Is My Teen Depressed — Or Just a Teenager? How to Tell the Difference

I wanna talk a little bit today about anhedonia. One of the symptoms that you might see in depression, that it's like moving through quicksand. Everything just feels so effortful, so difficult. It's like their energy, their interest is just blah.

They may tend to do things like withdraw, be alone, and that tends to drain people further. And so what we wanna do is kind of work with that balance.

Welcome back to the Parenting Pair Podcast. I'm Dr. Suzanne Allen.

And I'm Dr. Annalise Caron.

And today we're going to be talking about a topic that a lot of parents think about, and I think this question comes up frequently in therapy, that when a teen starts to do things or a tween, like staying in their room more or sleeping more or they seem to be more moody or irritable, parents begin asking the question, is this kind of typical teenager stuff? Like, is this what I should be expecting, or is there more going on here? Are these signs of depression, and should I be doing more?

I think that it's a really hard question. Yes. And so it's it's it can be challenging to sort of thread that needle as a parent to figure out when to worry and when not to.

Mhmm. So today we're going to talk a little bit about some of the differences between kind of what you might expect during the teenage years from some teens and depression. We're gonna talk in particular about one symptom of depression called anhedonia, which is kind of like the blahs and not feeling like doing things or having the same level of interest. And then some thoughts and ways that you can interact with

your teen that might be helpful. Yeah. So let's jump right in. Right? When should parents worry?

Right? And because a lot of the behaviors that we see, you know, teenagers, you know, in those tween to teen years do are more emotional or can be more emotional.

And if you look at lists between normative teenage behavior and signs of depression, often you're gonna see a lot of the same Moody, irritable, changes in sleep Right. Changes in in routine, interest, diet. So you're gonna see a lot of the same things. How do we

know what's what? So the way I think about it is really FID. Frequency, intensity, and duration. Right? K.

So are these behaviors is the moodiness or the behavioral outbursts or the withdrawal that you're seeing, is this lasting a long time? Right? If this is a one off or a big upset one night, even if it's a really big upset, then the next day, you're kinda back to normal and routines are fine and your child feels kinda like themself with a normal level of loneliness, we're not gonna be so worried about that because that's part of, you know, sort of the different demands and brain changes that come with being being a teenager. However, if this lasts for an extended period of time, a matter of weeks, certainly over two weeks, right, we're going to start to wonder, oh, there's been sort of more of a change. If it's just a higher level or greater intensity of whatever the concern is you're seeing, we're gonna pay attention to that.

And if there are sustained changes in how from where they used to be to now, like changes in, you know, their friendships or their drive to be with friends or engage in activities that they really enjoyed, If there are changes, either going too much into those things or pulling away from those things is often the case, that's when we're gonna start paying attention. Mhmm.

Yep. Okay. And you know, one other piece, and this isn't exactly intensity, but a lot of times I think too when you're looking at those symptoms lists, if you start seeing a couple of things hanging together, so it's not just maybe going into their room a little bit more after school, but it's going into their room more, having a hard time getting up in the morning, then withdrawing from activities, or you're seeing some grades drop a little bit, or they're starting to complain about a lot of physical symptoms. Sometimes it's not just the intensity of one symptom, like maybe they're irritable, but it's not off the charts irritability. But you have irritability, and then you layer on it sleep, and then physical symptom.

You And can it lasts see it the whole picture.

It lasts for a bit of a longer time.

Yeah. And with teens, let's not just like ourselves, let's not expect that things always resolve within a day as well. If your child or teen's friends drop them, if they have a breakup, if they don't make, you know The team. Yeah.

You know, the theater. Mhmm.

That's pretty to be expected that they're they're going to be upset and that you're going to see potentially some signs of distress. So, you know, we don't wanna overrespond to these things, and we also know that some of these interpersonal challenges and some of these losses can really contribute to depression.

And I think here's the thing. If you're unsure Yeah. It's very easy to just get other eyes on the situation, whether that be from, you know, talking to maybe someone you know who's had a child who's, you know, experienced depression and get sort of their input, trusted friend. You can also easily go to your pediatrician. Most pediatricians now screen regularly at well visits for depression.

