This episode discusses depression and suicide – listen with care. If you or someone you know is having thoughts of suicide, call or text 988 to reach the National Suicide Prevention Lifeline or go to SpeakingOfSuicide.com/resources for a list of additional resources.

This is Speaking of Teens. I’m Ann Coleman.

Earlier this year the CDC released the results from the Youth Risk Behavior Survey which was distributed to 17,000 teens from high schools across the US in the fall of 2021. They were jaw-dropping, to say the least.

The most alarming statistics were those connected to depression and suicidality – specifically rates for girls were around double that of boys and rates for LGBQ+ teens were even higher.

Almost 60% of girls and 70% of gay, lesbian and bisexual teenagers said they had persistent daily sadness for at least 2 weeks during the previous year (the mark for it to “count” as depression).

And 30% of girls and 45% of LGBQ+ seriously considered attempting suicide during the previous year.

This week on Speaking of Teens, the myths and truths about Adolescent depression; and the signs, and symptoms you should watch for in your teen.

There’s so much to discuss regarding the issue of teen depression, I can’t do it justice in one episode, which is part of the reason why I’ve waited until I’m a year in to this podcast before broaching the subject at all.

So, in this episode I want to start at the beginning to give you a clear picture of what teen depression looks like, what to watch out for and address the many misconceptions.

In future episodes – perhaps not consecutive to this one – I’ll cover screening, school’s role, and treatment options, including those on the horizon.

My mother has depression. I’ve experienced severe lingering depression at several points throughout my life, my son was diagnosed with major depressive disorder as a teen, my Godson has struggled with depression since he was a child. I’ve seen how this disorder can take people down some very dark paths and how hard it is to find your way out. Understanding what it is and what it looks like in young people is critical because the sooner you can get them help, the better.

And the likelihood that you may face this issue with one of your kids is pretty high considering the grim statistics I just quoted. I’ll talk about the signs and symptoms in a minute but let’s start with some of the major myths associated with adolescent depression.

Myth #1 It will be obvious when your teen’s depressed. Depression isn’t as visible as panic attacks, OCD or nervous tics. And unfortunately, there’s no “typical” way that a teenager acts when depressed. They don’t all dress in black and sculk around all alone. Teens of all sorts (jocks, hippies, academics, misfits, and loners) can become depressed. It’s not all crying and sitting alone in their bedroom. And by the way most teens spend a ton of time in their bedroom, which alone is not an indication of depression, but together with other signs like you’ll hear in a minute, can indicate depression. And quite often teens will hide or cover their symptoms to keep parents and loved ones from worrying about them. That’s why your emotional connection with your kid is so important. They need to feel safe sharing anything with you without worrying about getting in trouble, being judged, or shamed or ignored. Staying on top of what’s going on in their life can be crucial in detecting depressive symptoms (and we’ll discuss those shortly). One of the biggest complaints teens have when it comes to their mental health is that their parents don’t take them seriously when they do share with them. Don’t make that mistake. If they tell you they’re depressed (or anxious or anything else) it’s so much better to er on the side of caution and get them immediate help. It can’t hurt to overreact but not reacting could be a horrible mistake. So, understand that just because things may appear okay at surface level, doesn’t mean there’s not something going on in their head – know your teen well.

Myth #2 Medication is the best way to treat teen depression. How to treat teen depression depends on several factors including whether or not there are other mental disorders present such as ADHD, anxiety, bipolar disorder and whether they are using or abusing substances. Some pediatricians may recommend medication right off the bat. If your child is evaluated by a psychologist, they may refer them to a psychiatrist who more likely than not, will prescribe some sort of medication depending on the circumstances. It really depends on who your child sees as to what treatment options will be recommended. Milder cases of depression may be able to be treated with psychotherapy alone. Generally Cognitive behavioral therapy or CBT is quite helpful. Some professionals recommend trying therapy first and if after a few weeks symptoms don’t improve, they may suggest medication. I would never go with medication alone – there may be issues than need to surface in therapy. I recommend listening to episode 7 for more information on the types of professionals and who does what. On the flip side, there’s…

Myth #3 Antidepressants are dangerous for teens and should be avoided. This is actually not true either but is a bit complicated – and because I know medications are always a concern for parents, I think it’s worth diving into this a bit. Antidepressants are prescribed for teens on a regular basis by many pediatricians and psychiatrists, despite the FDA’s “black box warning” issued in 2004 about a risk of increased suicidal thinking for some people under the age of 25.

