Teens with depression may have low self-esteem. They may display poor concentration, low motivation, and withdraw from social or recreational activities. They may respond intensely to criticism or feedback. Changes in appetite, weight, and sleep issues may occur. Depressed teens may display a decline in grades, and experience boredom and lethargy.

In terms of seeking treatment, adolescents who struggle with identity issues may be reluctant to identify themselves as someone who has a depressive disorder. Issues with authority and concerns about confidentiality may make seeking out help problematic. I am sensitive to these issues and make sure to validate and normalize my client’s experience. I also tailor my interventions to adapt to specific factors connected to the type of depression my client’s may exhibit. Anger, perfectionism, avoidance, and divorce are just some traits and stressors that can exacerbate depression.

Anger and Depression

Adolescents who have depression may present with typical symptoms such as a depressed mood and withdrawn behavior. Males who are depressed may display more anger rather than sadness. Young teenage boys who feel pressure to live up to perceived gender norms may be less likely to show vulnerability. Their anger towards others may be a way to prop up their self-esteem and negative feelings about themselves. Unfortunately, their anger can serve to alienate them further. Therapy can provide a safe place for these adolescents to verbalize feelings and connect with deeper emotions. This can help adolescents feel more connected and identify and modify cognitions contributing to their distress.

How I can help

I teach clients how to identify negative emotional states and understand the connection between thoughts and feelings. Through the therapy process they learn how to modify dysfunctional thoughts that lead to anger. They develop alternative perspectives that are more balanced and adaptive. I help my clients see underlying self-esteem issues that contribute to anger and depression. They learn how to observe difficult emotions without becoming flooded or acting on them and communicate more effectively. I strive to create a safe place where adolescents can increase self-understanding about who they are and what is important to them. This understanding often leads to more self-confidence and a stronger sense of self.

Perfectionism & Depression

In adolescence one of the major development tasks is developing one’s identity and independence. As teenagers experiment with discovering who they are they may place more emphasis and passion towards focusing on specific domains such as academics, athletics and peer relationships. They may develop lofty goals and ambitions as they pursue their goals. There striving and dreams of excellence is not always problematic. However, for some falling short of meeting their goals can lead them to become extremely self- punishing and punitive toward themselves. They may perceive failure or setbacks as intolerable. This can lead to depression, anxiety and irritability. Some teenagers feel they will not live up to expectations and may avoid tasks all together. At times adolescent’s expectations may be unrealistic.

How I can help

Having high personal goals and expectations is not unhealthy and can lead to success. However, problems arise if people react punitively if they fail to meet goals. Being extremely critical of oneself if goals are not met can lead to depression and anxiety. Harsh self-appraisals after not meeting goals can also decrease emotional resilience and lead to avoidance behaviors. To manage this type of perfectionism, I work with adolescents on skills to help develop compassion towards themselves. I utilize mindfulness and acceptance skills to help them learn to be able to define themselves in a holistic fashion rather than just by outcomes. I help them to confront issues rather than avoid them by helping them break down fears and tasks into manageable components.

Often people who have high expectations of themselves also have high expectations of others, which can leave them feeling disappointed and frustrated. I help my clients develop more realistic expectations regarding others. They learn how to see other perspectives, which can increase empathy and mitigate negative mood states.

Peer Relationships and Depression:

As teenagers transition into adolescence there is a shift away from caretakers to peers and friends as a source of social influence. For example, support, validation and encouragement, become roles that friends take on more significantly. Adolescent’s relationships with peers can greatly impact their self-esteem and mood. Teenagers who struggle with peer relationships may isolate and avoid others expecting rejection. This can further increase isolation and depression. Alternatively, a strong desire to fit in may lead teenagers to be over accommodating to their friend’s demands at the expense of their own interests. They may believe that if they don’t not accommodate, their friends will reject or abandon them. This can create resentment and hostility. The over accommodating teenager may feel that relationships are not reciprocal and that they are being taken advantage of.

How I Can Help

I employ CBT skills to help teenagers manage feelings or fears pertaining to rejection. Often teenagers may view their relationships in a bias and negative fashion leading to distress. Adolescent’s may have inflated perceptions that others view them more poorly than is actually the case. Distress can be minimized by helping teenagers perceive relationships more accurately. Mindfulness skills to help them detach from others judgments or perceived judgments can mitigate depression and anxiety. Helping teenagers identify negative patterns when selecting friends and helping them create boundaries can help them establish stronger self-esteem. I explore with teenagers how their interpersonal style may impact relationships and get in the way of forming positive connections. I work with them on strategies for developing their interpersonal and communication style to improve relationships.

Divorce and Depression

Divorce can be an extremely painful process for teenagers. There are different stages adolescent’s experience as they go through the process. Initially, it may be hard for teenagers to accept, leaving them feeling shocked and emotionally numb. They may also become withdrawn and minimize their parent’s separation. As times goes on teenagers may blame themselves for the separation and believe if they just did better at school, were more well behaved or more lovable their parent’s relationship would not have dissolved. Missing the family unit and adjusting to the stress of the dissolution of the marriage may lead teenagers to feel unsafe and anxious. They may develop trust issues regarding relationships in the future.

How I can Help

I help teenagers verbalize anger or depression regarding the divorce. Expressing feelings such a betrayal and disappointment can allow them to gain more clarity, insight and be less prone to internalizing negative feelings and blaming themselves. Giving them a place to process feelings can also help prevent rebellious or acting out behaviors. Mindfulness skills can be extremely helpful in navigating feelings of abandonment and rejection they may feel from one or both of their parents. Consulting with family members on setting proper boundaries and communication strategies can also be helpful.

Depression Treatment for Older Adolescents

College can be an extremely exciting time providing the opportunity for intellectual and emotional growth. However, personal freedom, self-exploration and challenging academics although invigorating, can be stressful. Being away from home, facing new demands and thinking about the future can be daunting and contribute to anxiety, depression or self-doubt. The symptoms may derive from the existential struggles that college students often face regarding who they are intellectually, emotionally, and sexually. Am I smart enough? Am I good enough? What is my purpose? are common questions college students ponder. Starting and leaving college are both significant life style shifts and may be particularly difficult for students. Fortunately, therapy can help.

How I can help

Psychodynamic therapy is a deeper dive into motivation and can create expanded awareness allowing college students to understand and resolve issues pertaining to identity, relationships and choices about meaningful careers. During the process of psychodynamic therapy college students can have the space to explore possibilities and find their authentic voice. CBT and Mindfulness skills can also help college students cope with depression, anxiety or volatile emotional states. Learning how to regulate emotions with mindfulness skills can also help with academic performance and time management.