Teen anxiety and depression are not medically different mental health conditions from adult anxiety and depression. However, the symptoms of these conditions may present differently in teenagers than they do in adults.
This may be due to the different developmental and social challenges that teenagers typically face, such as hormonal changes, developing brains and bodies, and peer pressure.
Anxiety and depression in teenagers have been linked to high levels of stress, a lower quality of life, and, in severe cases, suicide.
According to the National Institute of Mental Health, around 3.2 million people aged 12–17 years in the United States had at least one major depressive episode in 2017. This represents 13.3% of all teenagers in the U.S. People with depression often also have anxiety disorders.
Causes
There are many possible causes of anxiety and depression in teenagers. These include:
Genetics: Teenagers with a family history of mood or anxiety disorders may be at higher risk of developing them.
Trauma: Teenagers with a history of trauma—such as sexual abuse, violence, or involvement in an accident—may be more likely to experience anxiety and depression.
Environment: A teenager’s social, school, and home environments can have an impact on their mental health. Difficulties such as abuse and neglect, divorce in the family, being bullied, poverty, learning disabilities, and struggling to fit in may all contribute to depression and anxiety.
Differences in the brain: Teenagers’ brains are structurally different than adults’ brains. Changes in teenagers’ brain circuits that are involved in responses to danger and rewards can increase stress levels. Teenagers with depression and anxiety may also have different levels of neurotransmitters—such as dopamine, serotonin, and norepinephrine—in their brains. These affect the regulation of moods and behavior.
Substance misuse: Drug and alcohol misuse may affect teenagers’ moods and lead to depression. They may turn to these substances to self-medicate their emotions.
Stresses of puberty: Teenagers who are experiencing puberty may go through hormonal changes that affect their mood and deal with the stresses of a changing body, which can make them feel different than their peers.
Negative thought patterns: Depression and anxiety in teenagers may be linked to negative thought patterns. If teenagers have regular exposure to negative thinking—often from their parents—they may also develop a negative worldview.
Symptoms
It can be difficult for a parent or caregiver to differentiate between behavior that is a normal part of growing up and behavior that may indicate a mental health condition.
If behavioral changes last for weeks or months, and if they interfere with a teenager’s daily life, they may be symptoms of depression, anxiety, or both.
If a teenager is presenting some of the following symptoms, they may be experiencing depression or anxiety:
They have low energy.
They have lost interest in things they used to enjoy.
They sleep too much or too little or seem constantly tired.
They have difficulty concentrating.
They are spending more and more time alone and avoiding social activities.
They diet excessively.
They engage in self-harm behaviors, such as cutting or burning their skin.
They drink alcohol, use drugs, or smoke.
They feel deep sadness or hopelessness.
They experience anxiety and panic.
They are often irritable and lash out.
They engage in risky or destructive behaviors, either alone or with friends.
They have suicidal thoughts.
Diagnosis
A teenager can receive a full clinical diagnosis from a healthcare professional such as a doctor, psychologist, or psychiatrist.
Certain medical concerns can mimic anxiety and depression. These include thyroid disorders and substance use disorders. For this reason, it is necessary to rule those out to obtain a proper diagnosis.
The American Academy of Pediatrics (AAP) endorses a universal depression screening guideline for people aged 12 years and above. Healthcare professionals may use the AAP guidelines or adult guidelines for older teenagers.
The doctor, psychologist, or psychiatrist will perform a psychological evaluation of the teenager by asking a series of questions about their behaviors, moods, and thoughts. They will also take into account the teenager’s family history, peer relationships, and school performance.
A teenager must meet the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition to receive a diagnosis of anxiety or depression.
Treatment
A healthcare professional will treat a teenager’s depression, anxiety, or both based on the severity of the condition. They may suggest psychotherapy (talk therapy), medication, or both.
Usually, a combination of the two is the most effective treatment. An antidepressant, or a combination of antidepressants, can help correct the chemical imbalance in the teenager’s brain. Meanwhile, talk therapy may help combat negative thought patterns and behaviors.
The Food and Drug Administration (FDA) has issued a warning that antidepressants may cause some children and teenagers to experience suicidal thoughts. The FDA has approved two drugs to treat depression in children: fluoxetine (Prozac), for children aged 8 years and older, and escitalopram (Lexapro), for children aged 12 years and older.
Experts state that they need more pediatric studies, as many antidepressants with approval for adults are not proven to work in children.
The FDA requires that all antidepressants include a warning about the increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults up to the age of 24 years.
Remedies
Aside from drug treatments and talk therapy, teenagers who are experiencing depression and anxiety may get some relief from:
exercising and staying active, even if it only involves a short daily walk
spending time with friends and family
breaking up large tasks into smaller, simpler, more manageable ones
trying to maintain a regular sleep schedule
eating a healthy diet
asking for help
Speaking with a support group may also help teenagers manage their depression or anxiety. Some organizations that offer help include:
Teen Line
Give Us the Floor
Depression and Bipolar Support Alliance
Support Groups Central
Risk factors
Factors that may increase a teenager’s risk of experiencing depression or anxiety include:
having difficulty adjusting socially
having a family history of depression and anxiety
having a lack of emotional support
being bullied in person or online
living in an abusive or violent home
experiencing a crisis, such as death or divorce in the family
experiencing past trauma
having a chronic illness
having difficulty with their sexual orientation or gender identity
Advice for caregivers
Parents or caregivers of teenagers who have depression, anxiety, or both can help them by viewing the condition as a serious matter that requires professional attention.
They should help their teenagers find a therapist that they feel comfortable talking with and discuss a treatment program with a medical professional.
Parents and caregivers can also try to encourage their teenagers to exercise, be social, schedule their activities into manageable chunks, and find an outlet for their emotions, such as a journal or support group.
Summary
There are many potential causes of depression and anxiety in teenagers. These include genetics, trauma, their environment, differences in the brain, substance misuse, the stress of puberty, and negative thought patterns.
The symptoms of depression and anxiety in teenagers may include low energy, a lack of interest in things they used to enjoy, disrupted sleep, and feelings of hopelessness.
The most effective treatment for depression and anxiety is usually a combination of talk therapy and medication.
Aside from medical treatment, teenagers may be able to improve their symptoms by exercising, making large tasks more manageable, socializing, maintaining a regular sleep schedule, and asking for help.
Medically reviewed by Alex Klein, PsyD — Written by Caitlin Geng on July 27, 2021
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