It is important to point out that when the FDA was studying these drugs, first of all they only studied 9 of them (not all – even though they extended the warning to all of them) and there were no kids in the studies who actually took their life. However, there was a small increase in suicidal thoughts compared to a placebo (a sugar pill), which was concerning enough to the FDA to issue their warning.

The big problem here is that it’s hard to say if it’s the depression that causes these suicidal thoughts or the medication. There could be many reasons for the increased risk for suicide that has nothing to do with the medication – it’s almost impossible to establish that clear causal relationship.

And here’s the thing, Doctors can prescribe these medications as they see fit, despite that warning from the FDA because the FDA has no authority to regulate physicians – only the medications and medical devices they prescribe.

And there are some researchers and clinicians who claim the black box warning is unwarranted and may in fact be harmful because it keeps some kids from receiving the medication they may need to prevent them from being suicidal. But there are still some researchers that claim that the black box warning is warranted.

The American Psychological Association guideline panel reviewed the literature, and made recommendations regarding treating adolescents for depression; They recommend the use of cognitive-behavioral therapy (CBT) or interpersonal psychotherapy for the initial treatment of depression in adolescents. And, for clinicians considering medication options, they recommend fluoxetine over other medications (which is mainly marketed as Prozac). They added that they didn’t feel there was enough evidence to determine, between psychotherapy and fluoxetine, which was more effective in treating the disorder. They also said if psychotherapy and fluoxetine were “ineffective, unavailable or unacceptable to the patient” that providers can consider other treatment options though the evidence for their effectiveness is less robust.”

 

 

For adolescents, the guideline offers a conditional recommendation that patients and providers might consider alternative antidepressants, but recommends against the use of clomipramine (tricyclic antidepressant marketed as Anafranil), imipramine (tricyclic antidepressant marketed as Tofranil) mirtazapine (Tetracyclic marketed as Remeronsoltab, Remeron), paroxetine (SSRI selective serotonin reuptake inhibitor Paxil, Pexeva, Paxil CR) and venlafaxine (SNRI selective serotonin and norepinephrine reuptake inhibitors Effexor XR) because of the potential for increased suicide risk in youth taking these drugs.

 

In spite of or because of all the research, the general medical consensus (from institutions like Mayo Clinic, Stanford Medicine and many others) is that these medications are an effective way to treat depression in many kids and teens. They also point out that it’s difficult to determine if the medications cause suicidal thinking or if it’s the depression itself. Kenneth Duckworth, MD, medical director of the National Alliance on Mental Illness (NAMI) has been quoted as saying, “letting the risk of side effects drive the decision-making process may put your child at greater risk”. Both the doctor and the parents should always closely monitor the teen’s behavior on any medication.

Listen, I kept a journal every time my son was put on a new ADHD medication, a new anti-depressant, whatever it was. I started with day one and charted mood, eating, sleep, outbursts, and noted anything at all unusual. I would tell you to do the same. And as the Mayo Clinic suggests, your child should always be evaluated by a mental health specialist experienced in the treatment of depression in adolescents – and that evaluation should include:

• A detailed review of any potential risk factors your child may have that increase the risk of self-harm
• An assessment of whether your child may have another mental illness, such as attention-deficit/hyperactivity disorder, substance misuse, bipolar disorder, or an anxiety disorder or an eating disorder
• An evaluation of whether there's a family history of mental illnesses or suicide

I’m going to link to the Mayo Clinic article in the show notes which goes on to discuss the antidepressants that are approved for kids by the FDA.

