Approximately 20 percent of teens will experience depression before they reach adulthood. Adolescent girls are twice as likely as boys to experience depression. While the core symptoms of depression, including feelings of persistent sadness, loss of self-worth and interest in daily activities, are the same in adolescents as they are in adults, adolescents may present differently than adults because of their stages of physical and emotional development.
Emotional Changes
Adolescents may feel extreme sadness, worthlessness, hopelessness, helplessness and self-loathing. While these feelings may manifest as depressed mood, adolescents frequently appear irritable. They may feel agitated, angry or anxious and may display hostility and argumentativeness that represent a significant change from prior behavior.
Social and Behavioral Changes
Depressed adolescents may show gradual or sudden changes in behavior at school, at home, or in relationships with family and peers.
Adolescents may defy curfew, disobey and talk back to parents or teachers, or otherwise behave in a willful or rebellious manner that is more extreme than typical teenage defiance and a significant change from past behavior.
Depressed teens may display out-of-character conduct such as shoplifting, truancy, or vandalism.
Many depressed teenagers bring home failing grades, find themselves frequently in detention, skip classes, or have fights and arguments with peers and teachers.
A depressed adolescent may sever old friendships and start new undesirable or maladaptive ones. He may stop participating in social events, or alternatively frequently engage socially in reckless or inappropriate activities (for example, parties with underage drinking)
A depressed teen may begin to act out sexually, engaging in risky sexual practices that could lead to pregnancy or sexually transmitted diseases.
The adolescent may develop a pattern of behaving irresponsibly, failing to take care of daily chores, after-school athletic or job responsibilities, babysitting or other tasks that are expected of her.
Cognitive or Mental Changes
Depressed adolescents may demonstrate difficulty concentrating or making decisions. They may experience memory loss and seem particularly disorganized and disconnected from the present moment.
Physical Changes
Depression can alter the immune system, increasing the likelihood of illness in a depressed teen. The psychological trauma of depression may also manifest itself somatically among teens such that they experience unexplainable persistent stomach pains or other malaise.
Marked, unintentional increase or decrease in appetite that may cause a noticeable change in weight in a short period of time is a symptom of adolescent depression.
Sleeping too little (insomnia), sleeping too much (hypersomnia), or having trouble falling asleep or staying asleep are common symptoms. In particularly, adolescents may have difficulty staying awake at school.
Depressed teenagers may feel exhausted much of the time and exhibit slowed motor functioning.
Substance Use or Abuse
Depressed adolescents may begin to use drugs, alcohol, or tobacco for the purpose of self-medicating, acting out, or to fit in with a new peer group.
Suicidality
Depressed adolescents may begin to think about suicide, develop a plan to carry out suicide, make suicidal gestures (self-harm such as cutting) or make actual suicide attempts. Antidepressants double the risk of suicidal thoughts and behavior among children and adolescents, so adolescents who are already taking an antidepressant or who are considering taking an antidepressant should be closely monitored by a professional.
