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Teenage Anxiety and Depression: Signs to Know, Steps to Take

by Justin Schafer

November 2021

Daily life has unexpected events that create stress and trigger feelings of anxiety, sadness, and worry. For many people, these feelings are manageable. For others, events like moving across the country or starting a new job cause emotions that just become too much. Though their situation might be different, it should be no surprise youth aged 12 to 18 can also go through life stresses and those experiences trigger anxiety and depression. According to public health experts, in North Dakota, these mental health conditions impact about 10 of every 100 teens and nearly four out of 100 teens have considered suicide. With so many teenagers throughout North Dakota being impacted, information about what anxiety and depression look like in teens, how families can help, and when to seek professional care is important.

Though anxiety and depression have common signs, the two conditions are different. In general, anxiety is the overwhelming feeling of worry while depression is the intense feeling of sadness. Teenagers with anxiety will worry and overthink about school, friends, and relationships. They may feel unfocused and have racing thoughts. Parents will notice that the teen can seem "on edge," be irritable or tired, have poor sleep, and not eat as much. Teachers find that the teenage student is not focused on schoolwork, has worsening grades, or even having regular headaches and upset stomachs.

As for depression, teenagers will be sad, have less interest in things they used to enjoy, or feel guilty and be irritable. Parents might notice physical changes, such as weight changes and decreased energy. