While the current circumstances surrounding 2019 coronavirus disease (COVID-19) are challenging for most people, many teenagers are particularly impacted. Some are missing the first season on their varsity team, their part in the school play, or their final semester of high school. As such, many teens may seem down, disappointed, or moody.

“Parents, who now have unprecedented access to their teenager’s day-to-day functioning due to social distancing, may find themselves wondering how to tell the difference between typical teenage sadness and depression,” says Aleta G. Angelosante, PhD, clinical assistant professor in the Department of Child and Adolescent Psychiatry at NYU Langone Health and also part of its Child Study Center.

Similarly, parents who have a teen who is or who has been depressed may wonder how best to support their teen during this unique crisis. Dr. Angelosante, in partnership with the Department of Child and Adolescent Psychiatry’s WonderLab, discusses things to look out for if you are concerned your child is depressed.

The Difference Between Being Sad or Disappointed and Being Clinically Depressed

“Sadness is a normal part of human existence, and right now, youth have a lot that may be making them feel sad. They may feel isolated from their friends, missing their normal routines, and worrying about whether things will ever go back to normal,” Dr. Angelosante says.

While it is hard to be away from their good friends, many teens can fill that void by using social media or video calls to connect with them. “What they cannot replicate as easily is the passive socialization that happens during the school day: people they chat with in class but are not close enough with to contact outside of school, the feeling of walking down a crowded hallway and hearing all of the conversations going on around them, or the shared moment of laughing together at something silly that happens in the classroom,” Dr. Angelosante says. “So sadness and disappointment make sense right now.” 

Depression, otherwise known as major depressive disorder, or MDD, is different from sadness not only in intensity and duration, but also in its symptoms beyond sad mood. “Up to 20 percent of teens may experience a major depressive episode at some time during adolescence,” Dr. Angelosante says. “To be diagnosed with MDD, a child must exhibit five or more symptoms that interfere with their daily life, nearly all day every day, for two weeks.”

“While adult depression often appears to be one solid mood state, youth depression can be more ‘reactive’ such that happy things can temporarily shake them out of their negative mood,” Dr. Angelosante adds. “These moments do not last, though, and the youth will soon be back to their low mood.”

Symptoms to Look for If You Are Worried Your Child Is Depressed

Dr. Angelosante says that parents can be on the lookout for these behaviors, which may warrant a visit with a doctor:

• Physical complaints. Stomachaches, headaches, or other vague physical symptoms can be associated with depression.
• Social withdrawal. If teens begin to completely isolate from parents, start to isolate from peers, or change peer groups entirely, this might be a sign of depression.
• Academic decline. A striking drop in academic performance or motivation, in conjunction with other symptoms, may indicate depression.
• Substance use. While some level of experimentation may be normal in adolescence, depressed youth are likely to attempt to self-medicate through the use of these substances.
• Self-criticism. An increase in frequency and intensity of negative self-statements, such as “I’m so stupid!” or “I can’t do anything right!” may also be a sign of depression.

“Most teens are likely to display one or two of these behaviors at some point in adolescence,” Dr. Angelosante says. “But parents should be more concerned if the changes have happened more rapidly, happen more consistently, or are occurring at once.”

How to Have a Discussion with Your Teen About Mood

Teens are often reluctant to discuss difficult personal topics with their parents. When thinking about how to broach this topic with your teen, you should consider the following:

• Chose the right time. Know how to pick your opportunities. Do not try to engage them in this conversation immediately after an argument or disagreement, or when they are in the middle of a fun task.
• Stick to the facts. You cannot know what is going on inside your teen’s mind. Let them know specifically what behaviors you find concerning, and ask if they have noticed those behaviors as well.
• Validate. Let your teen know that you can see how hard things have been for them lately. Express that you care about them and their wellbeing.
• Self-disclose. If you have ever experienced depression or know someone who has, sharing this can be a really powerful tool in this conversation. Let them know what it was like for you, or what you know about how it was for the other person, and what helped.
• Be ready for push-back … or not. Oftentimes parents are reluctant to have this conversation because they are so concerned that it will go poorly (it might). But you might be surprised to find that you child is thankful to have someone notice and validate their experience.

How to Get Help for Depression in Adolescents

There are many effective treatments for depression such as psychological treatments, including cognitive behavioral therapy, interpersonal psychotherapy, acceptance and commitment therapy, and medications, including selective serotonin reuptake inhibiters, also known as SSRIs. It may seem daunting to engage a new therapist or psychiatrist during this time, but many providers, including those at NYU Langone, have been able to adapt to the current climate by providing telemedicine appointments via video visits.

Additional Resources for Parents

Dr. Angelosante suggests these resources for parents:

• Anxiety and Depression Association of America: Watch, Ask and Listen: How to Tell if Your Child or Teen Is Anxious or Depressed
• Society of Clinical Child & Adolescent Psychology: Effective Child Therapy
• U.S. Department of Health and Human Services: Resources to Support Adolescent Mental Health