“My daughter seems angry most of the time,” I read in the email from a worried mom. “I often don’t know what has her angry, and if it weren’t for that I’d think she was great. She does well in school, she’s busy and successful in her many activities….I think she lives a charmed life! So why do I feel in my gut that something is wrong?”

Gut feeling and intuitive hunches count a lot when you are trying to assess your teenager’s behavior and understand it. This mom probably really is onto something, and it’s worth revisiting the important topic of depression in teenagers.

Depression isn’t always easy to spot or even diagnose in teenagers. This may surprise you, but depression in teens can present as anger or irritability, in addition to the more usual appearance of sadness. And mixed in with the common ups and downs of adolescent behavior, parents can find it too easy to write off problematic behavior as a passing phase. This can be dangerous.

It’s not always easy to determine which is the cause and which the effect, but depression is often linked with vulnerability to drug or alcohol abuse and other destructive behaviors such as self-injury and eating disorders. If a parent feels in your gut that something might be wrong, it is vitally important that you take action to help your teen seek assistance.

Families for Depression Awareness is a non-profit that provides help and support for the family members of those dealing with depression. In one case study on their site dealing with a 17 year old, they tell about his parents’ initial denial, and about his difficulty in putting into words how he was feeling. Kids facing depressive illness may be in the impossible position of being expected to describe how they feel…a task in which they are unlikely to be able to succeed. Families for Depression Awareness offers a free mood questionnaire you or your teen can take which can help you assess if professional advice should be sought.

The challenge of diagnosing depression is increased because the symptomatic behavior that can signal depression is the same list of behaviors most teens are likely to exhibit at one time or another.
Symptoms of teenage depression include:

• depressed or irritable mood
• decreased interest or pleasure in activities
• change in appetite or weight
• sleeping more or less than usual
• fatigue or loss of energy
• feelings of guilt or worthlessness
• decreased concentration
• substance abuse
• recurrent thoughts of death or suicide

Your intuition about your teen’s overall mental health will inform your initial assessment. A parent may pick up a sense from your teen about a fundamental change or shift that doesn’t feel right, or you may see worrisome behaviors such as those in the list above that last more than two weeks….two weeks is the guideline the professionals use beyond which you begin to take action. Another assessment guide for a parent is to compare your teen’s current behavior to her past behavior and make note of the duration, intensity and frequency of the behavior. Obviously an increase in any or all of these will be cause to take some action.

Teens who appear angry, irritable and different from the child you used to know, may indeed be dealing with depressive illness. Depression can take a toll on a teen -even one who continues to bring in good grades and participate successfully in outside activities. So, listen closely and tune in to your teen. If you have reason to be concerned, gather input from others who interact with your teen on a regular basis, and don’t hesitate to call a a school psychologist, guidance counselor, physician or therapist if you have any reason to wonder.

Teenagers’ complaints about stress today go way beyond tomorrow’s math test or their next appointment for the SAT’s. If you listen to teens talk, stress is at or near the top of their complaint list. While it’s fair to say stress impacts most of us, when we are parenting teens we need to look at our teenager’s response to the stresses s/he faces, and provide appropriate sensitivity and support.

What are the major sources of stress for teens? Some stressors are environmental, some are developmental; some wreak havoc over long periods and some are just passing irritations. Here are some major sources of stress:

• Social issues and peer relationships. Teenagers invest a tremendous amount of energy in their peer relationships, and their self-esteem is often connected to their interactions in their peer group. Loneliness and every-day peer dynamics impact stress levels, as does the fear of being left out, which is one of a teenager’s greatest fears.
• Pressure to achieve at school. For some kids, success is a mission and a passion. When over-doing it, they can drive themselves to such a degree that stress replaces pleasure in learning and achieving.
• Juggling all the demands from teachers, coaches, parents, etc. Some days the demands feel overwhelming to teens.
• Parental and societal pressure to achieve in school and elsewhere; unyielding pressure from parents to always deliver peak performance can generate a lot of stress.
• Avoiding expectations they don’t want to fulfill. Whether it’s avoiding the English paper that is due tomorrow, or trying to steer clear of parents sniffing around in one’s backpack or room, kids who are hiding from their responsibilities, or sneaking around doing the wrong things, are likely to be feeling stress.
• Teens are developing their identity and making important personal decisions about who they are. “Who are my friends?” “Who reflects my values and interests?” “Am I like my parents and my family, or am I different?” These developmentally appropriate questions can be big, stress-inducing questions to confront.
• Being judged “good enough.” In their competitive worlds, sometimes it’s sink or swim…with a lot attached. “Will I make the team?” “Will I get the solo in the play?” “Does my resume look good enough for my college application?” “Will I get that summer job?”

