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home : columns : dr. k June 24, 2016

11/9/2012 8:54:00 AM
Dr. K for Nov. 9, 2012
Teen's pervasive sadness may be sign of serious depression

DEAR DOCTOR K: My daughter is a high school senior. In the last year she's become extremely sad and uncharacteristically moody. Is she just a "normal" teenager, or could this be more serious?

DEAR READER: A few weeks ago I was talking with a friend about his teenage son. Remarking that his son became upset very easily, he said: "I'm wondering if this is normal behavior. Then again, I wonder if there is such a thing as a normal teenager."

Many teenagers have lots of emotional ups and downs. But in some cases a teen's sadness goes beyond normal "blues" and turns into clinical depression.

It's more likely to be clinical depression when the sadness is severe; lasts for more than a few days; or makes it hard to function at home, school, work or play. It's really important to recognize depression, since it can lead to drug and alcohol use, and, in some cases, to attempted suicide.

Doctors use the following symptoms to diagnose depression in adolescents:

-- depressed mood or irritability

-- decreased interest or pleasure in all or most activities

-- weight change (up or down) or appetite disturbance (increase or decrease)

-- not being able to sleep, or sleeping too much

-- doing things very slowly

-- fatigue or lack of energy

-- feeling worthless

-- difficulty concentrating, thinking or making decisions

Based on these criteria, it can be difficult to distinguish a normal teen from a depressed one. But as a parent, you can watch for warning signs that your daughter's sadness has gone beyond normal. These include, but are not limited to:

-- sudden behavior changes

-- anger, agitation or irritability

-- risk-taking

-- giving away prized possessions

-- withdrawal from social groups

-- huge changes in dress and appearance

-- constant boredom

-- trouble paying attention and concentrating

-- extreme sensitivity to being rejected or failing at something

-- frequent complaints of physical symptoms without a clear physical cause

-- missing lots of school

-- trying to run away from home

If you notice these or other concerning changes, call your teen's pediatrician as soon as possible. The pediatrician can do a basic evaluation to decide if your teen should speak with a mental-health specialist. If your teen ever expresses suicidal thoughts or feelings, take it seriously and see a physician immediately.

If you don't see such signs of depression, then you're probably just dealing with a "normal" teen. It's the unusual teenager who isn't irritable or doesn't sleep until noon. In the past 20 years, as our ability to study the brain has expanded greatly, we've come to understand that a teenager's brain is literally built somewhat differently than ours. And, for better or for worse, it will be built like ours by the time they reach adulthood.

(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)

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