Understanding Depression in Teens



Hey Listeners, Anna and I are back again for episode 2 (season 2) and are talking with Celeste Osborne, LPC-S, and therapist in Houston, TX. Celeste works with individuals who have experienced trauma and she really enjoys working with teens and adults, particularly women. What caused me to reach out to her for this episode, is her extensive expertise with anxiety and depression.


Especially during Covid-19, the topic of depression has become super relevant with everyone feeling isolated and school work keeping kids in front of the screen. Depression is thrown around a lot in regular conversation and one of my goals is to really define depression and make sure that we discriminate between the casual usage of the term and how we define depression as therapists.


Depression is not moments of sadness...even though people use it interchangeable with feelings of sadness.


The mayo clinic defines depression as a serious mental health problem that causes persistent feelings of sadness and loss of interest in activities. It is in effect how a teenager thinks, feels, and behaves that can cause emotional, functional and physical problems...it’s not moments of sadness, it’s persistent feelings of sadness.


A colleague had said something to me once that really resonated...It’s not feeling sad, it’s about not being able to feel happy when you are in a situation that should contribute to feelings of happiness. Loss of pleasure or the loss of interest. For me, that is how I approach it with my clients - asking the question, how are they responding to things they would normally view to be positive.


Some characteristics of persistent feelings of sadness, depression:


- low self esteem

- despair

- hopelessness

- not having worth or purpose or value


Signs to look out for in teens are; when they want to stay in their room and not do anything other than play video games, or talk to friends online, or maybe not anything. They often do not want to interact and talk with family, they don’t always want to come to the dinner table.


Depression is often shown as anger, it comes out as lashing out at everybody. Really inside they are hurting and sad and do not know how to handle it, so the only way that can do that is to express the anger. Another way you see it is in their grades dropping, along with the comments of “I am worthless and nobody likes me”. When you talk about action items, lethargy takes over, they know they should be doing something, but they feel they can't. Even though they should, it seems so hard and they physically can’t do it.


What Celeste and I both see in teens with depression as well, is that they struggle with sleep patterns. They are either sleeping a lot and are lethargic or sluggish, or they are not sleeping and maybe irritable and are up all night on social media or other technology. They may change their pattern to be up all night and sleep all day and while they are up all night the negative thoughts start coming,” I have no value”, “there is nothing good about me”, “nobody likes me”. They can start reading into things, like thinking that their friends don’t like them and are talking about them, that they don’t want them around and didn’t include them in something. They start imagining things that aren’t true and take it as fact.


We also talked about medication for depression, oftentimes parents feel medication is the absolute last resort, every other option needs to be exhausted first before they will consider it, including having them suffer. I struggle with that. I feel that we have science, it doesn’t have to be a forever thing, it can be done slowly and mindfully. I just worry about kids who aren't given the support they need and linger in that depressive state. Medication doesn’t need to be the first option, but it can help to get over that hump and make it easier to function after they can level out and feel good about themselves.

Something else that parents and any type of caregivers should be aware of, is that sometimes kids have had depression and anxiety for so long that it becomes their identity. This is the way they have communicated with others, have dressed, and expressed themselves for so long, that when they get the relief from these symptoms, they get scared about having to figure out a new identity. It is hard for them and they may want to stay in that depressive state because they are comfortable being uncomfortable.


Things to consider as risk factors in your teen:

- Weight gain

- Trouble in school

- Bullying/Trouble with other kids

- Isolation


What role does technology and social media play with depression?


Celeste feels that it is good and can be positive, but also bad because there is so much comparison on social media. When someone is comparing themselves to others they may start to think, “I don’t look like them, so I must not be good enough”. They start worrying about how many likes they get on their posts, or how many “snaps” they received. It can really make someone feel bad about themselves if they are already feeling down.


We are also seeing that kids are replacing non technology activities (sports, artistic endeavors, dance) with technology and social media. It's playing a role in their identity and how they feel connected, but it is also getting in the way of activities with family and friends. And often when they are with family and friends, everyone is all on their phones. Though they may feel entitled to contact with their friends all day and night with unlimited access to meet their social needs during COVID-19 or any time for that matter, it is becoming more harmful and time limits can be helpful.


Practical steps for parents can take:


- Keep your kids connected with family time, having dinner, keeping them involved

- Not letting the teen dictate what they are doing, especially younger teens

- Keeping close eye on behavior changes

- Ask questions if they are really angry all the time or being disrespectful


How do you know when to get a therapist involved?


If you start noticing any of the signs that we have been discussing such as,

your child is always in their room, not interacting with others, their grades are dropping, sad a lot of the time.


Kids really need someone to talk to, but don't often feel comfortable talking to mom or dad, so having a neutral party to talk to about what is going on can be very helpful. If it is done early, a therapist can see those warning signs and guide them on a different path possibly and give them the support they need before it becomes full blown depression.


As a general rule, the earlier the better it is if the teen talks about what is going on. And with social media and other celebrity teens coming out about depression it is more widely accepted to see a therapist and get help. More kids are actually going to their parents these days to ask to see someone.


If you have any questions about your specific situation, please reach out.


To listen to the podcast referred to, go HERE.

To learn about Celeste and her services visit her website, www.rhchouston.com.

To learn more about Dr. Tara Egan, visit www.drtaraegan.com.

To learn more about Dr. Tara Egan's private therapy practice, visit www.charlotteparentcoaching.com.

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