By Chantelle Dockter, MA, LPC, Associate counselor of Christian Counseling Centers of Oregon and Washington (CCCOW)

Question: My teenage daughter is moody, sullen, and has been hiding out in her room a lot. She doesn’t seem to want to even hang out with her friends much. Could she be depressed?

Answer: Depression is definitely a possibility. Anyone who has teenagers knows that teens can be unpredictable and moody in general, and this makes it difficult to accurately discern what expected teenage behavior is and what is cause for concern. However, it is important to differentiate due to the risks that teen depression brings.

            With the prevalence of drugs and alcohol, increased sexual activity, and teen violence it is no wonder that today’s teens have a high incidence of depression. The suicide rate continues to climb and now ranks as the 3rd leading cause of death in teens, according to the Centers for Disease Control and Prevention (CDC). Depression in teens can rapidly progress to a life-threatening stage and professional help is vital in fighting the depression.

            Parents and caregivers should be watchful for the following warning signs: poor performance in school, withdrawal from friends and activities, sadness and hopelessness, lack of energy, anger and range, poor self-esteem, substance abuse, self-harm behavior, changes in eating and/or sleeping patterns, fatigue, and suicidal thoughts. Depression in teenagers can look different than depression in adults. A depressed teen may be more irritable, restless, or aggressive than sad or tearful. They may withdraw from most but still keep a few connections with certain friends.

            So how do you tell what is within the range of “normal” teenage behavior and what is a red flag? Consider how many of the above symptoms your teen is exhibiting, for how long the symptoms have been present, and how much the symptoms are interfering with your teen’s functioning. Look at their relationships with family, friends, and teachers. Are they involved with a healthy set of friends; do they attend a supportive church youth group? See if their grades are dropping or if they no longer have interest in the extra curricular activities they used to look forward to. Also, try and determine how much his or her behavior, mood, and personality have changed from what it used to be.

             If you believe there could be depression, then you want to talk openly with your teen about this. Gently bring up the specific behaviors you are concerned with. Try not to ask a ton of questions or put your teen on the spot. Rather, let them know that you want to be there for them and that they can talk with you. Do your best to just listen to what they may share with you, and validate it, rather than trying to fix it.  Next, schedule a physical with their primary care doctor. A medical doctor can rule-out any physical concerns that may exist, as well as do a depression inventory. The next step would be to find a therapist that the teen can go to. Many teens may resist this at first, but if it is the right connection they often end up utilizing therapy well. They also are more willing if they can have some input on who they end up seeing. Look for someone who is well-trained and comfortable working with teens and the unique struggles they face. Much of my practice is working with teen girls, and they often tell me how nice it is to have someone other than their parent or peers to talk with. Teens are faced with the challenge of becoming independent and facing the world’s pressures, yet still being young and inexperienced, without having the tools and life experience to make it on their own. This time of life is difficult and can be overwhelming. Let your teen know that it is okay to need to talk with someone and that there is no shame in it.

            Church youth groups can be a very healthy support to teens, and often provide a safe place to go that offers an alternative to the trouble spots that many teens feel pressure to attend. Youth leaders, whether they are paid staff or young adult helpers, can come alongside teens and offer comfort and a healthy perspective. Often they give similar advice to those of parents, however since they aren’t mom or dad teens often listen in a different way and may be more receptive.

            Emphasize that your teen is not alone, and that God is there to turn to when they feel alone. Offer to pray with your teen, or for your teen. They may not want to verbally participate but it is rare to find a teen or adult that isn’t at least open to being prayed for. As a parent or caregiver, utilize your support system by asking others for prayers and for wisdom in how to deal with the teen. Encourage your teen to find a particular verse in the Bible that speaks comfort to them that they can memorize as their own, and draw on when needed.

            As a parent you are the “expert” on your teen. If you are uncomfortable with behavior or emotions you are seeing, or you just have a nagging feeling that something isn’t right, follow your gut. Seek help right away, rather than waiting to see if the concerning issues will just go away on their own. Whether it be depression or something else, a treatment plan can be put together as well as a support network to utilize so that the teen can get the help they need.

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 Chantelle has written more on Depression in Chapter 6 of Shepherding Women in Pain. For more information on CCCOW, go to www.CCCOW.org