Your teenager has likely experienced the occasional bad mood or behavioral changes. They are faced with many pressures in their lives, including puberty, school work and activities, conflicts with friends and trying to figure out where and how they fit in.

While moodiness is normal adolescent behavior, teenage depression is very different and can cause overwhelming feelings of anger, sadness and despair.

“Depression can present in a myriad of ways in teenagers,” Dr. Ron Spiegel, Pediatrician with Snoqualmie Ridge Medical Clinic, said. “The obvious sad mood, low energy and poor appetite are perhaps the most common manifestations. But teens can also display irritability, agitation and easy anger. Withdrawal is also common; wanting to be alone in their room and avoiding others, including family and friends. The trick is suspecting something is not right. Parents are most often in the best position to notice a change in patterns.”

Here are some signs and symptoms of teenage depression:

• Behaviors that are out of character, such as missing curfews, unusual defiance or sudden rebellion that becomes extreme or dangerous
• Withdrawal from friends and family or hanging out with new friends
• Talk of or attempts to run away from home
• Increase in irritability, anger, hostility and explosiveness
• Promiscuity or drug use
• Feelings of worthlessness or self-hatred
• No longer enjoying activities he/she normally would
• Excessive sleeping or difficulty falling or staying asleep
• Change in eating habits often resulting in unintentional, fairly rapid weight loss or gain
• Excessive feelings of guilt or shame

“As a parent, ask yourself how long the symptoms have been going on, how severe and how different your teen is acting,” Dawn Finney, Behavioral Therapist for Snoqualmie Valley Hospital District, said. “If several of these symptoms last for two or more weeks and are causing distress, then treatment should definitely be sought.”

The following signs are more significant and should be acted on immediately:

• Verbal threats of committing suicide
• Preparations for death such as goodbye letters, giving away special possessions
• Loss of interest in his/her own life

Finney suggested that one of the first places to start is with a primary care physician. They will determine if there are medical causes of your teen’s symptoms and be able to recommend a behavioral health therapist or psychologist specializing in teenage depression.

“Counseling provides your teenager a safe, objective, non-judgmental environment in which to discuss emotions and stresses and helps him or her learn to make healthier choices,” said Finney. “If the depression is not resolved, then medication may be warranted.”

Dr. Spiegel and Finney recommend that anti-depressant medication be used in conjunction with other support and services. Family therapy can also be helpful in supporting and coping with depression, especially if family conflict is contributing.

“Causes are not as important as recognizing something is wrong,” Spiegel said. “Often it is a series of events or just plain genetics that run in a family. However, there are definite stressful events that can trigger the onset, including the divorce of parents, loss of a relative, a break-up and bullying.”

“It is not easy parenting teenagers,” Finney added. “However, one of the most important things that you can do as a parent is to establish open and good communication with your teenager. This often helps ensure that your teen will come to you in the event that he or she is experiencing symptoms of depression.”