 

 

 

Myth #4 All teens with depression are a suicide risk. A mood disorder like depression or a trauma-related or stress-related disorder are key risk factors for suicide but not the only risk factor. Others include a recent serious loss (like a break-up, death of a loved one, friend or even a pet), prior suicide attempts, a substance use disorder, struggling with sexual orientation (as in not feeling supported by family or friends), a family history of suicide, abuse, neglect or other violence, access to firearms or pills and the list goes on. There are many key protective factors for suicide and I’ll link to a great article by Child Mind Instituted in the show notes. Just know that teens with depression don’t want to die – they just want the horrible agony they’re in, to stop. And they need help to make it stop.

Myth #5 Teens with depression don’t smile or laugh or have fun. Kids can have depression and still have moments where they enjoy themselves. They can laugh at something funny or smile when playing with a pet and yet, still feel the weight of depression most of the time. They may go out with friends to try and distract themselves. The problem is, even with friends, they will still feel alone. So, depression doesn’t always look depressing.

Myth #6 A teen with “everything” has nothing to be depressed about. In fact, research has shown that teens from upper class families are more likely to be depressed than even kids living in poverty. This is because of the pressure they feel from family, friends, their “high achieving, academically rigorous, fancy college focused schools”. “Success” is all these kids are sold since infancy. We can want so much for our kids that it clouds our better judgment and common sense. So, although depression is biologically and even genetically based, it can certainly be triggered by current stress – or even past traumas that haven’t been dealt with properly. A teen can look perfect on the outside, look like they have everything going for them and be falling apart on the inside because of pressures they’ve put on themselves or those from other people. And, once again, you won’t know that without that all important emotional connection (you can listen to episode 26 for more on that)

Myth #7 They’re not depressed, they’re just moody and irritable like all teens. Yes, teens do experience major mood shifts and can become angry, nervous, fearful very suddenly and for seemingly no reason. But they can also develop clinical depression, which can also show up as irritability and even anger. We’ll talk more about signs and symptoms in a minute but to assess whether your teen may be depressed, you should look at other signs along with the mood (like changes in sleep patterns, appetite, focus, motivation, etc.), which leads me to…

 

Myth #8 Teen depression looks like adult depression. No, it doesn’t. I’ve seen this first hand with both my son and Godson. Teen depression can look extremely irritable, angry even rage-filled and unhinged. Defiance, lashing out at parents, authority figures, using drugs and other substances…which can be terribly confusing for all but maybe a psychiatrist or perhaps a very well-educated pediatrician. As parents, we can really totally miss the ball here and concentrate solely on the outward behavior  - trying to rein them in and get them under control when they’re withering inside and do not have the emotional awareness to articulate it. And then, the opposite can also be true – your kid may seem completely emotionless – devoid of feelings, which can also be terribly confusing. So, again, doesn’t always look just sad.

Myth #9 I shouldn’t talk about depression or suicidal thoughts with my teen. So, not true. We worry that we might make them depressed if they really aren’t or might give them the idea to kill themselves if we ask them if they’re feeling suicidal. That’s simply not true. Open communication with your teen can be the key to helping them get better. Again, your connection with them is critical. They need to know, deep within their soul that they can share their feelings with you and that you won’t judge them, shame them, get angry, punish them, or turn your back on them. And while you think they know that – they don’t know that until you’ve shown them – until you demonstrate it to them. And if they’ve told you things in the past and you have punished them or shamed them – you better believe you have a ton of work to do to get that trust and connection back. Their ability in getting better could rest in your ability to prove to them that you’re ready with your love and non-judgmental support and assistance in finding the right help.

