Updated on February 11, 2022.
Over four million teens aged 12 to 17 in the United States experienced depression in 2020, according to the National Institute of Mental Health. That means 17 percent of teens—about 1 in 6—has had a major depressive episode during the year. This marks a steep rise even compared with 2013-2014, when the rate was 1 in 9—which provoked concern at the time, as that, too, marked a rise compared with previous years.
A national crisis
Experts in children’s health are concerned, with a coalition of them declaring a national emergency in child and adolescent mental health in the fall of 2021. In December 2021, US Surgeon General Vivek Murthy, MD, MBA, issued a Surgeon General’s Advisory about the crisis.
“Even before the pandemic, an alarming number of young people struggled with feelings of helplessness, depression, and thoughts of suicide,” said Dr. Murthy. “The COVID-19 pandemic further altered their experiences at home, school, and in the community, and the effect on their mental health has been devastating.”
The advisory noted new disruptions faced by many of the nation’s youth, including:
- Loss of in-person schooling and social opportunities
- Impaired access to health care and social services, food, and housing
- Worsened caregiver health
All of this was harder on young people who were already vulnerable to begin with, the advisory added. Those include youth who are:
- Living in rural areas
- Low-income or homeless
- Disabled
- Racial or ethnic minorities or living in immigrant households
- LGBTQ+
- Involved with child welfare or juvenile justice
Among other recommendations, the Surgeon General called upon the nation to recognize that mental health is a key part of health and to ensure that young people have access to mental health care, as well as addressing socioeconomic factors that worsen mental health.
What does depression look like in teens?
Typical symptoms of a depressive episode in an adolescent include:
- Loss of interest in things that were once pleasurable
- Extreme sensitivity to things like rejection and failure
- Sleeping problems
- Decreased energy
- Worsening school performance
- Lower motivation
Experts don’t know exactly what causes depression, but various factors are thought to contribute to the disorder.
Self-esteem issues
Scott Adams, PhD, Director of Youth Psychology and Quality at the Medical Center of Aurora in Colorado, sees numerous cases of teen depression in his practice. Many of those cases are related to low self-esteem.
Teens who experience bullying, academic problems, or body issues like obesity, are at higher risk for depression, according to Adams. That includes young people who are questioning their sexuality or gender identity or who identify as lesbian, gay, bisexual, transgender (LGBT). Some researchers think having low self-esteem as a teen makes for less emotionally resilient adults.
Health conditions
People who live with long-term diseases like asthma or chronic pain syndromes are at increased risk of depression. Bipolar disorders, personality disorders, and anxiety disorders can all coexist with depression, too, says Adams. “If they have a physical disability that sets them apart from other kids their age, that would be a risk factor,” he notes.
Genetics and family problems
While it’s not always the case, depression can be hereditary. If someone in the family has a history of depression or mental illness, a child may be more at risk for inheriting the disease. Teens who experience even normal stressful life events, such as divorce, death in the family, dysfunctional family dynamics, or exposure to a family member with suicidal thoughts also have an increased risk of depression, according to Adams.
Social media and unrealistic expectations
Another possible reason for depression in teens is the increasing popularity of social media.
“When using social media, they are faced with unrealistic expectations of how they should be and who they should be,” Adams says. Looking at actors, bloggers and other teens all day, every day can cause teens to put more pressure on themselves.
Multiple studies link adolescent mental health problems to the habit of spending large amounts of time on social networking sites, like SnapChat and TikTok. Companies are also aware of the problem. When Facebook surveyed teens in the United States and United Kingdom, over 40 percent of those using Instagram tracked their feelings of unattractiveness back to the app, according to the Wall Street Journal.
In 2018, a Pew Research Center survey of kids aged 13 to 17 found that 97 percent use a social media platform and 45 percent are online almost constantly.
Lack of sleep
We all feel out of sorts if we don’t get enough sleep. But when this happens to teens—all too common, especially among “night owls” who attend schools with early start times—they may face bigger issues than just moodiness. Evidence strongly suggests that sleep-deprived adolescents face a higher depression risk.
The National Sleep Foundation recommends that teens get 8 to 10 hours of sleep every night. Unfortunately, studies show the vast majority of teens do not get enough sleep, and nearly a quarter of adolescents are estimated to have insomnia.
Depression and sleep dysfunction often go hand in hand, as depression can also cause insomnia or other sleep disorders. And while researchers still aren’t clear as to why poor sleeping habits may lead to depression, a tired teen may have impaired judgment and may have a hard time dealing with regular daily stress.
If your teen is experiencing symptoms of depression that interfere with their everyday life, take the time to talk to them and listen to them, and reach out to a healthcare provider for additional support.
