to death, suicide, depression, anxiety, or hostility
  • All or none thinking - “Everyone either loves me or hates me.”
  • Overgeneralization - “I had a bad time at the dance, so I will have a bad time at all dances.”
  • Filtering - Seeing only one's failures, mistakes and problems. 
  • Catastrophizing - Blowing things way out of proportion - “I'll die if this relationship ends.”
  • Excessive guilt

Changes in Activities and Interactions with Others:

  • Loss of interest in previously enjoyed activities
  • Social isolation or withdrawal
  • Increased conflict with family or friends
  • Substance abuse

Changes in School Work and Behavior:

  • Disruptive behavior in class
  • Falling or drop in grades
  • Frequent absenteeism or tardiness

Physical Symptoms:

  • Changes in eating or sleep patterns: Sleeping much more than usual, disrupted sleep, non-restorative sleep
  • Weight loss or gain: Changes in eating habits or appetite
  • Frequent physical complaints
  • Neglect of personal appearance

Some Other Important Things to Know About Depression:

  • Your teenager can have any of these symptoms without being depressed. Everybody experiences some of these things sometimes.
  • The more symptoms you see, the longer they last, the more often they occur, the more they interfere with daily life…the greater the risk of depression or some other form of mood disorder. If you see any of these symptoms and they occur a lot of the time…check it out. Talk with your teenager. 
  • There are different forms and degrees of depression. And often depression is seen in combination with other disorders, like attention deficit disorder or a substance abuse disorder. 
  • There are different kinds of treatment for depression, and the right one can make a BIG difference. Some people improve with counseling and some with medications. Many people find that the combination of both works best.  It's also important to have a good plan for restoring vitality; regular exercise, a healthy diet, good quality sleep, the right amount of work, and building enjoyable activities into daily life.
  • If you are worried about your teenager, talk with your doctor, a counselor, or a psychologist. If your instincts are telling you that something is wrong, check it out.
  • Get help and support for yourself as you work to help your teenager.

How Family and Friends Can Help Someone Who Is Depressed:

The most important thing anyone can do for the depressed person is to help him or her get an appropriate diagnosis and treatment. This may involve encouraging the individual to stay with treatment until symptoms begin to abate (several weeks), or to seek different treatment if no improvement occurs. On occasion, it may require making an appointment and accompanying the depressed person to the doctor. It may also mean monitoring whether the depressed person is taking medication. The depressed person should be encouraged to obey the doctor's orders about the use of alcoholic products while on medication.

The second most important thing is to offer emotional support. This involves understanding, patience, affection, and encouragement. Engage the depressed person in conversation and listen carefully. Do not disparage feelings expressed, but point out realities and offer hope. Do not ignore remarks about suicide. Report them to the depressed person's therapist (or parent or other trusted adult). Invite the depressed person for walks, outings, to the movies, and other activities. Be gently insistent if your invitation is refused. Encourage participation in some activities that once gave pleasure, such as hobbies, sports, religious or cultural activities, but do not push the depressed person to undertake too much too soon. The depressed person needs diversion and company, but too many demands can increase feelings of failure.

Do not accuse the depressed person of faking illness or of laziness, or expect him or her “to snap out of it.” Eventually, with treatment, most people do get better. Keep that in mind, and keep reassuring the depressed person that, with time and help, he or she will feel better.