So there are easy ways to just get some advice, either you or to bring your child in Mhmm. If they don't already have a mental health professional of their own.

I think that's great advice that parents we we can't be expected. We're not all clinical psychologists. And even clinical psychologists, we we get help and go for extra assessment when we're unsure about things with our or teens. So reach out, ask for help. So I want to talk a little bit today about anhedonia, which is one of the symptoms that you might see in depression in teens and can be a tough one and cause some kind of distress for parents, and also at times conflict between parent and teens, which So is a really tough a lot of times I describe to teenagers themselves, anhedonia, in this way, that it's like moving through quicksand, that everything just feels so effortful, so difficult, And so they just it makes it harder to do it.

They feel less interested. They don't feel as much reinforcement from it. It's like their energy, their interest is just blah.

Yep. Yep. And I I I think that that that was the word that was in my mind actually, you know, blah because their energy isn't there, and it and it feels genuinely so difficult Yes. To do the thing. And I think that's an important thing for parents to keep in mind when they're interacting with, their their child about this or trying to understand it is that if you feel anhedonia, even though you can't see a change, like when you break your leg, you get the cast on and you see, oh, that's why they're so slow or withdrawn or not playing soccer anymore.

There can be this sort of subtle change that builds over time where suddenly things that used to be fun really aren't fun. Things that they used to be done to do take much more energy. And that's what anhedonia is.

Yeah. And that's kind of the trap sometimes, and I know this is why parents feel really strongly about intervening on this at times because what can happen, right, is not having that energy to be able to engage or to hang out with friends or to do the things that they liked, right, and so pulling back from those things leads to greater isolation and less opportunity to do things that might help them feel good or feel capable or accomplished, and that furthers depression.

So what you're saying is almost the coping strategy, if you feel low energy, right, is to remove yourself further because I don't have the energy to do that. But as you're saying inadvertently, that can make things worse. That can make your teen feel Mhmm. You know, more depressed over time. And it's, you know, one sort of little tidbit that's helpful to remember that, you know, research has shown us many times is that, you know, motivation or feeling like doing something usually comes after doing it, not before.

We talk about it as a feeling or an idea. I feel motivated to go study for that test, or I feel motivated to try out for that play. What actually often happens is by doing the thing, that's when the motivation comes. Right? There are those studies of exercise.

You know, after you exercise for about three weeks, then you sort of naturally get the endorphins and the motivation to keep doing it. But that first week, you may not have the motivation to do it.

Yeah. Right. And and this brings us to kind of the primary and the initial intervention for depression, which is behavioral activation and doing the thing, helping someone do it even if they don't feel like it, right? Which often is the reason why we we say we're not gonna do it because I'm not in the mood for it, I don't have the energy for it, that's right, but there is very solid research behind being activated and doing whatever it is in terms of helping improve and help people move through a depressive episode.

And I think so so if what we do or what we don't do affects how we feel, the question becomes how do we help teenager make strides for themselves or our teenager make strides for themselves or move towards doing something that may feel really hard to do and have really low energy to do? And I think this is the challenge that parents face. Yeah. You know? Because it's very confusing to suddenly see your teenager not be interested in doing something that they were doing a few weeks ago with ease.

Mhmm. And so I think there's there can be a dynamic that's that's brought from that of, we'll just do it, you know, and then there's this, you know, kind of friction. And so I think step one is just understanding, that this is really, really difficult. Mhmm. You know, before a parent tries to support, do, fix anything, this is this is really tough.

Yeah. And hopefully that's what you'll get from this podcast today is a is a greater understanding of how difficult this is so that you can start with meeting them where they are and empathy. And then I I think hopefully kind of slowly moving them progressively into being able to do more. And sometimes parents just really thinking about that, you know, starting I don't even like to call it small, but just kind of starting in this little place, right, and building over time.