Myth #10 Treating them like they’re not depressed will make it go away. Obviously not. But I think what happens with many of us is we get frustrated with their outward behavior – the symptoms of depression that disrupt our household, impact siblings, schedules, and routines, even holiday traditions. It’s easy to think, “They just need to get over it and stop acting like this!” And it can become all too easy to punish them, issue consequences or restrictions. And to a kid who’s already depressed and can’t help how they feel or how they’re behaving because of those feelings, this isn’t fair and can make their situation much worse. One of the driving factors for teens is the need to fit in and to be accepted by their peers – popular even. If you take away their ability to be with their friends, to Snapchat or DM them online, you’re taking away the one thing that may be keeping them from sinking below the surface. Don’t punish a depressed teen. If they could do better, they would. Teens, kids…want to please you – they do. They don’t want to feel the way they do or act they way they do. They wish they could just snap their fingers and change but they need help instead.

Myth #11 Teens are just lazy by nature – it’s not depression. First, teens aren’t “lazy”, they’re sleep deprived. Their brain keeps them alert and awake about 2 hours longer than when they were younger, which means they generally aren’t even tired until around midnight, then have to get up 6 or 7 hours later when they actually require at least 9 and a quarter hours of sleep a night. That’s why they fall asleep in class, why they nap in the afternoons, why they want to sleep late on the weekends. So, that’s first. Second, teens who’re depressed are even more sleep deprived because depression keeps lots of people awake at night. Depression can also affect their energy levels, motivation, focus. Depression makes you feel like your swimming in molasses. Everything becomes a daunting chore – from getting out of bed to even eating. So, again, checking in with your teen and trying to get to the bottom of their outward behavior is key in knowing what steps you might need to take next.

Myth #12 If your teen refuses your help, there’s nothing you can do. Remember, you have the ability to get out there and find resources to help you, help your teen. If you can’t figure it out, reach out to me at acoleman@neurogility.com and I’ll help. There are plenty of online resources that will walk you through how to ease your kid into counseling. Talk to a counselor yourself about how to talk to your kid. Get their advice on getting them in the door to see them. Talk to your teen and see if they’d agree to a different form of counseling – virtual or even text counseling is better than none at all. Talk to their pediatrician, watch YouTube videos, buy a book. Do not give up. Your kid needs to see you’re not going to give up on them – that may actually be the impetus they need to join in their own recovery.

Myth #13 Depression affects both girls and boys equally. Obviously, if you heard the statistics I read off at the top of the show, you know this is untrue. Girls are twice as likely to develop depression than boys. Several reasons for the inequality have shown up in recent research. One study showed that girls experience twice as many interpersonal stressors as boys and react more strongly to those stressors. According to the accepted research definition interpersonal stressors are “stressful episodes between two or more people that involve quarrels, arguments, negative attitudes or behavior, an uncomfortable atmosphere during a conversation or activity, and concern about hurting others' feelings.”

On the other hand, boys tend to act more aggressively than girls while experiencing depression. And I’ve seen that first hand. A combination of anxiety and depression broke every solid wood door in my house, knocked holes in several walls, broke furniture and turned over an unanchored kitchen island.

Studies have also shown that boys tend to be more impulsive and are therefore much more likely to commit suicide but more than 2-3rds of teen antidepressant users are girls – which means girls receive more treatment than boys, which could mean so many things (that girls are more likely to ask for help, that parents are more likely to feel their girls need that help, that boys are better at hiding their depression) – Just stay close to your teen and watch their behavior and again, work on that connection. Listen to that little voice in your head – it’s usually not wrong.

Myth #14 Depressed teens will get better once they get back to a normal routine. It’s easy to assume that your kid is just out of sorts because they’ve gotten off their normal routine. Maybe they’ve skipped a couple of track meets or haven’t felt well and missed some outings with friends. But the truth is that usually your teen has missed these things because they were feeling depressed, and these things just seemed too hard to do. Pushing and prodding or fussing at your teen to get them to do things they don’t feel capable of handling right now because of depression, is not going to help. Get them to a mental healthcare provider and get their input on how to handle activities. I remember trying to get my son to go outside and just feel the sun on his face or walk around the block and he couldn’t even manage that.

