A parent’s guide to understanding and supporting a teen with depression

Adults aren’t the only ones who can experience depression: Depression in teens is an increasingly common and serious mental health issue. According to the National Institute of Mental Health (NIMH), 20 percent of teens suffered at least one major depressive episode in 2021, and that number seems to be increasing each year.

Teenage depression may conjure dark feelings of sadness, frustration, and fatigue that last much longer than a simple mood swing. The symptoms of depression in teens can make enjoying daily activities or pursuing interests and passions seem impossible, with intense emotional pain broiling under the surface.

Recognizing leading causes, signs, and both the physical and mental symptoms of depression in teens is a crucial step toward getting treatment for these young individuals and recognizing the need for preventative care.

Is My Teen Depressed? Check for These Signs

“Warning signs for depression might be easy to miss, depending on the teen,” says Evan Csir, a licensed professional counselor at Thriveworks. “This is not to discredit parents’ intuition about their teen, as they know them best, but very few teens are comfortable coming forward and stating, ‘Hey, I need some extra help right now.'”

Factors like the age of the teenager, how long they’ve been depressed, their personality, external circumstances, and their ability to cope with emotional distress can also impact the presentation of depression.

Early Warning Signs:

• Social withdrawal: Isolating from friends, family, and social activities, often preferring to be alone
• Loss of interest in daily life: Hobbies, relationships, and academic achievements no longer seem important or bring any joy
• Difficulty concentrating or sitting still: Increased restlessness, fidgeting, trouble processing directions, or finishing tasks
• Altered sleep patterns: Trouble falling asleep, staying asleep, or oversleeping (more than normal)

More Advanced Signs:

• Feeling hopeless, apathetic, or profoundly sad: Apparent levels of sadness higher than normal, crying spells, and a negative outlook conveying that “nothing matters” or things “will never get better”
• Disproportionate frustration or anger: Heightened irritability over even small inconveniences, leading to snapping or lashing out
• Fatigue and lethargy: Difficulty getting out of bed, being active, or performing tasks, plus noticeable tiredness or confusion
• Behavioral issues: Acting out in class, reckless behavior like drinking, driving too fast, or dangerous activities as harmful outlets
• Weight loss or gain: Abnormal weight fluctuations caused by undereating or overeating as a coping mechanism
• Abnormal periods: For teens who menstruate, depression can cause shortened or skipped periods
• Increased substance use: Substance use and abuse frequently co-occur alongside teen depression
• Thoughts of death or suicide: In severe cases, teens may express suicidal ideation through art, writing, music, or social media

Csir puts it succinctly: “If something feels royally wrong with your teen, chances are something is going on.”

How Do I Know If My Teen Is Stressed or Depressed?

The key difference: If your teen seems overwhelmed but an extra day off might help them reset, it’s likely stress. However, if they’ve lost interest in activities they once loved and feel defeated by everything for months, it’s more likely depression.

“This question is rather tricky,” acknowledges Csir, noting that teenagers are naturally moody due to physical, emotional, and hormonal changes. The distinction often comes down to duration and scope.

For stress, Csir suggests looking at your teen’s schedule: “Think about your child’s schedule: yes, it might be full of things they love, but do they get a chance to rest? If it seems like an extra day off might fix things, it’s stress.”

Depression, however, involves deeper changes. “When your teen starts to lose interest in things that they love doing—playing music, hanging out with friends, painting, playing with their pets, reading—and they feel defeated by everything for a few months, then it might be depression,” Csir explains.

What Are the Leading Causes of Teenage Depression?

Like many other mental health conditions, depressive disorders have no singular leading cause. Instead, depression in teens arises from multiple, possibly overlapping factors:

Biological Factors

A family history of depressive disorders, brain chemistry imbalances, or hormonal changes can influence a teen’s mood and ability to self-regulate emotions.

Environmental Stressors

School pressure, social dynamics, family financial hardship, and peer relationships can greatly impact a teen’s self-esteem and trigger depressive symptoms.

Major Life Events

Sudden changes like divorce, illness in the family, losing friends, or moving to a new city can cause significant stress and discord in a teen’s life.

Adverse Childhood Experiences

Trauma, including loss, bullying, family conflict, abuse, and other difficult experiences, can contribute to depression development.

Risk factor note: Being a teenage girl increases depression risk, as teen girls are much more likely to develop depressive symptoms than teen boys. Teens with pre-existing physical health conditions may also be more susceptible to developing depression.

How to Help Treat Depression in Teens

Depression can start developing as early as preschool, though it is uncommon. For adolescents, it doesn’t matter whether a teen is 13 or 19—depression can still develop. That’s why taking the signs seriously is so important, starting with connecting to mental health professionals who can offer insight, compassion, and evidence-based treatment strategies.

Encourage Open and Nonjudgmental Communication

Though communication is crucial, it isn’t always easy. “At their age, teens are actively working on being independent and moving away from their families, which is normal and healthy. However, this also means it’s not uncommon for them not to volunteer information to their parents,” Csir explains.