And so But building on exactly that point, I like to sort of from an educational standpoint, both for teens and tweens and for their parents, the idea of what someone's doing can either be kind of a brain drain, which might lead to feeling more kind of down or tired or fatigued or less motivated, or a brain boost, something that might just give a little bit of dopamine, a little bit of feeling, a little bit better. Right? And that if we can work on that balance, because when people experience anhedonia, they may tend to do things like withdraw, be alone, socialize less, you know, maybe, you know, passively scrolling for too long, you know, on social media or video games or whatever it might be, and that tends to drain people further. And so what we wanna do is kind of work with that balance or help our teenager, educate our teenager to help them see how they can work with the balance to kind of do more brain boosting activities, which might be a short walk outside, you know, texting a friend that maybe they haven't texted in a while, That sort of thing. To try to make it from so many brain drains, you know, that are weighing you down to adding in those brain boosts to kind of lift the mood.

Mhmm. I I love that idea too. I think, you know, giving this information to parents, but I think this is something that parents can frame and talk to their teens about, right? Because we're wanting to empower them, particularly in this time when they want more independence and they're figuring themselves out to be thoughtful themselves about what things for them, not just what we think, but for them, they think give them that little bit of a boost or might be something that's a drain. Because I know as a parent when I go in and I'm like, when you've been on YouTube too long, you're in a bad mood, and this, that, and the other, that shuts yeah, yeah, no, I just said this

last I totally

Yeah. This is a direct quote from last night's dinner with one of my kids. When we do that, that automatically, no, doesn't, you're wrong, Right? Versus like, you know what? Pay just pay attention.

Like, I'm kind of noticing for myself that, you know, and and this is an honest acknowledgment. If I get online and I go on Pinterest, I would say scrolling through Pinterest for me is a brain boost because I love the visual stuff. There's a lot of creative things on there. Like, it it makes me feel energized and gives me ideas. So scrolling that is a boost for me.

But it's interesting because I can imagine if you're a parent of, you know, a a teenager who maybe seems a little bit more withdrawn lately and they're on their phone, you could be reactive. Like, oh, you're doing this passive activity that's probably making you feel worse. But for you, Suzanne, as you're pointing out, scrolling Pinterest might be exciting and positive. Mhmm. And so bringing that curiosity instead of our judgment Mhmm.

Like YouTube is bad, which is funny because we're going to upload today's episode onto YouTube. Stay tuned for that. This might not

help our algorithm.

Oh, the irony. Anyway but but our judgments, often come from a good place, good intention, but often are fed by anxiety, just lead to pushing our teenager away more. And so I I I love the advice to start with curiosity, Find out what they may feel is a boost for them. If they can acknowledge it, if they're willing to talk about that. Yeah.

You know? But not jump to conclusions or demonize whatever they are doing because that will just honestly make someone feel a little more pushed away. And talking about that sort of feeling pushed away or feeling more distant from your parent or your loved one who may be experiencing some depression symptoms, I always think sort of the next step beyond curiosity and understanding better is really trying to let your teen know that the goal here is not to be intrusive, but to let your teen know that you're both on the same team against depression Mhmm. Or against the anhedonia, that it's not that you're criticizing them as a human or they need to be doing more, aren't enough. It's more like, I see that, you know, you're you're really struggling with this kind of the blast.

And that that's an awful feeling, I imagine. And depression can

be so hard. Depression can be brutal sometimes, isn't it? Right? Aligning with them that like depression is doing this to you. You and I see you and I'm I'm with you on this, on this same team against it and how hard it can be.

And when I feel that someone's on my team like that, I'm much more likely to open up or maybe maybe be open to what their suggestion or idea might be versus if I think they're demonizing or judging whatever it is I'm doing.

Yeah. Well, I think, you know, whether it's recommendations from books, online, from listening to us talk, right, I think a lot of parents, right, even if your child is in or teen is in therapy, the therapist is seeing them for forty five minutes to an hour each week and they're offering suggestions for behavioral activation and parents wind up in the role of being the ones to encourage, support, motivate, try to get them to do it. Mhmm. And so, you

know That feels like a lot of pressure, by the way. It is. It it feels like a lot of pressure to parents. And I can understand Yep. When you feel that pressure and that burden and maybe the depression is more in control, so your tween or teen isn't signing up to walk around the block or take a run again or whatever it is Yep.

