By - Claire Mitchelmore – Provisional Psychologist

There is increasing evidence that depression is one of the most common mental health challenges for young people in Australia and that the rate of depression amongst our teenagers is rising. This is concerning because depression often has long-term effects on a young person’s social, emotional and academic development. Identifying the symptoms and intervening early is therefore important in mitigating these potential long-term effects. So how will you know whether your teen is experiencing depression and how can you support them?

Signs and symptoms of depression in your teen

Signs that your young person may be experiencing depression include ongoing feelings of sadness, hopelessness and irritability. You may also notice that they have lost interest in activities that they previously found enjoyable, and may withdraw from socialising with friends and family. Other signs include changes in sleep and appetite, and poor performance at school or extracurricular activities. More serious signs, which require immediate professional help, include taking potentially harmful risks or self-harming behaviour, substance use, or thoughts or talk of suicide. Signs to look out for are listed in more detail below:

       Emotional Changes 

• Feelings of sadness, emptiness, or hopelessness that lasts for at least two weeks.
• Increased irritability, anger, or frustration, often over minor matters.
• Feeling extremely sensitive, worthless, or misunderstood.

Behavioural Changes 

• Loss of interest or pleasure in usual activities, hobbies, and social interactions.
• Withdrawal from friends, family, and social gatherings, preferring to be alone.
• More arguments, aggression, or hostility with family and friends, leading to increased conflict.
• Engaging in risky behaviours, such as being involved in dangerous activities, unhealthy relationships, vandalism or fighting.
• Turning to substance use (alcohol or drugs) to cope with feelings.
• Engaging in self-harming behaviours, which may include thoughts or talk of suicide. If you suspect your teen is thinking about suicide, seek immediate help.

Physical Changes

• Eating significantly more or less than usual, with changes in appetite leading to observable weight gain or loss.
• Changes in sleep patterns such as sleeping much more or less than usual, or having trouble falling or staying asleep.
• Feeling tired and having low energy, which can also lead to frequent physical complaints like headaches or stomach aches.

Cognitive Changes

• Difficulties focusing, making decisions, or remembering things.
• A decline in academic performance, poor school attendance, or a lack of motivation or effort at school.

How mood disorders differ from typical teenage behaviour

Many teenagers become withdrawn, moody and irritable as a normal part of their development. They may start to eat more as they grown and their sleeping habits change, staying awake later at night and being reluctant to get up in the morning. They often close their doors and no longer want to talk to the adults in their lives, seeming to withdraw from family life. Many young people seem to spend more time on a screen than on their schoolwork or chores. Sometimes there can be an obvious stressful event that impacts your young person’s wellbeing. However, for most young people, it can be a combination of stressful events or issues that accumulate in their day-to-day lives that influence their feelings, thoughts and behaviours. So how is depression different from these normal developmental phases and life stressors?

While it is true that many young people have occasional mood swings and display instances of irritability, these symptoms are more severe, happen more frequently and tend to persist for some time during a depressive episode. Whilst changes in sleep and appetite are normal, significant shifts that do not align with apparent growth spurts should also be noted. If your teen seems sad, irritable, and feeling worthless for more than two weeks, and these feelings are stopping them from participating in the things they used to find enjoyable, they may be experiencing depression.

Identifying that your teen might be depressed can be confronting and worrying. You might not know how to approach your teen or might easily  jump to ‘worse case scenarios’. However, in most cases, depression is mild or moderate rather than severe and can be easily managed with appropriate support.

Effective therapies for depression

Whilst therapists work in multiple therapeutic modalities, Cognitive-Behavioural Therapy (CBT) and Acceptance and Commitment and Acceptance Therapy (ACT)  have found to be particularly effective in treating depression in young people.  Both approaches are described below.

Cognitive-Behavioural Therapy (CBT)

CBT is considered a gold standard treatment for teenage depression that teaches young people how thoughts, feelings and behaviours influence one another. CBT sessions are generally structured and in which the young person and therapist work collaboratively to identify and change negative thought patterns and behaviours. For moderate to severe depression, it is recommended that CBT sessions take place for at least three months.  They have been shown to improve mood, problem-solving skills, social skills, and self-esteem through the following techniques:

• Goal setting: 

The therapist and teen collaboratively set specific problems and goals to work on together.

• Behavioural activation: 

This technique encourages teens to engage in activities that they once found pleasurable or that give them a sense of accomplishment. This helps counter isolation and can lead to more positive thoughts and feelings.

• Identifying and challenging negative thoughts: 

A therapist helps a teen identify unhelpful or negative thought patterns, such as "no one likes me" or "things will always be this way". The therapist and young person then work together to challenge these thoughts and find more balanced and realistic ones.

• Improving skills: 

CBT helps young people develop skills to improve their problem-solving, decision-making, and social interactions.

Commitment and Acceptance Therapy (ACT)

ACT (pronounced as the word ‘act’) can be effective for teens with depression by teaching them to accept difficult thoughts and feelings rather than fighting them, and then to take action that aligns with the way they want to lead their lives, that is, according to their values. ACT is therefore a collaborative and action-oriented therapeutic approach that is often more appealing to adolescents than traditional talk-therapies, and has been shown to lead to clinically reliable changes in symptoms of depression. It focuses on building psychological flexibility through the following concepts and skills:

• Making Room:

The young person learns to accept that negative thoughts and feelings are a normal part of the human experience and do not need to be avoided or controlled.

• Being Present:

The therapist teaches the young person to step back and observe their thoughts or feelings and allow them to flow through them without getting caught up in them, recognising they are just thoughts and not necessarily truths. They are also taught to intentionally focus on the here and now through mindfulness.

• Being Authentically Me:

The therapist encourages the young person to take actions that matter to them and that will lead to the positive outcomes, even when they are experiencing sadness or anxiety.

In both approaches, the therapist may assign activities for the young person to do at home and it is important that you are prepared to assist your teen in practising any skills between sessions. Both approaches are effective in treating anxiety and depression in adolescents and, whilst different in philosophy and approach, are complimentary and can be used in conjunction with one another.

Taking the next step

If you are concerned about your young person, it is important to contact your general practitioner who can provide a referral to a trained therapist.

At Spencer Health, we assess and work with children, adults, parents and families with a variety of presentations, including depression and anxiety. We offer a range of services such as assessment, therapy and coaching with many services being delivered via telehealth. If you are ready to book in an initial evaluation of your child, or are maybe interested in just having an initial conversation with one of our trained psychologists to decide if it is worth pursuing treatment, please get in touch. Spencer Health is a neurodiversity-affirming organisation and we are lucky to count many neurodivergent psychologists as colleagues.

If you would like to meet more of our team, or learn more about our services you can do so here https://spencerhealth.com.au/spencer-health-team/ or if you are ready to book in, you can do so here https://spencerhealth.com.au/contact/