Differentiating between typical teenage mood swings and clinical depression can be difficult even when we are not in the midst of a pandemic. Parents now face an even bigger challenge as they navigate the changes and adversity that have occurred because of COVID-19.
Teens are missing many important milestones in their young lives, such as graduation ceremonies, participating in after-school clubs or playing on sports teams. Practicing social distancing has caused teenagers to report feeling lonelier than usual. All of this is concerning since adolescence is a time in development when peer relationships are particularly critical.
Adolescents may also be concerned about the physical, emotional and financial well-being of their family and friends. Feeling sad, disappointed, irritable or moody is understandable, and it’s important to recognize that it’s also normal. There is a common misconception that mental health means feeling happy all of the time. However, mental health actually means having the right emotions at the right time and being able to tolerate difficult emotions when they arise.
Meredith Gunlicks-Stoessel, PhD, LP, is an M Physicians psychologist and is also an associate professor with the Department of Psychiatry and Behavioral Sciences at the University of Minnesota Medical School. As an expert in child and adolescent mental health, she talks about the differences between sadness and clinical depression and how to open a dialogue with your teen about their mood.
Differences Between Normal Sadness and Clinical Depression
How do we know if a teen is experiencing normative sadness and irritability or clinical depression that requires treatment?
“One of the important differences is the intensity and duration,” Dr. Gunlicks-Stoessel said. To be diagnosed with depression, a teen must experience a very sad, depressed mood or irritability for most of the day, nearly everyday, for at least two weeks. In addition to a depressed or irritable mood, a diagnosis of depression requires other symptoms, such as:
- Loss of interest in activities
- Lack of energy
- Changes in sleep patterns
- Feelings of worthlessness
- Changes in appetite
- Difficulty concentrating
- Feeling hopeless or helpless
- Thoughts of death or suicide
A diagnosis of depression during the teenage years is common. Approximately 20 percent of teenagers will meet the criteria for diagnosis at some point, with girls being twice as likely to develop depression compared to boys.
The good news is that depression is treatable and there are several effective treatment options available, including telehealth. There are psychotherapy (talk therapy) approaches, including interpersonal psychotherapy and cognitive behavioral therapy. Medications, including selective serotonin reuptake inhibitors (SSRIs) are also effective. Importantly, both psychotherapy and medication appointments are available via telehealth. Telehealth sessions are conducted through a secure, web-based video conferencing system, allowing families to attend appointments from the safety and comfort of their own homes.
“If you’re feeling concerned about your teen, you should trust yourself. Getting an assessment from a professional, such as your teen’s pediatrician, can be a good place to start. Your pediatrician can also help with treatment referrals, if needed,” Dr. Gunlicks-Stoessel said.
Having a Conversation With Your Teenager About Mood
Parents often feel anxious about broaching topics like mental health with their children. It’s important to remember that many teens do want to share their thoughts and feelings with family members but may feel anxious about doing so. Dr. Gunlicks-Stoessel lists some suggestions to open up dialogue.
Aim for good timing. Try to avoid the initial conversation when emotions are running high, whether it be your teen’s emotions or your own. Let your teen know that you’d like to find a time to check in. “If it isn’t a good time, ask when another time might work better,” she said.
Share your observations and express curiosity. Try to explain what you’ve observed without passing judgement. Here’s an example of how open-ended questions within a conversation can lead to the topic:
- “I’ve noticed that you’ve been spending a lot of time by yourself in your room and you’ve been sleeping a lot.”
- Then, express interest and curiosity. “Have you noticed that too? What do you think about that? Does it bother you?”
- This can lead to: “I’ve been wondering a little bit about your mood. Have you been feeling sad or depressed at all?”
Listen More. Talk Less. Dr. Gunlicks-Stoessel says to try to avoid giving advice or encouraging them to think about the positives. Instead, take a step back and provide them with a safe space to share. Listen to understand, not to respond. Ask them to elaborate on issues when given the opportunity.
Empathize and Validate. Let your teen know that you can see how upset they’ve been feeling and how hard things have been for them. “Tell them you care and that you’re glad they shared their honest emotions,” she said.
Step Back (if necessary). If your teen isn’t engaging with you, Dr. Gunlicks-Stoessel says don’t continue asking a lot of questions. Instead, let them know what you observed and how you perceived it. Inform them that it seemed like a change and that is why you wanted to check in. Always present the option for discussion at a later time and let them know you are available to listen.
More Information About Depression and Treatment
- Participate in Dr. Gunlicks-Stoessel’s Research Study: Treatment Research Study for Depressed Adolescents
- Society of Clinical Child & Adolescent Psychology: Effective Child Therapy
- American Academy of Child & Adolescent Psychiatry: Facts for Families