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JUST THE FACTS

What is a depressive disorder?

A depressive disorder is a disease that affects mood, thoughts and behavior. Without treatment, symptoms can last for weeks, months, or years. The greatest obstacle to treating depression is lack of recognition. When a "bad day" turns into a bad week, month, or more, there may be a medical explanation for this change in behavior or feelings of hopelessness. Fortunately, appropriate treatment can help more than 90% of those who suffer from depression.

Depression and teens

Experts estimate that 5% of all teenagers will suffer from depression. Unfortunately, only 20% of depressed teens are appropriately diagnosed and treated. When diagnosing a mood disorder, adolescents can be at a disadvantage. The symptoms of depression and bipolar disorder (manic-depressive illness) in young people can differ from adults. Symptoms can be missed if you don't know what to look for. Read on to learn more.
Well meaning parents or teachers may think that a young person is unhappy or moody because it's a natural part of being young. This is especially true for adolescents, who are expected to be "hormonal" and rebellious. Persistent unhappiness or moodiness is not normal for anyone.

Depression is a medical illness

Depression is a medical illness caused by a chemical imbalance in the brain. In the brain, neurons send messages from one nerve ending to another across synapses. Neurotransmitters, such as serotonin, are chemicals that help transfer information. In depression, these neurons do not function normally, which leads to changes in a person’s thoughts, feelings and behavior. Antidepressant medications work to restore proper chemical balance in the brain.

There are two primary types of depressive disorders: major depression (unipolar disorder) and manic-depressive disorder (bipolar disorder).

Symptoms of Major Depression

  • Irritability and/or depressed mood
  • Loss of interest in usual activities
  • Low energy and/or restlessness
  • Poor concentration
  • Sleeping too much or too little
  • Weight loss or weight gain
  • Feeling hopeless and helpless
  • Feeling worthless and guilty
  • Thoughts of death or suicide

Symptoms of Manic Episodes

  • Significant mood swings
  • Too much energy
  • Easy distractibility
  • Grandiose ideas or overconfidence
  • Inability to sleep
  • Fast talking, racing thoughts
    Risk-taking behavior


Risk factors for depression

  • Children under stress, who have experienced loss, or who have attention, learning, or conduct disorders are at a higher risk for depression
  • Girls are more likely than boys to develop depression
  • Youth, particularly younger children, who develop depression are likely to have a family history of the disorder
  • Four out of every five runaway youth suffer from depression


Treating Depression

The good news about recognizing and understanding depression early is that it can be treated. Antidepressant medications are widely used, effective treatments for depression. Antidepressant drugs are known to influence the functioning of certain neurotransmitters (chemicals used by brain cells to communicate), primarily serotonin, norepinephrine, and dopamine, known as monoamines. Older medications – tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) – affect the activity of all of these neurotransmitters simultaneously.

Their disadvantage is that they can be difficult to tolerate due to side effects or, in the case of MAOIs, dietary and medication restrictions. Newer medications, such as the selective serotonin reuptake inhibitors (SSRIs), have fewer side effects than the older drugs, making it easier for patients to adhere to treatment. Both generations of medications are effective in relieving depression, although some people will respond to one type of drug, but not another. Medications that take entirely different approaches to treating depression are now in development.

Psychotherapy is also effective for treating depression. Certain types of psychotherapy, cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT), have been shown to be particularly useful. More than 80 percent of people with depression improve when they receive appropriate treatment with medication, psychotherapy, or the combination.

Recently there has been enormous interest in herbal remedies for various medical conditions including depression. One herbal supplement, hypericum, or St. John’s wort, has been promoted as having antidepressant properties. However, no carefully designed studies have determined the antidepressant efficacy of this supplement. NIMH is currently enrolling patients in a first large-scale, multi-site, controlled study of St. John’s wort conducted in the U.S. as a potential treatment for depression. It is important that you or your teen seeks professional help before trying to self medicate with this or any other over-the-counter medication.

Consequences of untreated depression

  • Once a young person has experienced an episode of depression, he or she is at risk for developing another episode of depression within the next five years
  • Depression in childhood may predict more severe depressive illness in adulthood
  • Depression in children and adolescents is associated with an increased risk for suicidal behaviors

Help is Available

Depression is treatable. Early diagnosis and treatment are essential for teenagers with depression to live normal lives. Teens who exhibit symptoms of depression should be referred to and evaluated by a mental health professional who specializes in treating teens. The diagnostic evaluation may include psychological testing, laboratory tests and consultation with other specialists. A comprehensive treatment plan may include psychotherapy, ongoing evaluation and monitoring, and in some cases, psychiatric medication. Optimally, this plan is developed with the family, and whenever possible, the child or adolescent is involved in treatment decisions. See our reference guide for information on available resources.

*Facts made available by the National Mental Health Association, DRADA, Department of Health and Human Services

Day for Night is NOT about Suicide Prevention or Violence Prevention. This film is not intended for use in Suicide Prevention Programming or Violence Prevention Education.

