Talking to your kids about important issues can be tricky. ‘Parents and Teens’ is an ongoing series exploring topics that impact the lives of modern adolescents, including everything from stress and bullying to depression and substance abuse. This week’s focus is depression, how it impacts teens and what can be done to address it.

Just like no two teens are the same, neither are the contributing factors, warning signs or possible treatments of depression in modern youngsters.

Depression is as unique as the person experiencing it, which is why a proper diagnosis and determining appropriate treatment methods is so important. That goes double for teens, who tend to experience life in more extreme terms than adults.

Nikki Kontz is the clinical director for Teen Lifeline (teenlifeline.org), an Arizona-based non-profit dedicated to combating depression and teen suicide. Kontz is a licensed social worker and has been with the company for 25 years, starting out as a teen peer counselor in high school after losing a close friend to suicide.

According to Kontz, one of the trickier aspects of teen depression stems from the fact that the teenage years are typically full of peaks, valleys and changes in behavior as a young adult tries to figure themselves out.

“There’s no right or wrong way to be a teenager, so how do you know if your teen is in trouble or if this is just a ‘normal’ part of being a teen? The key is to pay close attention to your teen,” Kontz said. “How frequently are they showing signs of distress? Warning signs don’t usually show up just once; your teen may be in trouble if these signs continue for a couple of weeks and don’t go away.”

Kontz said how “extreme” the behavioral shift is can also be a good indicator

“If it’s extreme or vastly different from their usual behavior, then it might be a sign that your teen needs some help,” she continued. “It’s important to remember that no one sign means that there is a problem; you must pay attention to the nature, intensity, severity and duration of a behavior.”

Factors

According to Kontz, another obstacle when treating teen depression is the variety of factors that can contribute to it.

“If there was just one, or even just a few contributing factors to depression or suicide in our youth, we would be much further in prevention,” she said. “Stress, bullying, real or perceived high expectations and even relationship and environmental factors all have roles in how our children interact with the world and may even lead to symptoms of depression.”

Kontz said there’s a biological aspect of mental illness and clinical depression, too, which sometimes gets overlooked.

“I wish the research was far enough along to pinpoint, but what we do know is that brain development, early trauma, family history, the existence of protective factors including problem solving and coping skills all play roles,” she added.

Signs

Kontz said more children are being diagnosed with depression than in earlier generations, noting that many of the factors contributing to the condition are preventable and treatable.

“What makes depression different between adults and children is how it shows up,” Kontz said. “For youth, things show up as immaturity or behavioral problems, which makes it hard for adults to recognize it separately from just being a teen.

“What I tell parents and other adults that work with our youth is to pay attention to how long these behaviors have been going on and their intensity.”

Kontz offered some warning signs of depression, including:

*Decrease in enjoyment and time spent with friends and family.

*Significant decrease in school performance.

*Strong resistance to attending school or absenteeism.

*Problems with memory, attention or concentration.

*Big changes in energy levels, eating or sleeping patterns.

*Physical symptoms, such as stomach aches, headaches, etc.

*Feelings of hopelessness, sadness, anxiety, or frequent crying.

*Frequent aggression, disobedience or lashing out verbally.

*Excessive neglect of personal appearance or hygiene.

*Substance abuse.

*Dangerous or illegal thrill-seeking behavior.

*Is overly suspicious of others.

*Sees or hears things others do not.

Communication

As previously noted, Kontz said one of the best things a parent can do is watch and listen.

“Keep a close eye on a teen who seems depressed or withdrawn,” she said. “It’s important to keep the lines of communication open and express your concern, support and love. If your teen confides in you, show that you take those concerns seriously.”

Kontz notes that something like a fight with a friend might not seem to the parent like a big deal in the grand scheme of things but, to a teen, it can feel immense and consuming.

“It’s important not to minimize or discount what your teen is going through, as this can increase their sense of hopelessness,” Kontz added. “If your teen doesn’t feel comfortable talking with you, suggest a more neutral person, such as another relative, clergy member, a coach, a school counselor or your child’s doctor.”

When speaking with your teen, Kontz said that the language used, tone of voice and body language will tell your teen whether they should open up or shut down.

“Be aware of the ways you are expressing yourself to your teen by utilizing nonjudgmental, supportive and reflective language,” she suggests. “Validate your teen’s feelings by using ‘active listening’ and allow your teen to be heard.

“Avoid using dismissive statements that minimize your teen’s feelings. Often times, teens do not believe that their feelings will change or that life will get better. As a parent, you want to create opportunities for open, honest communication. Invalidating your teen’s feelings or dismissing their pain can create road blocks in communication, openness and trust.”

When to act

Kontz reiterated the importance of remembering that no one sign means a teen is having a problem.

“If behaviors, feelings or emotional reactions are intense and/or pervasive, I would suggest reaching out for support,” Kontz suggests. “You can contact your primary care provider and request a referral to mental health services and counseling. Ultimately, if you are worried about your child, don’t hesitate to reach out to their doctor or even the Teen Lifeline. We are there for teens to be able to talk to other teens, but we are also there to support parents and families.”

When asked if there is a “golden rule” parents should keep in mind when it comes to depression in teens, Kontz suggest that parents listen to their gut instincts.

“If you feel like something might be wrong, there is a good chance there is,” she said. “Trust that you know your children and, when you feel that they may be struggling, ask them about it open and honestly.”

If a parent is worried their child is having thoughts of giving up or suicide, she said it’s a topic that should be addressed directly.

“Some parents are reluctant to ask teens if they have been thinking about suicide or hurting themselves,” Kontz continued. “Some fear that by asking, they will plant the idea of suicide in their teen’s mind. It’s always a good idea to ask, even though doing so can be difficult.”

Next week: Substance abuse.