Teenage depression – or adolescent angst? How can you tell the difference between depression and moodiness?

A teenage depression test is in the works but until then, how do you know when hormonal tantrums cross the line? What are the signs of depression?

“For years we had her on unofficial suicide watch. She didn’t notice but we always had someone nearby just in case, keeping an eye on her. The problem is that teenagers are really impulsive and that’s how you lose them. They’ll just have a bad half day and decide that’s it.”

Jennifer’s daughter, Hannah, developed severe clinical depression aged 13. The jolly and talkative girl transformed, quite suddenly, into a moody and uncommunicative adolescent, who hated to socialise and developed inconsistent sleeping habits.

“She was the life and soul of the party, the one who was always laughing. And then suddenly, she fell off a cliff,” says Jennifer. “If you look at photos, you can see the point where it happens. She was smiling, smiling, smiling in all the photographs and then suddenly you get to a photograph where she looks like she’s trying to hide.”

But despite her career as a doctor, it took Jennifer three years to realise that Hannah’s unhappiness and self criticism were more than typical teenage angst.

Signs of depression overlap with moodiness and so the condition is incredibly difficult to diagnose during teenage years, when young minds typically go through a great deal of change and a fair amount of unhappiness. Many of the symptoms of depression – isolation, antisocial or aggressive habits, a change in sleeping patterns or eating habits, and decreased personal hygiene – are typical of teenage years. Scientists believe they have developed a blood test to diagnose depression. But in the meantime, how can parents spot a serious illness from typical rebellion?

Jennifer says she was sitting in a coffee shop when she finally realised that her daughter’s intense and persistent self-loathing were symptomatic of more than just teenage hormonal changes. “I remember quite strongly I realised, ‘Oh my God.This child is profoundly depressed.’”

She took Hannah to a GP, who recognised the symptoms immediately and referred Hannah to a psychiatrist, who prescribed both medication and therapy. But Jennifer says this had a limited effect, in part because doctors are extremely cautious about how they treat young people with depression. The therapist was also more accustomed to treating teenagers with reactive depression – as in, depression that results in part from context, such as argumentative parents, fragmented friendship groups or stressful schooling – whereas Hannah was showing the beginnings of a long-lasting clinical illness.

It was only when Hannah started university, once her medication was changed and increased, that Jennifer began to feel that she had her daughter back. “She’s sociable, she laughs, she doesn’t think she’s a worthless piece of s***. She’s a completely different child,” says Jennifer now.

The family are relieved that treatment for Hannah’s depression has been a success but recognise that she has an illness that could last for a lifetime. Many mental illnesses, such as bi-polar disorder or schizophrenia, aren’t easily diagnosed until patients are in their twenties and so Hannah’s severe adolescent depression could well continue to develop into adulthood.

“You have to think, maybe she won’t be able to support herself,” says Jennifer. “So that’s not a jolly thought either.”

Around 1.4 per cent of 11- to 16-year-olds in the UK are estimated to be seriously depressed, according to the charity Young Minds. Although Hannah has a particularly severe form of depression, there are many teenagers whose moods slip beyond typical misery into clinical depression.

Beth Murphy, head of information at the charity Mind, says it can be very difficult to spot depression, and teenagers and parents should never attempt to self-diagnose or make an assumption about others – it’s best to present the symptoms to a clinician.

But there are signs that should warrant concern, including extreme social isolation, an inability to function day-to-day, general tearfulness, suicidal thoughts and self-harm.

“Comments like, ‘I don’t want to go on anymore’ should be ringing alarm bells. Self harm can be quite common in young people with depression so keep an eye out if they’re wearing a long sleeved T-shirt when it’s a hot day,” says Beth.

For teenagers with less extreme symptoms, parents should look out for sudden changes in their behaviour and the length of time teenagers are unhappy – while mood swings are transient, the symptoms of clinical depression last far longer.

“If they were always into computer games and they’ve become grumpy with you but are still interested in their computer games, that’s less to worry about than if that was a passion of theirs and they’ve stopped doing that and have withdrawn from their friends. Are they rebelling because they’re growing up or withdrawing from things they used to really enjoy previously?”

Loss of interest in passions and a sense of hopelessness – that the future is pointless or life is not worth living – are signs that unhappiness has slipped beyond typical angst.

But adolescent depression needn’t be a life sentence, as many people recover or experience it only occasionally throughout their lifetime. And learning the psychological skills to cope at a young age can help teenagers to build resilience as they get older.

Beth says that the first step in helping an unhappy teenager is to talk to them without judgement or assumptions. Whether they’re depressed or just moody, teenagers may answer in monosyllabic grunts – but it still helps to listen.

Typical signs of depression:
Antisocial or antagonistic behaviour, insomnia, hypersomnia (sleeping all the time), overeating, eating too little, decreased personal hygiene.

Symptoms to help distinguish teenage angst from depression:
Isolation, inability to function, suicidal thoughts, self-harm, sense of hopelessness, uncharacteristic changes in behaviour, loss of interest.

This article first appeared in The Telegraph on 16th September 2014 and is written by Olivia Goldhill. (http://www.telegraph.co.uk/women/mother-tongue/11097839/Teenage-depression-or-adolescent-angst.html)

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