Myth #15 Teens can’t inherit depression from a parent. Actually, they can (along with other types of mental disorders). According to scientific studies we know genes at least play a role in depression. They’ve done twin studies on identical and fraternal twins that show this. In identical twins who share 100% of their genes, if one twin has depression, the other twin will also have depression approximately 76% of the time. With fraternal twins who only share 50% of their genes, if one twin has depression, the other twin will only have depression 19% of the time. They’ve even done studies with identical twins raised in separate homes and shown that if one twin had depression, the other twin was still 67% likely to develop the disorder. This shows there is some genetic link to depression although they’ve not uncovered a specific gene for the disorder. It appears that having a parent or a sibling with depression means you are 1.5 to 3 times more likely to develop depression than someone without a first-degree biological relative with the disorder. Scientists seem to feel that this genetic relation just means one would have the tendency or a vulnerability to become depressed, which would then interact with other stressors to actually bring out the disorder – in other words, it’s not a given – some say it’s just a 50/50 chance you’d develop it. But they really just don’t know the answer yet. I’ll provide some links in the show notes.

Myth #16 All teens get depressed, it’s just part of adolescence. No matter our age, we all experience sadness, unhappiness now and again – it’s just part of life. Depression is not simply feeling sad or unhappy. Not by a long shot. Sadness may last for a couple of days, but depression can last weeks and weeks, even months or years. Depression can come on because of major stressors or it can spring to life all on its own. The best way I can describe depression is – it’s kind of like that feeling when you’re so sick – down to your bones - that you can’t imagine ever standing up and walking again, or eating or smiling. You see people walking around and you think – how can they be okay, and I feel like this. Depression can stop someone in their tracks. They can feel stuck in the mud. It disrupts daily life in one or more ways. It can keep someone from school, regular activities, friends. There are things they just don’t feel they can do. They may not be able to focus or move right, everything seems off. And remember this is an illness just like any physical illness and it has to be treated. If ignored and left untreated it can lead to substance use disorder, problems in school, including school refusal, falling grades, social isolation, risky behaviors, self-harm and even suicide.

Myth #17 Only people who are weaker mentally, emotionally, or intellectually, or are just pessimists get depression. Mental illness doesn’t work that way. Intellect, character, temperament or personality don’t really matter. Anyone, anywhere can get depression. Look at Kate Spade, Anthony Bourdain, Robin Williams. It happens to the best, the brightest, the talented, the rich and the famous. But there are some protective factors such as greater emotional regulation, care and companionship of peers; support from, connection to and guidance from parents, connection and sense of belonging at school, having high self-esteem, community involvement, good problem-solving skills, these things can help reduce the risk. The fact that your teen is depressed is nothing to hide, be embarrassed about or be ashamed of. It happens.

Myth #18 – the last one here – A teen could snap out of it if they’d stop feeling sorry for themselves. Someone can’t “will” themselves to snap out of depression any more than they can “will” themselves to fly. Mental health disorders have nothing to do with willpower, the need or desire to feel better. No one chooses to be depressed. Depression should be treated just as you would any other medical disorder – by a professional. And I’ll repeat this, ignoring your teen’s feelings, telling them to snap out of it or being critical of them, will exacerbate the problem. It’s hard enough for a teen to tell an adult, much less a parent, about an emotional issue – if they tell you something’s wrong – something IS wrong. Get them help immediately. Again, episode 7 may be able to help you.

Now let me make a couple of points before I rattle off some signs and symptoms to watch for. First, talk to your kid and let them know that you know that so many teens have a hard time with depression or anxiety and that if they ever feel “not right” to let you know – that you will get them the help they need – that they can trust you. That’s all you have to say – a couple of sentences – don’t make a big deal about it.

Also, please tell them that, in this same vein, you want them to know that if they ever suspect a friend is struggling and that friend is not talking to their parents about it, that a) you’d be willing to talk to them about it (because I’m telling you right now, you’d want another parent talking to your kid if they’re not coming to you – and of course, you’re going to talk that kid into going straight to their parents) and

1. b) that even if this friend doesn’t want to talk to you, that telling you when a friend is struggling is not a breach of trust with that friend – it’s an act of friendship and loyalty and love to protect them if they’re in pain.

