Teenagers are known to be irritable, moody and sometimes outright rude. They spend hours in their room, face timing with friends, keeping the door shut and snarling at either parent who dares to open the door. So how do you know if your daughter is depressed or if it’s just normal teenage angst?

An adolescent (or adult) who is diagnosed with Major Depressive Disorder, according to the new DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition,) “shows five or more of the following symptoms have been present during the same 2-week period and represent a change from previous functioning (and at least one of the symptoms is either depressed mood or loss of interest or pleasure.)
1) Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g. feels sad, empty, hopeless) or observation made by others (e.g. appears tearful). (Note: In children and adolescents, can be irritable mood).
2) Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
3) Significant weight loss when not dieting or weight gain, or decrease/increase in appetite nearly every day.
4)Insomnia or hypersomnia nearly every day.
5)Psychomotor agitation or retardation nearly every day.
6) Fatigue or loss of energy nearly every day.
7) Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
8) Diminished ability to think or concentrate, or indecisiveness, nearly every day.
9) Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.”

The symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning. The episode is not attributable to the physiological effects of a substance or to another medical condition.

Clinical depression often runs in families and is a biological disorder. The average age of depression onset is 14 years old. By the end of their teen years, 20 percent of teens will have had depression. More than 70 percent will improve through treatment (cognitive behavioral therapy and medication), but sadly 80% of teens do not receive help for their depression.

So how do you know?

Is the mood related to a specific incident that occurred in your teen’s life? Is anyone close to him dying, are you getting divorced or constantly fighting with your spouse? Has there been any other major change in your teen’s life such as a recent move, change of school, problems with friendships, school or their own physical illness? Is your teen a perfectionist? At times a teen who’s life doesn’t go exactly as planned or if he doesn’t quite meet his own high self-expectations might experience bouts of depression. Has your teen always had difficulty regulating her emotions?

Some signs to look for in your teen can be:

School refusal
Gaining or losing significant weight
Loss of appetite
Feeling tired most of the time, having difficulty getting out of bed
Tearfulness and extreme moodiness (more than typical for your teen)
Defiant, Oppositional Behavior
Self-injurious behavior (including drinking, drugs, cutting)
Somatic Complaints (stomachaches, headaches)
Socially isolating

What should you do?

Your teen might resist going to talk to a professional for help so your first appointment might be with the pediatrician. It will be important to rule out any physical illnesses that might be affecting his mental state. The pediatrician can also make the suggestion directly to your teen to seek professional help which might reduce your teen’s opposition to meeting with a mental health professional.

It is important for you to show your teen you are not the enemy and you want her to be able to express her emotions, whether it be with you, another relative or someone else not related to her. Encourage your teen to find an outlet to get her feelings out, such as writing in a journal. Encourage her to exercise and eat healthy. Talk to the school. Is there a staff member you trust to confide in and see if there is anything going on at school of which you might be unaware? Suggest your teen keep a gratitude list of all she is thankful for. All of these suggestions might be good ideas for you to follow as well to help you through this difficult time.