How parents can help: Deborah Weinstock-Savoy, a psychologist who specializes in working with children and families, suggests there are two major areas of intervention for parents to consider:

• Keep home a safe haven Teens need home to be a place of nurturing and love. They need to be able to relax and let their hair down; to re-charge their batteries and feel loving support. Don’t underestimate the significance of this nurturing, as it provides a teenager’s most basic line of defense. Parents need to make sure kids are eating right and getting enough sleep. Providing the unconditional love that teens deserve will go a long way in supporting their efforts to manage their daily stresses.

• Teach coping mechanisms As parents provide coaching and support, engage your teens in coming up with solutions themselves. Kids often have ideas about this, and by actively engaging them in the problem-solving process, you are teaching them to develop a sense of self-awareness. As kids become more self-aware, they will see strategies emerge and develop; these will grow into important skills that will help them to deal with stress as they grow. In an effort to help teens become self-regulating, parents need to gradually behave more like coaches, rather than problem-solvers on the teens’ behalf.

Knowing when parents should intervene: Unfortunately, it’s tricky business to know when parents should become directly involved in helping a teen manage stress-related issues, and how, because the best parent-interventions are likely to differ for various children, parents and circumstances. In addition to empowering kids and coaching them to identify solutions themselves, parents should pointedly observe their teen’s behavior. Compare current behavior with typical behavior for this child: how much of the teen’s life is being affected? How long as this been going on, and how extreme is the behavioral change? The longer the duration, the more widespread the impact, and the more dramatic the changes, the higher the likelihood that professional help may be warranted.

Consider this: are you the source of your teen’s stress? Finding the right balance between pressure that enhances a child’s efforts and success without overdoing the stress isn’t always easy. Even professionals struggle with this. Parents should begin by observing your teen over time, so you can identify if the stress levels are within a healthy and normal range, or if they signify that change is necessary. Also, check in with your teen regularly so s/he knows you will listen to her and that there are options open to her. And…need I say…double check your messages to make sure the pressure you are applying is helpful, appropriate, and not too intense. Worse things can happen than getting an occasional bad grade… keep things in perspective and make sure you are part of the solution, not part of the problem.

I recently came across an interesting blog written by Vanessa Van Petten, a LA-based 23 year old who shares information for parents to help them understand their teens. She happens to have just written an article for parents with some tips to minimize your teen’s stress. Check it out

Do you know that depression in teenagers doesn’t always look like depression in adults? If not, you better read on.

Depression can be confusing. Parents of teenagers can find it particularly challenging to understand their teen’s behavior, and to determine if something is wrong, particularly with so many changes happening during adolescence anyway. Give your intuition some credit here; despite what might be confusing changes, you really do know your teenager better than anyone else. Your gut instinct matters. But you need to be knowledgeable, too.

There is a difference between depression as a feeling of sadness, and Depression that is depressive illness. We’ll share some facts and basic information here, along with places where you can get additional information.

First of all, why does it matter? All kids must face and address sadness and challenges as a part of growing up. Right?

It’s not that simple, actually.

Teenagers have certain developmental tasks that they must work through during adolescence: they must establish their independence, learn and perform in school, develop a mature sexual identity, create new friendships and loving relationships, and prepare for long term plans including getting a job. Suffering from Depressive disorder can negatively impact any or all of these essential developmental tasks. Additionally, teens suffering from depressive disorder are more vulnerable to alcohol or drug abuse and other destructive behaviors such as self-injury and eating disorders. In its worst case, depression can lead to suicide, making this a potentially fatal illness.

