What are the warning signs of teen depression? How do you talk to your child about his or her mood swings? How do you know when it’s the right time to consult a social worker?
Kimberly Nelson, a licensed clinical social worker at the Wheeler Clinic, has provided answers to various questions regarding how to both spot and treat teen depression.
In May, C-HIT hosted a forum on teen depression: Uncovering Our Kids: Towards A Better Understanding Of Teen Mental Health. Nelson, who specializes in adolescent behavioral health, was one of the forum’s panelists. The questions were asked by the forum’s attendees. This Q&A was done in collaboration with the Hartford Courant, a forum media partner.
Q: What are the signs of teen depression? As a parent, it’s hard to know if my teenager is moody, or if his/her mood swings are the signs of something more serious that should be evaluated.
A: Depression in teenagers can be challenging to recognize. It isn’t uncommon for teenagers to seem irritable, moody and to be easily frustrated. Teenagers tend to isolate some and commonly withdraw from parents and family. This is normal. However, when irritability, moodiness or other signs and symptoms interfere with your teen’s ability to function adequately at school, with peers and in the community, it probably would be a good time to consult with the teen’s pediatrician, a school social worker and/or a behavioral health specialist. If you notice any significant changes in your teen’s mood, behavior, appetite, sleep patterns or physical complaints, you should consult with your teen’s pediatrician or a behavioral health specialist.
Q: My son/daughter resists my attempts to talk about his/her moodiness. Any advice on how to start a conversation without resistance? Should I bring in a third party, such as a school social worker?
A: Having a conversation with teenagers is hard. It’s not uncommon to encounter resistance when trying to talk to teenagers about their mood or behavior. Don’t stop trying. Timing can be everything. If your teen is experiencing moodiness and irritability, then it probably wouldn’t be a good time to discuss your concerns. Wait for an opportunity to present when your teen is calm. Express concern and support. Validate their feelings. Remember, adolescence is hard to navigate. Ask your teen if he or she would like to talk with a behavioral health specialist to process their feelings. Offer to go with him or her, but don’t be upset if they refuse. Sometimes, the teenager will be more comfortable and more apt to engage with another family member — aunt, uncle, older cousin, family friend, and coach — than a parent or guardian.
Q: How can parents – or a family – work together to support a teenager with depression?
A: Depression, just like any other medical condition, sometimes cannot be prevented, but can be managed or mitigated. Watch for early signs and symptoms such as irritability and agitation, extreme moodiness, changes in appetite and sleep patterns, loss of interest in activities your teen once enjoyed, decreased energy, sleep disturbances, inability to concentrate, frequent crying, sadness, hopelessness, withdrawal from family and friends, unexplained aches and pains, and any deviation from what’s typical for your teen. Parents and family members should be supportive, open to listening, non-judgmental and willing to seek professional assistance. Never ignore signs of depression, and seek professional consultation. Reaching out for help early is the best way to help and prevent things from worsening.
Q: How do we address the stigma attached to depression?
A: Depression is a medical condition caused by a combination of genetic, biological, environmental and psychological factors. Approximately one in five youth experience depression or another serious mental health issue before the age of 18. We can help reduce the stigma associated with depression by talking about it, and other behavioral health issues, with our family and in our communities. You don’t have to be an expert to talk with your kids – and in fact looking for information and resources together can be a great way to keep the conversation going. You can help to change attitudes, and to change the larger conversation around mental illness.
Q: Are there any good youth-directed phone apps for a teenager to use to manage their behavioral health?
A: New tools to support youth and adults with mental health disorders are emerging all the time, including apps. There are apps that teach relaxation techniques, apps to help track symptoms of depression, apps to help with mindfulness, quitting smoking, time management… and so much more. Some apps are available for free and some come with fees or charges. As with any tool or technique you should carefully look at any app with your teen and your behavioral health provider or pediatrician together to be sure you know what the app can and cannot do, understand all of the terms of use and privacy that come with the app and reach an agreement about how and when the app should be used. Technology can be a helpful tool, but be sure your teen knows when to talk with you or another trusted adult, too. You can learn more about many resources and related topics at Connecticut Clearinghouse (www.ctclearinghouse.org).
Q: Is self-injury related to depression?
A: Self-injury, an act of deliberately harming yourself, through actions like cutting or burning, can be used as way to cope with emotional pain, intense anger and frustration. Teenagers who self-injure may be experiencing depression and other negative emotions that they are having difficulty managing or regulating. Self-injurious behavior should never be ignored. Take it seriously, and follow up with your child’s pediatrician or a behavioral health provider.
Q: How can I tell if my child is depressed or has bipolar disorder?
A: Depression can be a symptom of bipolar disorder as well as an illness in and of itself. Bipolar disorder is characterized by significant mood instability and extreme shifts in moods that are out of the range of normal for a teenager. For example, pressured communication, risky and unpredictable behaviors that are not typical for your teen, extreme irritability and temper, and behaviors and/or emotions that are characterized by extreme highs and lows. Always consult with a professional if there are concerns about depression or mood disorders.
Q: How can I work with my school system?
A: There are several resources available in school systems, from teachers and support professionals, to guidance department, family resource center teams and more. Explore your options with staff at your child’s school, and ask about available school-based mental health services, including formal assessment, counseling, consultation, and referrals for services and supports in the community. Additionally, some schools house school-based health centers, which provide a range of health services. Each school is different, so inquire at your child’s school about what resources are available. Your son or daughter’s teacher or school counselor may also have valuable observations or insight about behavior at school, academic performance and peer interactions.
Q: How can I access behavioral health services for my teen?
A: No matter your income or your insurance status, behavioral health services are available to help you and your child. If you have insurance, talk to your insurance carrier to find out what services are covered and who is in your network. You also can discuss your situation with your pediatrician who may have access to a child psychiatrist through ACCESS Mental Health Connecticut, which assures that all youth, regardless of insurance status, can get help through their relationship with their pediatrician.
Connecticut’s 2-1-1 provides youth mental health information and services, including statewide Emergency Mobile Psychiatric Services for youth in crisis, accessible by calling 2-1-1 and pressing option “1,” and information about resources such as child guidance clinics and federally qualified health centers in or near your community.