Now, let me run through some of the emotional changes you may see in your child if they’re suffering from depression:

(obviously) Feelings of sadness, which can include crying spells for no apparent reason

Frustration or feelings of anger, even over small matters (and these first 2 are tough because teens are apt to feel sad, cry get pissed over nothing but if it’s happening more often, it’s more intense or it’s accompanied by any of these other signs, you’ll know something’s up – plus you can always ask them)

Feeling hopeless or empty (Hopelessness is a very common part of depression. For teens, this is because every negative situation or emotion can feel like the end of the world – it can feel life-altering, and permanent.

You have to remember that their life experience is so limited. Dating, friendships, school – at their young age, a few months is a big chunk of their life so far. Think about that. So, a break-up with a boyfriend or girlfriend of a year can be totally devastating, especially if it’s their only dating experience. You need to put yourself in their shoes, empathize and understand that from their perspective, things look much different. They don’t have the advantage of looking back from 25 years down the road. So, teens can feel completely overwhelmed and hopeless about something that you and I may know won’t matter in the near future (and, by the way, you can’t change their perspective, you must remember to listen, empathize, reflect what they say, help them with an emotion word – download my free guide you can find right there in your episode description in the app = “10 Keys to Unlock Your Teen’s Emotional Intelligence”.

 

 

 

 

 

Irritable or annoyed mood I mentioned earlier in one of the myths that being irritable and moody may not be just typical teen behavior. Yes, teens are moody and irritable by nature. But, there can also be something else going on there. And this is something I really missed in my own son. Because actually, anger, moodiness and irritability can be symptoms of both depression and anxiety in teens.

Have you ever seen the illustration of the iceberg – where it shows the part of the iceberg above the water (the emotions you see – like anger, irritability, frustration, agitation) and the iceberg, which is just as large, floating under the water (the emotions you don’t see and that possibly your teen isn’t even consciously aware of).

Of course, we associate depression with major deep feelings of sadness, but very often teens may not show that emotion and may not even be consciously aware that they feel sad.

Instead, those subconscious feelings of sadness or hopelessness end up eking out as irritation, anger, even rage. They may take it out on you, siblings, teachers, friends, co-workers, or the order-taker at McDonald’s.

Loss of interest or pleasure in usual activities A major warning sign for depression in teens and adults alike is loss of interest in stuff they used to really enjoy. They just shrug their shoulders and act like it doesn’t matter to them anymore. While, as I said earlier, depression doesn’t mean they can’t smile or laugh now and then, it becomes painfully obvious just how difficult it generally is for them. It’s just hard to do – it takes way too much effort and feels way too hard to force. Sometimes just seeing other people having fun and enjoying themselves is enough to bring on tears. They just have such a hard time making themselves do these things.

Loss of interest in, or conflict with, family and friends – they may not want to talk, interact, have meals together, again, it’s just so hard to force themselves.

Low self-esteem

Feelings of worthlessness or guilt

Fixation on past failures or exaggerated self-blame or self-criticism Listen to episode 27 about negative self talk – this is a lot of depression and it’s a lot of what cognitive behavioral therapy focuses on

Extreme sensitivity to rejection or failure, and the need for excessive reassurance

Trouble thinking, concentrating, making decisions and remembering things

Ongoing sense that life and the future are grim and bleak

Frequent thoughts of death, dying or suicide

 

 

Okay, those were more emotional changes. Now, let’s look at some of the behavioral changes you may see:

Tiredness and loss of energy  This can look like extreme laziness. But as I said earlier, teen’s are not lazy, as many people assume – they’re actually sleep deprived, and depression adds to that inability to sleep. So, if your teen is usually bubbly and active and all of a sudden, you can’t get them off the bed or sofa, that could be a symptom of depression. Depression just tends to suck the life out of someone. It takes all the energy right out of your body where you just feel like you have nothing left to move you from place to place. So, if their usual sleepiness in the mornings or weekends turns to an inability to scrounge up the energy to do much of anything – it’s time to figure out what’s going on.