That might help them feel better or get out in the sunlight early in the morning, when they're not just naturally agreeing to that, it can be very anxiety provoking to the parent because it's like, I'm trying. I'm trying to do what the therapist is saying, but I but I can't make them do it.

Yeah. It can feel like a lot of pressure that can bring up our intensity of you've gotta do this now. This is your therapy homework. If you don't, the depression is gonna get worse. And so we want to put out there that treatment for depression and kind of moving through depression is not a quick process and very often takes many months to.

And so that doesn't mean, you know, we don't do anything, but we wanna say that to alleviate some of the pressure that goes along with this, and then the inevitable conflict sometimes from kind of going at this very strong. And with saying that, that doesn't mean that you may not need to kind of strongly encourage slash push, right? But when we can start with not just jumping to you need to do this, we have to do this, you're gonna get more depressed, but when we start with validating how hard this is and then inviting them to do something. And often I suggest to parents, invite them, give them two options. Like, how about we either go sit in the sunroom together or we go for a walk?

And you know, they still might pick the third option, which you didn't provide, which is stay in their room, right? So I understand that's not a foolproof method, but sometimes just giving two options, what you'll find is that teens will pick the path of least resistance, and they might choose one of those. Mhmm. But start with validating how hard it might actually be.

And this can be really small. Yes. This can be just come come out of your bedroom. I I miss you. You know?

And if it and I don't want to, I can't well, how about just for five or ten minutes?

Mhmm.

You know? And we can just have whatever it is, your your favorite cup of tea or, you know, a a Doctor Pepper or whatever it is that you enjoy.

Yep. I'll go get you the Starbucks that you love. Yeah.

Just to change the environment. Get a little more daylight. Be with it can be that small, but those small steps over time can be really helpful. So we wanna, you know, again, not suggest to parents that you're the therapist or that you are responsible for changing someone's you know, your teen or tween's clinical depression or depressive symptoms Mhmm. Or feelings of anhedonia.

That's not your job. But it's just that encouragement, that validation that this is really hard. School is starting, and I know school is difficult for you. That's gotta feel make your blas even more blah. You know?

But I wonder, you've been kind of alone a lot. Let's let's just walk out to the mailbox together, and you can just tell me about, you know, whatever, what you're scrolling on Pinterest or what you're, you know, what what's going on in the NBA, whatever it is.

And I think all of these suggestions that we've made, right, being curious, helping our teens be curious, framing this as we're a team together Against depression. Against depression. Validating, connecting with them over how hard this is before inviting them. Making small steps.

Mhmm. Right? Knowing that this is a long process And, you know, but just small steps. We don't have to change everything overnight. All

of those suggestions, I think, are really doing what we hope parents are hearing here, which is really balancing, yes, behavioral activation is important, and as a parent, you likely have a role in supporting this, and the relationship is incredibly important. And so we don't want to put parents in this therapist or, you know, drill sergeant, you know, or or kind of role where we forsake your relationship with your teen. Because ultimately, in the end, one of the greatest motivators that gets us and supports us to be able to make changes and do things is the love and support within a relationship. So we wanna hold both, and that's not easy for parents, but just keep in mind both of those are equally important. And extraordinarily important.

I I would add one nuance here. You know, if you're doing some of the things that we're talking about with your teen and it really just feels like that's not changing, of course, you can see a mental health professional or it's not moving the needle. It also is okay to sort of push a little bit harder, you know Mhmm. You know, and just sort of set a boundary like, we're gonna do this. We're gonna take a five minute walk.

Mhmm. You know? Suzanne and I, you know, in the interest of maintaining the relationship, which which is one of the most important things for teenage mental health, for all of our mental health is, you know, being in supportive and close relationships where we feel understood. We tend to approach most things in life in terms of keeping that in mind. But you can be a bit stronger, you know, if the more gentle and curious ways are not working or not say, just a small thing.

We're gonna take that walk, you know, or providing, as Suzanne said, the option of, do you wanna do a ten minute walk or a five minute walk?

Mhmm.

That's what we're going to do. And being a little bit more strong about it.

Yeah. And that can be really distressing as a parent. And so I know we want to talk a little bit about parents taking care of themselves during this too. But kind of keeping in mind, and this is another phrase I'll just throw out there, and I think we use this with anxiety, but, you know, I love you. I want to support you.

