Teens and depression: The two words are often heard, read or talked about together. But they make a dangerous pairing, and we often find ourselves striving to keep this harmful partnership away from our own family and friends.
According to the U.S. Department of Health and Human Services, an estimated 2.3 million adolescents ages twelve to seventeen had at least one major depressive episode with severe impairment in 2017. And although girls are twice as likely as boys to be diagnosed with depression, boys are more likely to act out, harm themselves or hurt others.
There’s no definite reason for the prevalence of aggressive depression in teen boys. Some boys have mild to moderate alexithymia, meaning they’re unable to recognize their own feelings or communicate effectively, according to Dr. Deborah Serani, psychologist, professor and author of Living with Depression. This can come from genetics, upbringing or social factors. “Alexithymia throws a monkey wrench into a person’s ability to know their own self-experience or understand the intricacies of what others feel and think,” Serani says.
“It is difficult to distinguish what are normal, hormonal and pubertal changes in boys from more pathological behavior,” says Dr. Sasha Hamdani of Psychiatry Associates of Kansas City. “Typically, we look for marked changes in behavior such as an increase in isolative behavior or a big spike in anger and irritability.”
Hamdani suggests that parents be proactive with boys and depression. “It’s time to see a physician any time you are not sure,” she says. “An adept psychiatrist will discern what is normal and abnormal behavior and will help delineate a plan for treatment.” Hamdani does emphasize that if a teen is displaying any signs of self-harm or suicidal or homicidal thinking, that’s an emergency and requires an urgent visit with a psychiatrist or to the emergency room.
Hamdani’s biggest piece of advice for a parent navigating possible depression in their teen son is to start a conversation. “Bringing up the change in behaviors to your teen can be difficult to address, but phrasing things neutrally instead of ‘accusing’ them of being depressed is important,” she says. “So instead of saying, ‘Do you want to be alone because you’re depressed?’ a gentler approach might be, ‘I’ve noticed you’re in your room a lot more. Why is that?’ This type of communication can open up dialogue and continue the conversation.”
Team sports can help
If you want to be proactive in helping a teen boy who is battling symptoms of depression but don’t see the need for urgent intervention, most experts agree that team sports and other organized group activities help teens focus on positive engagement rather than negative feelings.
A 2019 study by Washington University in St. Louis says participation in teams helps kids improve fitness and social skills and is linked to the development of the hippocampus region of the brain. (In adults, low hippocampus volume has pointed to depression). Perhaps most importantly, the study linked team participation to a reduced rate of depression in boys.
If you think your child is having suicidal thoughts, get help immediately. Go to a hospital, call 911 or call the National Suicide Hotline at 1-800-SUICIDE.