By Dr. Danielle Platt 

 
From "The Heathers to 10 Things I Hate About You" to "To All the Boys I’ve Ever Loved Before," we are all well-acquainted with the image of the “moody” teenager. Across generations, we have been trained to believe that all teenagers are angsty and that mood changes are part of growing up. While it is true that adolescence is complicated and full of emotional ups and downs, as one of the most significant mental health issues affecting teens, it is important to recognize that clinical depression does not equal teenage “moodiness”.  

Depression can be subtle, but a caring and questioning parental eye can identify potential depressive symptoms by looking for these 5 signs:

1. New onset anger/irritability/rage

2. Significant change in performance

3. Frank sadness and/or withdrawal

4. Loss of…

5. When words aren’t spoken, listen to the body

New Onset Anger/Irritability/Rage

While some teenagers with depression express frank sadness, others display their signs of depression as angry outbursts. Parents should be careful not to assume that new onset rage or anger is just a part of growing up. Anger, especially if it leads to significant verbal or physical aggression, school suspensions, or police involvement, should be addressed and monitored. Try talking to your teen when he or she is calm and try to determine if their anger seems justified or whether it’s likely masking something else that may require professional help.

Significant Change in Performance

Some school subjects can be more difficult than others depending on your child’s academic differences but a sudden change in overall school performance can suggest an underlying shift in a teen’s mental health. Look for poor performance in subjects that they previously excelled in or even outright school avoidance in a teen that otherwise enjoyed going to school (even if only for the social aspect). Ask your teen about bullying or other stressors that could be going on at school that could exacerbate the depressive symptoms. Additionally, significant changes in performance in areas other than school can raise red flags as well; shifts in interest or functioning in sports or other extracurricular activities can also hint toward changes in mental health status.

Frank Sadness and/or withdrawal

Many adolescents with depression can express that they feel sad; however, some depressive episodes in teens can manifest instead as the loss of the ability to express or feel sadness. Depression could cause your teen to become withdrawn. While depression disrupts the emotional well-being of the person experiencing it, it could appear as though he or she does not feel anything at all.

Loss of…

Depression can manifest as losses of things that were previously present in your child’s life. For example:

• Has your teen suddenly withdrawn from previously enjoyed sports or other activities?

• Has your teen suddenly lost interest in things they used to enjoy doing at home, like play video games or draw?

• Has your teen suddenly lost friends or changed friend groups?

• Has your teen lost (or gained) weight without explanation or intention?

• Has your teen lost energy?

• Has your teen lost or had trouble sleeping?

Don’t be afraid to ask your teen about these perceived losses or about any changes you have noticed. Helping your child verbalize what may be contributing to these changes and unearth clinical depression can be lifesaving.

When words aren’t spoken, listen to the body

Our minds and our bodies are connected in ways that are both beautiful and complex; when one component unexpectedly suffers or thrives, the other will often adjust, compensate, commiserate, or even overtake the other. Our bodies can hold stress and speak on behalf of our minds even before we are consciously aware that we are having shifting feelings. Sometimes, depression can, therefore, manifest as physical symptoms. Look for seemingly organic physical complaints that may not have clinical explanations like new onset headaches, abdominal pain, chest pain, fatigue, generalized pain etc. Listen to your child, have them evaluated by a medical professional if these complaints become concerning, and recognize that these physical complaints may be their bodies’ way of telling them/you something is going on emotionally (if not otherwise explained by a diagnosable medical condition).

At the end of the day, you know your child best and can and should be their best advocate. However, it is important to keep in mind that being a good parent does not mean that you have children without problems or are all-knowingly capable of solving all of the ones they may have. Instead, good parents stand by their children and help them get the help and support they need and deserve. Turning to professionals in times of need and even asking your children outright about symptoms of depression and suicidality are acts of parental strength. Discussing suicide and/or self-harm does not drive people to harm themselves; instead, it can uncover problems and even make people feel safer knowing that their distress is not going unnoticed and will be addressed.

Sometimes the most sensitive humans, the ones who are destined for meaningful adulthoods full of deep and rewarding relationships, are the ones who struggle the most during their teenage years. Adolescence is the time where young people are feeling things so deeply while simultaneously learning how to manage the depth of those feelings. Allow them to go through these changes, stepping in when necessary. Because, ultimately, knowing your child and spotting the signs of depression are essential in helping you help your child grow into a successful and safe adult.

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Danielle Platt, MD, is an Assistant Professor in the department of Adolescent Medicine at the Children’s Hospital of Philadelphia where she is the co-medical director of the CHOP at Belmont Behavioral Health System collaboration. Dr. Platt is skilled in the treatment and management of eating disorders, mental health advocacy, and improving physician competency in recognizing and understanding childhood/adolescent trauma.

This op-ed is connected to a project by the Jewish Federation of Greater Philadelphia and the Center for Parent and Teen Communication, which aims to equip Jewish teens and families with resilience-building tools rooted in science and Jewish values.