I want to help you and not the depression, which is why I'm standing in this room and I'm opening your window shades right now. Or why I'm saying, we're going to this doctor right now. So if the forcefulness is necessary, you know, or kind of being a little bit stronger in that messaging, you can still throw in there things that are acknowledging, I love you and this is why I'm doing this for you. This is hard, but I believe you can do it, and I believe I can tolerate how hard this is for you too. And that doesn't mean that on the inside you are not quaking, shaking, and doubting whether you're doing the right thing, but then that's where we want to work on getting you as parent a that support to be able to hold that strong message.

And one viewpoint that I think Suzanne and I have on this picture, having been psychologists and and worked with so many families over the years, I have had teenagers who were then, say, in their twenties, reflect back to me that they couldn't have done it themselves, that they needed that push, that they knew they were being, quote, unquote, mean, difficult, problematic, but they that really felt they couldn't help it. And so sometimes having that stronger push, again, in the way that Suzanne described, protecting that relationship and clarifying that that's why I'm going to, you know, push a little bit here and say, we're gonna do this, was what was needed. And so even if in the moment it doesn't feel good, sometimes upon reflection, a a former teenager might say, that's really what I needed at that time.

Mhmm.

You know?

And I think this this cues right to the parent the part of kind of parents caring for themselves because the most common symptom that we see in adolescent depression is irritability. Mhmm. And so parents, you may really be bearing the brunt of a lot of negativity and anger and frustration, particularly if you're trying to push them or support them in being more activated. And so I think for parents, you know, one of the things that you mentioned is a confidant. You know, if you have a friend, a family member, someone that you know who maybe has struggled with depression themselves or has a child or teen who struggled with depression, what an incredible resource.

If not, but it's still a really empathic, great listener who's supportive and validating and helps you, find that confidant. Mhmm. You know, if that's not possible, or in addition to that, trying to identify one small self care. Listen, if you can get it to be big, go big. But we know parents don't don't have a lot of time.

You know, a five minute walk yourself, even if your teen won't go with you. Making sure you keep your favorite coffee pods in the house so that you start your day with something really lovely that's just for you. But, you know, do those things for yourself. And I cannot encourage this strongly enough that supporting your teen in this way, you may absolutely benefit from your own support and therapy. Even if your teen's unwilling or un I'm sorry, I shouldn't say unwilling, struggling to get support for themselves, that does not mean that a parent can't get.

We just can't underestimate how debilitating it can feel for a parent who desperately wants to help their teenager when it feels as though even if they are helping, but when it feels as though they're not. And, you know, just know that what you're feeling, the anxiety or the stress or the exhaustion or the fatigue. Some parents, you know, worked with people who maybe have depression themselves and then they worry or feel guilty. Did I do this to my child? This is a lot.

This is exhausting at times and it's really okay to get your own support, particularly if your child isn't willing or if your teen isn't willing, to seek additional support from, say, a mental health professional. Really get that support for yourself because supporting yourself will help you better be able to support your child. And I think people say, oh, oh, I just need that for my child. You know? It's like, do it for you and that can actually really change not only how you feel but the dynamic in your home too.

So I think that brings us to what now? What now?

Yeah. I think there's there's the what now of when do I worry? And I think holding on to that frequency, intensity, duration. Let's not come away from this podcast thinking that Moody or teenagers who are staying in their bed until noon on the on the weekends, but otherwise are doing okay that they're depressed. That's not the case.

And need to be activated all the time. Yeah. No. Rest is very important.

Yeah. To feeling well. Yeah. Without a doubt. Without a doubt.

Yep. And not doesn't need to be earned. Rest is just an essential life ingredient for wellness for ourselves and for our teens.

Yeah. But I think the second point in all of the things we discussed with regard to really trying to validate how difficult it is to experience anhedonia, how difficult it is to experience the blahs that aren't the blahs that are gonna lift the next day, really aligning yourself with your child against that depression or against the, the experience of anhedonia can go a long way for your relationship. And that is that's really what ultimately will help in healing. Mhmm. Okay.

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