Our stereotypes about adolescents tell us that they are tempermental, dramatic, and hormonal. And while we might be inclined for us to brush them off as such—it’s vital to remember that whatever they’re feeling is valid and providing a source of comfort, not hostility, is the best way to help them. 

Adolescents, like any of us, are human beings with a complex range of emotions. For us to forget this is a grave mistake—adolescents already feel as if they are deeply misunderstood, since they are just beginning to discover the self and navigate the world. 

So when the adolescents in our life appear to be struggling with depression, it is of utmost importance that we take them seriously. After all, teen suicide is the third leading cause of death in individuals ages 10-24 in the US. And 20 percent of all teens suffer from depression before they reach adulthood—with only a slim 30 percent of that group receiving treatment. 

If you or a loved one is suffering from depression in the turbulent period of adolescence, we’ll describe what their symptoms might be, then outline the best treatment methods to overcome it, such as:

• Psychotherapy
• Medication
• Transcranial Magnetic Stimulation (TMS)
  

NOTE: If you or a loved one is in imminent danger, please call 911 or the National Suicide Prevention Lifeline at 1-800-273-8255, which is available 24 hours a day. You may also utilize the Lifeline Chat, an online service via the National Suicide Prevention Lifeline, which connects individuals to counselors for emotional support and direction to other services. 

Adolescent Depression

Major Depressive Disorder (MDD), commonly known as depression, is a psychiatric disorder that affects 20 percent of all teens before they reach adulthood. Depression is more than just feeling “down in the dumps” or “moody”—in reality, it leads to 30 percent of teens with depression developing substance abuse problems and increases a teen’s risk for attempting suicide by 12 times. 

Teen depression is often compounded by other harmful elements of teen life, such as the pressures of school. In 2016, it was found that about one out of five—or 20.8 percent—of students reported being bullied, and in a 2018 poll, nearly 45 percent of students said that they were stressed “all the time.”  

As we have established, teen depression is very serious. However, it often manifests differently from adult depression. Common signs and symptoms of teen depression include:

• Constantly feeling irritable, sad, or angry
• Having a lack of interest in doing the things you used to love
• Feeling bad about yourself—feeling worthless, guilty, or just “wrong”
• Sleeping too much or not enough
• Turning to alcohol or drugs to cope
• Having frequent, unexplained physical pain, like headaches
• Crying at anything and everything
• Feeling extremely sensitive to criticism
• Gaining or losing weight unintentionally
• Having trouble concentrating, thinking straight, or remembering things—with school grades perhaps suffering as a result
• Feeling helpless and hopeless
• Thinking about death or suicide  
  

Risk factors that may trigger or exacerbate teen depression include:

• Serious illness, chronic pain, or physical disability
• Having other mental health conditions—such as anxiety, eating disorders, or ADHD
• Alcohol or drug abuse
• Academic problems
• Family problems
• Bullying
• Trauma from violence or abuse—physical OR emotional
• Recent stressful life experiences—such as parental divorce or the death of a loved one
• Navigating one’s sexual identity in an unsupportive environment
• Loneliness and lack of social support
• Spending too much time on social media  

The Best Treatment Methods for Adolescent Depression

It can be intimidating for a teen with depression to accept the fact that they need the big “h” word—help.  And when they do, they might not even know what options they have. In this section, we’ll discuss how you might have a conversation about treatment and what the best treatment methods are.

Persistence with Boundaries

Treatment starts with acceptance—an adolescent’s acceptance that they are, in fact, suffering from depression. If they are not capable of doing this on their own, then the best way to help them get help is by being supportive. 

If an adolescent you know is struggling with depression, then you must do your best to make them feel heard and loved—not lectured. If they are open and willing, they must feel safe to share with you. If and when you first talk to them, try to avoid any advice (“Just cheer up!”) and rather use affirmations (“I don’t know what you’re going through, but that sounds really hard.”)

On the other hand, there is a nuanced balance to be had when you speak to your loved one, because you want to be gentle, but persistent. Since it is pressing that this person gets the help that they need, you shouldn’t give up if they shut themselves out to you. 

Be respectful of privacy and boundaries— “not giving up” doesn’t mean you should be aggressive—but revisit the topic and try different conversation starters. Remember that you are there to listen to and support them.     

Psychotherapy 

Psychotherapy, sometimes called “talk therapy,” is a broad term for a variety of treatment techniques that try to target a patient’s troubling thoughts, emotions, and behavior. 

You might think that psychotherapy is only reserved for certain kinds of people—you might associate it with an image of someone lying down on an expensive chair, discussing their dreams—but therapists specialize in a wide range of psychiatric issues and patient demographics, so there is a therapist for everyone.   

It’s not always the case that the first therapist is a good match—but don’t let this discourage you, whether you’re the teen or a loved one. Since psychotherapy is done in a one-on-one setting, it is important that you feel 100 percent comfortable with your therapist. Oftentimes, you can do a preliminary meeting with a therapist to get to know them and their style. Make sure to find the best fit for you. 

Medication

Medication is often used in conjunction with psychotherapy to treat the chemical imbalances in the brain that are caused by depression. 

The most common prescriptions for depression are selective serotonin reuptake inhibitors (SSRIs). Serotonin is a neurotransmitter, or chemical in the brain, that is often called the “happy chemical” since it is attributed to happiness and wellbeing, and people with depression are known for having low levels of serotonin. SSRIs prevent reuptake—the breakdown—of serotonin in the brain, resulting in higher serotonin production.   

Common SSRIs include fluoxetine (Prozac) and citalopram (Celexa). These medications often take 4-6 weeks before patients see significant results. When starting SSRIs, it is often the case that appetite and sleep are regulated before mood.

Side effects of SSRIs include drowsiness, nausea, dry mouth, insomnia, diarrhea, dizziness, sexual problems, headache, and blurred vision.

Each patient will have different reactions to pharmaceutical medications, so consult your doctor to find out what is best.

Transcranial Magnetic Stimulation (TMS)

Although traditional methods of psychotherapy and medication are generally very effective, some patients do not find relief even after months or years of treatment. This is when transcranial magnetic stimulation (TMS) is an excellent option.

TMS is a non-drug, non-invasive procedure in which patients wear a headpiece of electromagnetic coils that stimulate areas of the brain related to depression to treat symptoms. Sessions are short, ranging from 20-40 minutes, and are completed four to five times a week, for 4-6 weeks. 

TMS is known as a safe and effective treatment for adolescents, showing significant improvement in teen subjects. 

TMS has very little side effects—the main side effect being mild headaches which often subside quickly and are very tolerable, especially when compared to potential side effects of medication.

Most often, patients who use TMS also continue to take medication as well as go to therapy. It is not discouraged to do these treatments in conjunction with each other.  

What treatment is best?

When tackling depression, treatments aren’t one-size-fits-all. We strongly recommend talking to a doctor about your treatment options so that you or your loved one can move forward in this healing process.

For all your psychiatric consultation needs—including TMS therapy—you can also consult us directly at My Transformations. We’re happy to help you formulate a treatment plan, or even just give you friendly advice!