Insomnia or sleeping too much And, once again, teens do tend to sleep extra on weekends, they may nap in the afternoon, they may be difficult to get up in the morning, already. So, figuring out if something is going on with their sleep is where you compare what’s going on with their usual pattern and other emotional or behavioral signs and symptoms. If they’re suddenly just in their bed asleep all the time or on the sofa asleep, something may be up. Additionally, watch out for insomnia – worse than usual – as I said earlier teens don’t get sleepy until around midnight but if they’re awake until 3 am or up and down all night, that’s an indication you don’t want to ignore (and may also point to anxiety).

Changes in appetite — They may be suddenly eating a lot less and losing weight or, if they’re like me, they may eat when they’re depressed (or anxious or pissed off) – so some may gain weight. Neither one is healthy of course and you need to really watch how you approach this issue. Listen to episode #37 for some advice here.

Use of alcohol or drugs While not always an indicator of a mental disorder like depression or anxiety – it certainly can be. (Many teens experiment with alcohol or drugs at some point. So, they may be using because they want to fit in, be part of the group, gain acceptance, or it could be something else altogether. They may be looking for anything to make them feel better, to mask their feelings of hopelessness, to just forget for a while, self-medicate. They may even fool themselves into thinking they feel better, despite the fact that alcohol is a depressant. Listen to episodes #42 and #43 for more.

Other risky behaviors, acting-out, disruption – It can feel very confusing for a kid and they may be just trying to feel something.

Agitation or restlessness — You’ll notice this right away if they’re not usually the pacing, hand-wringing type.

Slowed thinking, speaking or body movements Remember, everything feels like it takes so much energy.

Mysterious and frequent complaints of various aches and pains – like headaches, stomach aches - they may end up in with the school nurse often. These aren’t generally made-up aches and pains – they can literally be caused by their mental anguish and emotional distress.

Social isolation Not all teens are extroverts so your teen may reenergize all alone in their room, but they likely still enjoy time with friends and family. If your extravert or introvert suddenly becomes withdrawn and starts spending more and more time alone, it may be depression.

Academic difficulties, excessive absences -  Depression clouds thinking, causes issues with focus and concentration and making decisions can seem impossible. Of course, as we said, it also zaps energy, and none of this is helpful for studying, listening in class or working on school projects. These things can also hurt athletic performance or a part-time job.

Less attention to personal hygiene or appearance – Again, because of the lack of energy, loss of interest in anything, isolating, these things can also fall to the wayside.

Self-harm is also something that often comes with depression – but this can be hidden under sleeves and pants - but there could be signs – watch for implements in the bathroom or their bedroom.

 

And, of course, suicidal thoughts and behavior including planning and attempts – this is the most dangerous part of depression – when they start talking about feeling hopeless, talk about being a burden or that people would be better off without them, make goodbye posts on social media, it’s time to act fast.  Take any mention of suicide seriously, no matter whether you believe they would really do it or not. Just imagine not doing something and being wrong.

Do not hesitate to call the police or rush them to the ER the minute they start talking this way. At a very minimum, make sure nothing is available to them to hurt themselves – knives, guns, rope, cording – nothing. They really need to be in a secure facility when it gets this bad. Again, please listen to episode 7 and you might even want to listen my family’s story – episode 10.

 

Okay, that’s all I have for you today, but I want you to please jump on over to the show notes at neurogility.com/51 for all the resources I mentioned and the link to the transcript if you want to study this information. And please pass this episode to every mom you have in your contact list. It would be horrible for someone who needs it, not to have it. And click follow where you’re listening to make sure you don’t miss an episode.

This podcast is sponsored by neurogility.com, where I help moms communicate and connect better with their teens. Our producer and editor is Steve Coleman, written and hosted by me, Ann Coleman.