Use of Information

The information on this site is intended to help users learn about teenage depression and related mood disorders. It is provided for informational and referral purposes only. The web site should NOT be used as a substitute for medical advice, counseling, or other health-related services or as a replacement for the services of a trained medical or mental health professional. For medical or mental health advice, services, and treatment, consult your primary care physician or a qualified mental health care professional.


Depression is a Medical Illness


Depression is a medical illness caused by a chemical imbalance in the brain. In the brain, neurons send messages from one nerve ending to another across synapses. Neurotransmitters, such as serotonin, are chemicals that help transfer information. In depression, these neurons do not function normally, which leads to changes in a person’s thoughts, feelings and behavior. Antidepressant medications work to restore proper chemical balance in the brain.

Day for Night is NOT about Suicide Prevention or Violence Prevention. This film is not intended for use in Suicide Prevention Programming or Violence Prevention Education.

Use of Information

The information on this site is intended to help users learn about teenage depression and related mood disorders. It is provided for informational and referral purposes only. The web site should NOT be used as a substitute for medical advice, counseling, or other health-related services or as a replacement for the services of a trained medical or mental health professional. For medical or mental health advice, services, and treatment, consult your primary care physician or a qualified mental health care professional.


Frequently Asked Questions About Teenage Depression



Q: What is a mood disorder?

A: A mood disorder (also called an "affective disorder") refers to disturbances in mood that are medical in origin. Major depression, manic-depressive illness, and related anxiety disorders are physical diseases, which cause the brain to improperly regulate the chemicals that govern thoughts, feelings and behaviors.

Q: How many American teenagers are clinically depressed?

A: It is estimated that five percent of all teenagers will suffer from major depression. Unfortunately, only 20 percent of these teenagers will be diagnosed and even fewer will receive proper treatment.

Q: Is depression affected by gender?

A: Young children experience mood disorders at an equal rate, but by adolescence twice as many girls as boys become depressed. This ratio continues into adulthood.

Q: Is it easy or difficult to diagnose adolescent depression?

A: It can be challenging to diagnose clinical depression in adolescents because the teenage years can be difficult and often the normal "moodiness" of adolescence masks an underlying depressive disorder.

Unfortunately, depression is not the best word to describe what children and adolescents experience with a mood disorder. Most teenagers actually tend to get much more cranky and angry instead of sad.

Professionals are trained to recognize the ways in which teenagers unknowingly mask their depressions, such as with drug and alcohol abuse. These behaviors may be the way a teenager deals with feelings of worthlessness and despair that come with depression.

Q: What role does stress play in clinical depression?

A: Sometimes stress can precipitate an episode of depression or mania in someone who is particularly susceptible -- for example, someone who has a family history of depression.

Q: Are antidepressants addictive?

A: No. Doctor-prescribed antidepressants are neither addictive nor habit forming. They do not cause an emotional high or numbness. Antidepressant medications repair brain chemistry so the brain can function normally.

Q: Will my depression ever go away for good?

A: Clinical depression and manic depressive disorder tend to be episodic in nature. These illnesses are treatable, but right now cannot be cured. The goal of treatment should be to manage the disease, decrease the severity of a depressive episode and keep recurrences to a minimum.

Q: What is the difference between depression and manic-depressive illness?

A: Clinical depression is also called "unipolar" depression because a person's mood swings only in one direction - down. Normal periods are separated by a steady drop in mood, which becomes lower and lower. In contrast, manic depression is "bipolar," because the mood swings range from low to high (manic) and back again.

Q: Is there a connection between alcohol or drug abuse and mood disorders?

A: Yes, definitely. A significant number of teenagers who abuse these substances are really suffering from an underlying mood disorder. Without realizing it, they may be trying to "self medicate" their symptoms of clinical depression or manic depressive illness.

Teens with mood disorders who abuse alcohol or drugs may seek these substances because they temporarily offer relaxation, or help them feel more confident or energetic. Unfortunately, this is temporary and can cause the depression to worsen, resulting in two serious conditions rather than one.

Q: Is there a relationship between eating disorders and major depression?

A: Yes. Often teenagers who suffer from bulimia or anorexia and are bingeing, purging, or barely eating may have an underlying depressive disorder.

Q: How can I tell whether someone is depressed or just dealing with teenage stresses?

A: Doctors look for the following symptoms. Five or more, lasting for at least two weeks and as a change from the usual you, indicate depression.

  • Depressed mood (life seems sad, blah, empty)
  • Much less interest or pleasure in almost all activities
  • Significantly less or more appetite
  • Sleeping more than usual, or inability to sleep
  • Slowed speech or movements, or inability to sit still--enough that other people notice
  • Fatigue, loss of energy
  • Feeling worthless or extremely guilty
  • Difficulties in thinking or concentrating

Day for Night is NOT about Suicide Prevention or Violence Prevention. This film is not intended for use in Suicide Prevention Programming or Violence Prevention Education.

Use of Information

The information on this site is intended to help users learn about teenage depression and related mood disorders. It is provided for informational and referral purposes only. The web site should NOT be used as a substitute for medical advice, counseling, or other health-related services or as a replacement for the services of a trained medical or mental health professional. For medical or mental health advice, services, and treatment, consult your primary care physician or a qualified mental health care professional.

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