What are the symptoms of depression?

Typically, depression will affect one or more of these areas, according to Dr. Karen L. Swartz of the Johns Hopkins University School of Medicine:

• mood,
• sense of vitality and
• attitude about one’s self.

Although adults associate a depressed, or sad mood with depression, it doesn’t always appear this way in teenagers, and this is essential for parents to understand. In teenagers, depressive disorder can appear as irritability or anger.

When depressed in the clinical sense, one is unable to feel joy. This can lead to a diminished interest in participating in activities in which one previously found pleasure. For teens, a new disinterest in spending time with friends, participating in sports or others previously-enjoyed activities can be a red flag.

The change in vitality may appear as changes in energy level, concentration, appetite, sleep patterns and weight gain or loss. Experimentation with drugs or alcohol often accompanies this change in vitality, and kids who find that this usage changes how they feel may develop a habit for this destructive behavior. Depression may also manifest in self-injury or eating disorders; data shows that many times eating disorders are accompanied by an underlying mood disorder. Depressed teens often have difficulty concentrating, which makes poor performance in school a possible sign of depression.

Lastly, an attitude change about one’s self during a depressive episode can appear as lack of confidence, and loss of self-esteem; more indicators for which parents need to be on the lookout.

Symptoms of Teenage Depression*:

• Depressed or irritable mood
• Decreased interest or pleasure in activities
• Change in appetite or weight
• Sleeping more or less than usual
• Feeling restless or slowed down
• Fatigue or loss of energy
• Feelings of guilt or worthlessness
• Decreased concentration
• Sense of hopelessness
• Substance abuse
• Recurrent thoughts of death or suicide

Not all of these symptoms necessarily occur, and it is possible for anyone to have some of these symptoms without having a clinical depression. But it’s hard to tell without professional input. Professionals will look for a clustering of symptoms.

The way for a parent to make an initial determination is to compare your teen’s current behavior to his past behavior and examine three elements: duration, intensity, and frequency of the problematic behaviors. A general rule of thumb is to get help if the new behavior has been going on for two weeks.

If you have concerns about your child being depressed, don’t wait. Get help. You can begin by speaking to your teen’s guidance counselor at school, physician, or you can get a referral from a friend who has had a similar experience. Do not fall prey to outdated social mores that may make you feel afraid to talk about it. You owe your child more than that.

Here are some additional sources of information:

Massachusetts General Hospital:

www.schoolpsychiatry.org

National Mental Health Association:

www.nmha.org

Families for Depression Awareness

www.familyaware.org

Teens health – Answers and Advice

www.kidshealth.org/teen

Center for Substance Abuse and Mental Health Services

www.samhsa.gov

Parents, The Anti-Drug

www.theantidrug.com

* Swartz, Karen, M.D.; Recognizing Teenage Depression; The Prevention Researcher, Vol 8, Number 4, 2001.

Complaints about the stress in our lives is not constrained to the adult population; more and more we hear about the problems teenagers have trying to manage stress. Many parents find themselves searching for ways they can help their kids deal with the stress, not wanting to pass along this unfortunate, yet common, malaise.

In seeking professional input to this important topic area, I interviewed Deborah Weinstock-Savoy, Ph.D., a psychologist trained in working with children and families, specializing in parenting education.

Sue Blaney: What are the primary sources of stress for teenagers?

Deborah Weinstock-Savoy: The ups and downs of peer relationships will be right near the top of list. When kids have a sense of belonging, they have a buffer to help them deal with stress. Without that sense of belonging, they confront loneliness, which adds more stress. The other areas at the top of the list include managing their life at school and all that entails. Additionally, and this is a bit more abstract but also very important, teens are developing their identity – and this too, creates stress. They are confronting important questions as they explore their similarity, and differences, to their parents and their friends.

SB: The developmental part of teens’ experiences – are parents tuned in to this?

