Teenage depression: how to detect and overcome it?

With Anne-Victoire Rousselet, psychologist and psychotherapist at GHU Psychiatry-Neurosciences Paris, Sainte-Anne site.

While it is common in adolescence to go through moments of unease, to feel sad or irritable, it is also important to be sensitive to these symptoms, which can reveal a deeper problem.

Definition: what is depression?

Teenage depression is a common mental health disorder. According to the High Authority for Health (HAS), nearly 8% of adolescents aged 12 to 18 suffer from depression. This can have a considerable impact on the daily life of adolescents and those around them. ” Depression is a disturbance of the intrapsychic and physiological balance. The whole person is affected. This disruption of internal functioning affects all aspects of the person’s life. “, explains Anne-Victoire Rousselet, psychologist and psychotherapist in CBT (behavioral and cognitive therapy) at the GHU Psychiatry-Neurosciences Paris, Sainte-Anne site. According to the World Health Organization (WHO), depression is theone of the main causes of disease and disability in adolescents.

Signs, symptoms: how to detect depression in young people?

Symptoms of teen depression can vary from person to person, but they often include:

– a mood disorder with deep sadness or persistent irritable mood and prevailing negative emotions (sadness, anxiety, shame, guilt, fear),

– a loss of interest or pleasure for usual activities,

– behavioral changes, especially in eating or sleeping,

– low self-esteem,

– thoughts focused only on negative things, death or suicide,

– body pain

– difficulty concentrating.

These symptoms are not always easy to spot, because at this age multiple transformations take place. The teenager has more difficulty communicating about his emotions, asks himself a lot of questions, does not always feel good about himself, can experience moments of depression…
Unlike depression, the feeling of depression is lighter in intensity and has no particular impact on the daily life of the young person, their relationships, their schooling… However, depression can develop into real depression and deserves to be monitored. Symptoms of depression can also be mistakenly thought to be a simple teenage crisis. In the slightest doubt, it is better to consult to confirm or invalidate a diagnosis of depression by a psychiatrist.

Depression in adolescents: what are the causes?

Teenage depression can have many causes, including biological, environmental, and psychological factors.

– Of the family history of depression: There is often a biological character. We always ask if there are depressions in the family because it tells us about the nature of the malaise felti”, confirms Anne-Victoire Rousselet, psychologist and psychotherapist in CBT.

– Stressful life events: a romantic or friendship break-up, bad grades, a class trip that goes wrong, bereavement, etc. As with any mental illness, depression can arise from decompensation in the face of stress important, or for which no strategy has been found. It is not the situation in itself that is stressful, but the way in which it is perceived in a given context. One can then start, depending on one’s biological background, OCD, schizophrenia, depression… “, continues the psychologist. She adds that mental disorders may be more frequent since COVID with this long period for young people from desocialization, deschooling. Teenagers found themselves deprived of their usual landmarks and new experiences. They discovered a new and invisible fear of harm without intention (possible transmission of COVID).

– disorders of identity or sexual orientation,

– eating disorders,

– drug addiction problems,

– family conflicts,

– traumatic experiences.

Depressed teenager: what are the consequences?

Teen depression can have many negative consequences on a teenager’s daily life and general well-being.

  1. School difficulties: depression can lead to difficulty concentrating, disinvestment in school, and reduced motivation, which can affect academic performance. The teenager cannot work.
  2. Social problems : teens with depression may feel isolated and have difficulty making friends. They are often parasitized by their own devaluation. They may also have conflicts with their family and find it difficult to maintain healthy relationships with others.
  3. Increased risk of risky behaviors: they have a higher risk of risky behaviors, such as alcohol or drug abuse, risky sexual behaviors, impulsivity due to their emotional instability.
  4. Suicidal thoughts: they may have negative cognitions, suicidal thoughts, and be more likely to be life-threatening.
  5. Impact on physical health: depression can impact an adolescent’s physical health by affecting sleep. He may then suffer from insomnia or hypersomnia. His diet can be disturbed with excessive food intake or, on the contrary, a loss of appetite. His energy level is low. The teenager may experience chronic fatigue, digestive problems, etc.

Treatment, solutions and support: what to do in the event of depression in adolescents?

It is not always easy to consult a psychologist right away. Initially, it is possible to discuss these difficulties with the attending physician who knows the adolescent and his family well. This can be a first step towards care, adopting a empathetic approach and ask to see the adolescent again for a future visit. If necessary, he will refer to a mental health professional to take stock more precisely.

Testing and diagnosis of depression

The diagnosis of depression can go through questionnaires, tests like the Children’s Depression Inventory (CDI). These tests do not spare a psychological and/or psychiatric evaluation to detect a sad mood, physical disorders and other symptoms present over a long period. ” To speak of depression, the symptoms must have existed for at least two weeks “recalls Anne-Victoire Rousselet. The HAS adds that the adolescent must present at least five symptoms of depression including at least depressed (or irritable) mood or loss of interest (or pleasure). The HAS explains that “ in the short and medium term, the objective of the management of depression is to manage the suicidal crisis and to protect the adolescent “.

Therapy and/or drug treatment (antidepressants)

Treatment for teenage depression can include a combination of therapy and medication. First, the support for the mild depression can be treated with simple therapy. There are different types of psychotherapy. The most common therapies are cognitive behavioral therapy (CBT), psychoanalysis, systemic therapy and family therapy, depending on the problem encountered by the adolescent. The professional will create a climate of trust to free the floor. According to HAS recommendations, the place of the family in the care must be an integral part of the care process insofar as depression is often linked to a relationship problem with the parents “.
When depression is moderate to severe, or that the symptoms persist beyond 4 to 8 weeks of psychotherapy, it is necessary to go through medication in addition to psychotherapy. It will always be the psychiatrist and the doctor who will give the anti-depressant treatment. Commonly prescribed medications for depression in adolescents are selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs). ” On depression, it’s a bit serotonin which is deficient, as if an area of ​​the brain had dried up. Serotonin must be poured abundantly in order for the brain system to function again. Patients already see a benefit within three weeks. But the biology of the brain, this arid land, takes almost 12 months to rehydrate itself in serotonin. Often, as they feel better, patients stop their treatment too soon “, warns the psychologist.

Hospitalization in case of emergency

In the most serious situations, the child psychiatrist can advise more extensive care with hospitalization. This happens especially when the risk of acting out, of attempting suicide, is strong and imminent or when the family situation is unfavourable.

If your teenager shows symptoms of depression or you have doubts about his mental health, it is important to consult a professional to make a diagnosis of depression. ” It is estimated that depression will affect 1 in 5 people in their lifetime. It’s very common. There is no guilt to be had. The human body is an incredible machine that is allowed to have bugs from time to time. It’s organic “, reassures the psychologist. In addition, the treatments are effective and can help to significantly improve the teenager’s quality of life.