Overview, Causes, & Risk Factors

Depression is a medical condition that leads to intense feelings of sadness or despair. These feelings don't go away on their own. They are not necessarily related to a particular life event.

What is going on in the body?

Depression is a disorder of the brain. Researchers believe that chemicals called neurotransmitters are involved in depression. Nerve impulses cause the release of neurotransmitters from one nerve cell to the next. This release allows cells to communicate with one another. Too little or too much of these important neurotransmitters may be released. This can cause or contribute to depression. These neurotransmitters include serotonin, norepinephrine, and dopamine.

What are the causes and risks of the condition?

There are many theories about what causes depression. Depression may be caused by any of these things:

certain illnesses

certain medicines, including antibiotics and medicines used to treat acne

changes in brain chemicals

heredity

hormonal changes

lack of sunlight

major stresses

negative thinking patterns

Common risk factors for depression in adolescents include:

abuse or neglect

alcohol abuse

breakup of a romantic relationship

chronic illness, such as diabetes

cigarette smoking

divorce of parents

drug abuse and addiction

family history of depression

learning disabilities

low self-esteem

major trauma, such as a natural disaster

other psychiatric disorders, such as attention deficit disorder or adolescent conduct disorder

Adolescent girls are twice as likely to develop depression as adolescent boys.

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Symptoms & Signs

What are the signs and symptoms of the condition?

Some symptoms are common in people of all ages with depression. These symptoms include:

appetite problems

decreased energy

difficulty paying attention or making decisions

feeling very sensitive emotionally

feelings of irritability

feelings of sadness, despair, and emptiness

inability to feel pleasure

low self-esteem

loss of motivation and withdrawal from others

pessimism, negativity

sleeping problems

thoughts about suicide and death

Teens with depression may have additional symptoms, including:

alcohol abuse

difficulty with friendships or social outings

drug abuse and addiction

fear of death

frequent vague physical ailments, such as headache

irritability or hostility

poor school performance, tardiness, or absences

problems with authorities

recklessness

sensitivity to failure or rejection

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Diagnosis & Tests

How is the condition diagnosed?

Screening tests for depression in teens include:

the Beck Depression Inventory (BDI) 19

the Center for Epidemiologic Studies Depression (CES-D) Scale

the Children's Depression Inventory (CDI) 18

A teen who screens positively on one of these tests should have a comprehensive evaluation for depression. The evaluation may include a medical history, physical examination, and laboratory tests.

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Prevention & Expectations

What can be done to prevent the condition?

Depression may not be preventable. However, these steps may be helpful in preventing it:

avoiding alcohol and illegal drugs

avoiding cigarette smoking

getting prompt treatment for other psychiatric disorders

seeking effective treatment for chronic diseases

talking with a counselor after experiencing a major trauma

Depression can lead to suicide. It is important to recognize and treat the condition early. Teens should be encouraged to talk to someone if they are concerned about depression. There are many people to whom they can talk, including:

a clergy member

a family doctor

their own parents, a friend's parent, or a trusted family member

a professional at a mental health center

a psychologist

a school counselor

What are the long-term effects of the condition?

Most adolescents recover well from a single episode of depression. However, episodes are likely to recur. Adolescents with depression are at risk for further episodes of depression later in life. They are also at risk for adult personality disorders.

There is a strong connection between depression and suicide in adolescents. Suicide is the third leading cause of death for people between the ages of 15 and 24.

What are the risks to others?

Depression is not contagious and poses no risk to others.

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Treatment & Monitoring

What are the treatments for the condition?

The two most common ways of treating depression in adolescents are with antidepressant medicines and psychotherapy. Often a combination is used. Occasionally, a teen must be hospitalized for intense treatment.

Antidepressant medicines are effective in:

increasing the teen's ability to function in daily life

lowering the risk of suicide

making the teen feel better

Antidepressant medicines known as selective serotonin reuptake inhibitors (SSRIs) can be used in teens. Some common SSRIs include fluoxetine and paroxetine.

Psychotherapy can help adolescents:

cope better with having depression

feel less alone

improve relations with family, friends, and coworkers

learn about depression and how it affects them

learn to recognize and avoid situations that can bring on a depressive episode

learn to view the world and others more positively and more realistically

positively address problems that they may be facing

stop episodes of depression early by recognizing warning signs and symptoms

Treatment of depression in a teen should involve the family as well as the individual.

What are the side effects of the treatments?

Antidepressants may cause mild and usually temporary side effects in some people. The most common side effects are:

agitation

constipation

dizziness

drowsiness

dry mouth

nausea

What happens after treatment for the condition?

An episode of depression in a teen usually responds to treatment with medicine and psychotherapy. The teen can help prevent relapses by living a healthy lifestyle. Some important parts of the healthy lifestyle include:

avoiding alcohol, illegal drugs, and smoking

doing regular exercise

eating a balanced diet, following the food guide pyramid

finding a support system for dealing with depression

finding ways to manage stress

getting enough rest

How is the condition monitored?

Once a teen has an episode of depression, he or she is at higher risk for further episodes. Any new or worsening symptoms should be reported to the healthcare provider. The provider may recommend regular visits to monitor symptoms. The provider may also order blood tests to monitor the levels of medicines.

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