Depression in adolescents and young adults has increased in recent years and studies suggest there is a growing number of young people with undiagnosed and untreated depression. It is more important than ever to not only be able to recognize the signs and symptoms but also connect to depression treatment resources. As a parent and caregiver, learning to be an advocate for your child begins with educating yourself and being the source of support and encouragement they need as they’re feeling confused, alone, and misunderstood. We at Milestones Counseling can help your child manage their depressed feelings and support your family in the process.

How is Depression Different from Sadness?

Feeling sad is a normal part of the human experience and can be triggered by many things, such as disappointment, losing someone, a breakup, or someone hurting your feelings. When you are feeling sad, you can usually connect it to an event or interaction that triggered these feelings. While it’s painful and frustrating to have such experiences, the sadness you feel in response to these events is a normal and expected part of life.

Depression, however, is a bit more complicated. It’s about more than feeling sad and often doesn’t have a specific trigger. Depressed feelings can have a sense of hopelessness that feel hard to explain to others but are very real to the person experiencing them and the symptoms are present for an extended period. Depression also leads to a decreased ability to function socially, at school, or work.

According to the Diagnostic Statistical Manual of Mental Disorders (DSM 5), the presence of at least 5 of the following symptoms for 2 weeks indicates clinical depression :

  • Depressed mood for most of every day
  • Decreased or diminished interest in activities that formerly brought enjoyment
  • Weight loss or weight gain
  • Significant changes in sleep patterns
  • Slowing down of thought or movement 
  • Fatigue/loss of energy
  • Feelings of worthlessness or guilt
  • Less ability to concentrate or make decisions
  • Regular thoughts of death or dying

There are several kinds of depressive disorders, but the four most common types include:

  • Major Depression: feeling profoundly low, loss of interest in activities you used to enjoy, and other symptoms previously mentioned above. Symptoms of clinical depression last at least 2 weeks and impact all aspects of your daily life.
  • Dysthymia: a milder form of major depression with symptoms that are less severe and prolonged.
  • Bipolar Depression: periods of depression and periods of mania extreme or unstable mood swings; seems to be most closely linked to family history. Symptoms triggered by stress and conflict.
  • Seasonal Affective Disorder: this is a type of depression experienced by some people as winter approaches and  there is less natural sunlight. Typically it appears and resolves at the same time each year.

Causes of Depression

Several factors can contribute to developing depression, including family history, environment, and experiencing medical conditions.

Family History: Children with a parent or close relative who has been diagnosed with depression are more likely to experience depression.

Biochemical and Medical Factors: Biochemical imbalances in the brain and changes in hormone levels can play a role in the onset of depressive symptoms. Being diagnosed with a chronic medical condition, such as type 1 diabetes, Celiac disease, or Crohn's disease can trigger feelings of hopelessness and other depressive symptoms. 

Environment: Changes at home or school or stressful life events like moving, changing schools, parent divorce/separation, or even change in family composition, such as becoming part of a blended family can lead to depressive symptoms.

Signs of depression can be expressed quite differently in children, teens, and young adults, so it is important to know what to look out for. Often, depression can be overlooked or misdiagnosed in children because it can present differently in children than in adults.

Recognizing Signs of Depression in Children

Some things that come to mind when you think of depression probably include sadness or tearfulness, hopelessness, loss of interest in fun or pleasurable activities, and sleeping more than usual. While this is true, in children, depression can also look like:

  • Irritability or crankiness
  • Feeling unloved or worrying about if people love them
  • Anger/angry outbursts
  • Sensitivity to rejection or failure
  • Defiance
  • Hyperactivity or restlessness
  • Failure to make expected weight gains
  • Bed-wetting or increased accidents
  • Frequent stomach aches or headaches that have no medical cause
  • Change in appetite
  • Frequent crying or whining
  • Nightmares
  • Separation anxiety or clinginess
  • Feeling like nothing matters, not caring about anything, or “not caring anymore”
  • Complaining of boredom
  • Withdrawal or social isolation
  • Inability to concentrate
  • Low self-esteem
  • Poor school performance

Teens and Depression

Being a teenager is hard. It’s a time when you are seeking to establish an identity outside of your family and begin to define who you really are. Friendships and relationships become more important than ever and you're faced with even more academic, social, and emotional pressures than when you were younger. Pressures to define your spiritual beliefs, to explore your sexuality and gender identity, and to engage in alcohol in drug use. Social media use creates an acute awareness of what others are doing which can lead to comparison, feelings of isolation or exclusion, and fearing that you are missing out on fun things other kids are doing. The amount of pressure to determine your future, deciding if and where you will attend college, what you will major in, and how to achieve the grades necessary to get where you want to go can be overwhelming.  