Deborah Weinstock-Savoy: It is easy for parents to forget about this identity exploration this part in the day-to-day busyness, because it’s less obvious. But once reminded about it, parents really can identify with it. It helps parents to remember this because it helps them to take the daily struggles with their teens a little less personally.

SB: What can parents do to help their teens deal with stress?

Deborah Weinstock-Savoy: There are two major areas of intervention that parents can focus on. The basic nurturing that parents offer in providing a loving and comfortable home is the first line of defense. Making home a place where kids can re-charge their batteries, feel safe and supported; this is very important. Parents need to make sure their teenagers are eating well, getting enough sleep, and it’s extremely important that teenagers get the message that their parents are there for them.

The second type of intervention has to do with engaging the teen’s own sense of what he/she needs. This can be explored together through conversation by asking kids what they think will help the situation. Kids often have ideas about this, and engaging them in the problem solving is important and beneficial. Additionally, and this brings out yet another level of intervention, parents should help teens develop their own sense of self-awareness. In becoming more self-aware, teenagers begin to see strategies emerge and develop that will help them deal with stress. These strategies will be important to them throughout their lives. Parents can assist kids in becoming more self-aware through some sympathetic coaching as they help their kids deal with peer issues or academic issues.

SB: How do parents know how much they should get involved in helping their teenager solve a problem?

Deborah Weinstock-Savoy: This can be tricky, and it is likely to be a bit different for each child and each parent. Obviously, the younger the child is, the more parents will be directly involved in problem solving. As teens get older, parents must encourage and empower them to do more of the solution-finding themselves, with parents simply providing behind-the-scenes support.

However, many parents I see tell me their kids won’t share what is going on in their lives, let alone accept some coaching from their parents, so let’s be realistic about this.

SB: You seem to be in touch with the sense of rejection that some parents feel.

Deborah Weinstock-Savoy: You bet. Parents need to accept the fact that sometimes their kids won’t allow them to share their wisdom with them. Sometimes parents need to accept on faith that their kids really do know that they are there for them. And, by the way, parents should not try to do this all alone; they should try to extend the network of support – both for their child’s sake and for their own. Parents need to identify for themselves who else is out there, who else will help provide advice, help keep their teens safe, and offer support. They should ask their teenager: “Suppose you did have a situation and you didn’t want to come to me first; who would you go to?” Parents can, and should, intentionally extend the mantle of protection.

SB: What are some of the warning signs that parents should be aware of?

Deborah Weinstock-Savoy: This can be difficult, even for professionals, because it is, naturally, such a tumultuous time. Parents need to compare their child’s behavior to that same child’s typical behavior… because it’s the significance of the changes that matters the most. Examine the severity of the behavioral changes – how much of the child’s life is being affected? Are the changes affecting just home life, or school as well? Is it affecting extra-curricular activities? Relationships with friends? How long has this been going on and how extreme is this behavioral change? The answers to these questions should provide some guidelines for parents in knowing whether they should seek professional help.

SB: What else do parents need to watch out for in regards to stress in teenagers?

Deborah Weinstock-Savoy: Sometimes, too often actually, parents inadvertently contribute to stress. Often parents have extremely high expectations of their children, and this can make things worse for kids. In wanting the best for our children, parents can get over-wrought about any individual decision. It’s easy to get caught up in thinking that one’s career is a linear path; but it’s not. For most people there is a bit of wandering around, experimenting; parents can benefit from having a longer vision and more flexibility. Parents need to remember that this is a time for exploration, and even for making mistakes, and that is often how people learn.

SB: That is a difficult balance for parents – that balance between giving kids more freedom and yet keeping them safe and productive.

Deborah Weinstock-Savoy: Yes, there is a constant tension between encouraging and pushing inappropriately. Parents need to step back occasionally, separate our feelings from our kids’ feelings and ask ourselves “Is this working? Is this helpful to my teenager? Is it about us or about our child? What if we didn’t do it? What might be the consequences?” Parents can really benefit when they reflect back on their own adolescence and ask themselves what made them develop the way they are. This helps them understand more about their teens’ experiences and developmental journey.