As a parent, your role is to:

• Provide a safe, accepting, and open space for your teen
• Listen without judgment and avoid “shoulds” and “shouldn’ts”
• Try to understand what they’re saying and comfort them when needed
• Be patient with their mental health journey

“It definitely does not hurt to talk to your teen and check in with them,” Csir says, but he cautions: “I do not recommend just taking your teen to therapy without consulting them first, as this can create resentment.” Working with them through their options and informing them about what therapy entails is integral to success.

Explore Talk Therapy Options

Talk therapy is one of the most effective ways to treat depression, with several helpful approaches:

Individual Therapy

Individual teen therapy provides a safe, one-on-one space where teens can process their experiences at their own pace. Tools like cognitive behavioral therapy, dialectical behavior therapy, and psychoeducation help teens learn to process emotions, adjust thinking patterns, and understand how their depression works.

Group Therapy

Group therapy offers community and understanding with peers facing similar challenges. It helps bring depressed teens out of isolation, validates their struggles, and reduces stigma and shame.

Family Therapy

With teens, family dynamics are hugely influential to their emotional experience, which is why family therapy is an important part of treating teen depression. Often used alongside individual therapy, family therapy takes a look at a teen’s relationships to their family members and works to give each member a sense of understanding and closeness, all while the teen processes personal feelings and concerns in their solo sessions.

Attachment-based family therapy is frequently used to help teens and families, with a focus on both closeness and autonomy for all parties. Family therapy is reciprocal, meaning that the parents must be just as open to change and vulnerability as the teen. For relationships to improve, each person will listen to what each other has to say, and together, develop a way of interacting and loving that works for everyone. These changes can create a stable foundation for the teen to heal from and foster feelings of emotional safety as they work on themselves.

Discuss the Possibility of Medication

For mild depression, teens are often treated with psychotherapy alone. However, when symptoms are severe or unmanageable, medication may be needed alongside talk therapy. Medication helps balance brain chemicals like serotonin, making it easier to regulate mood and manage symptoms.

Common medications used to treat teen depression include:

• Fluoxetine (Prozac)
• Escitalopram (Lexapro)
• Sertraline (Zoloft)
• Citalopram (Celexa)
• Paroxetine (Paxil)

Since depression can lead to physical issues with sleep, eating, and activity levels, involving a medical professional in your teen’s care team ensures they stay healthy throughout treatment.

Behind the Scenes: How Therapists Approach Teen Depression

Adolescent therapy for depression is tailored to each client’s unique needs, so specific approaches and techniques vary from person to person. The level of parental involvement also differs by state regulations.

“In general, therapists will meet independently with the teen and then consult with the parents about what is going on and how to best support their teen,” Csir says. “In some states, the teen has to give the therapist consent to talk to their parents, but in others, parents have the final word on involvement and consent.”

What Sessions Look Like

“Some therapists may follow a family therapy model,” Csir explains. “In this model, the family meets with the therapist, and together, the team talks about the client’s challenges, how they affect various family members, and how the teen can start to reconnect with the family.”

Sessions involve various techniques for processing emotions. “Depending on the teen and therapist, treatment may consist of traditional talk therapy or perhaps more creative forms of therapy such as art or dance,” Csir notes, “though just like adults, some teens do not want their interests used in therapy.”

The key to success: The more individualized the therapy process is to the teenager, the more effective and confidence-building the treatment will be. Therapy for teens requires balancing autonomy with relationship-building, helping teens learn to manage depression, lean on supports, and move through the world with confidence and self-awareness.

A Closer Look at Depression in Teenage Girls

According to a 2024 study, adolescent girls are three times as likely to have experienced depression as boys. Though many of the causes are the same across genders, teenage girls face unique risk factors, including:

• Body image pressures: Elevated risk due to social and digital influences pressuring girls to appear a “certain way”
• Eating disorders: Greater likelihood of development, which increases with more frequent social media usage
• Anxiety disorders: Higher rates that evidence suggests can cause or be caused by underlying depressive symptoms
• Digital harassment: More exposure to cyberbullying and online hazing, largely due to higher rates of social media use

The social issues girls face during their teen years significantly influence their development, making early detection of depression symptoms especially important for this population.

The Bottom Line

Depression in teens is a serious mental health condition driven by biological, psychological, and social factors. Recognizing symptoms such as persistent sadness, irritability, fatigue, behavioral changes, and altered sleep patterns is crucial for early intervention.

If you’re concerned about your teen, the mental health professionals at Thriveworks are here to help. They work with both you and your teen to identify challenges, develop effective treatment strategies, and foster the confidence and resilience needed to bring joy and hope back into your teen’s life.

Remember: Depressive disorders rarely resolve on their own. Professional support provides the tools and strategies necessary for teens to overcome depression and build lasting mental wellness.