It’s normal to experience sadness and days where you feel down, but if it’s a prolonged experience or you’re feeling like it’ll never end and you start to notice some of the signs listed above, it’s time to consider reaching out to get additional support.

Depression in Young Adults

It’s an exciting time as you transition from your teen years into early adulthood. But with that comes a lot of change, uncertainty, and pressure to start figuring everything out: career, relationships, where to live, and how to become financially independent - just to name a few. There is a lot of fear and anxiety that comes with wondering what will happen if you don’t have all the answers or are not meeting the expectations of those closest to you. There is often a heavy weight put on us to be successful, but defining what that is and how that fits for you can feel elusive and overwhelming, especially when you feel like you still need time to experiment and explore. The increased levels of stress over the choices you’re now facing can lead you to feel lonely, irritable, and sad. And while it’s normal to feel these things in the face of growth and change, try to be honest with yourself. If you find you are experiencing the following challenges, please don’t hesitate to get support:

  • Spreading more time alone away from your friends and family
  • Low energy and a lack of motivation
  • Increased alcohol and drug use
  • Trouble concentrating
  • Waking up early in morning despite feeling exhausted
  • Changes in weight or appetite

Depression Treatment

The therapists at Milestones Counseling are uniquely equipped to help children, teens, young adults, and families with depression treatment. We use empirically-based approaches that are designed to meet each child and family where they are. Some of the methods that we use include:

  • Psychotherapy: Sometimes children can overcome depression by working with a mental health professional, such as a clinical social worker, professional counselor, or psychologist, who is trained in treating pediatric mental health issues. Psychotherapy can often be as effective when used alone as when used in conjunction with medication.
  • Play therapy and Art therapy: are effective forms of depression treatment for children and work well for younger children as well as those who are nonverbal.
  • CBT (Cognitive Behavioral Therapy): is a modality that works well for older children.
  • Medication: Sometimes medication is helpful when biochemical factors influence depression or if it is necessary to stabilize your child’s mood. Should you decide that your child may benefit from taking medication to manage their emotional and behavioral concerns, your child’s pediatrician or the therapists at Milestones Counseling can help you find a psychiatrist or nurse practitioner who specializes in child and adolescent mental health. They can evaluate your child for whether medication is appropriate. Medication is most effective when used in conjunction with psychotherapy.

At Milestones, we believe the best treatment involves parents in the treatment process, either through family therapy, parent education, or parent training. We join you and your family on your journey, providing a safe place where you can be vulnerable and feel supported. We tailor depression treatment to the client rather than trying to make the client fit the treatment. We meet you where you are at and help you to grow. Regardless of the methods used, you will gain a better understanding of how depression is impacting your child and you will learn how to better respond to depression symptoms.

When To Seek Help For Depression

Have you noticed concerning changes in your child’s behavior? As a parent and caregiver, you are the person most likely to know if something has changed in how your child is functioning day-to-day. It can be helpful to keep track of any symptoms, mood changes, and behaviors that shift or intensify. Are you noticing a pattern? Has the duration or frequency of their symptoms increased to where you’re noticing them every day or most of every day?

Has your child shared with you that he or she is having suicidal thoughts, wants to die, or perhaps has attempted suicide? If so, call 911 or your local mobile crisis team or take your child to the nearest emergency room

Depression is a serious condition, that if left untreated and unaddressed could have severe consequences. If you think your child may be experiencing depression, please:

  • Reach out to us at Milestones Counseling and Consulting Services at 443-574-4295.
  • Reach out to your child’s pediatrician to rule out possible medical causes
  • Speak with your child’s school counselor about receiving additional support in school
  • Call the National Suicide Prevention Hotline at 1-800-273-8255
  • Text hello to 741741 (The Crisis Textline)

At Milestones, we have a growing practice of various therapists and expertises and we’d love to help you get connected to the right one. Let us partner with you in managing the issues that your child or your family are facing. Please call Milestones Counseling at (443) 574-4295 if you would like to schedule an appointment with one of our talented and compassionate counselors today!

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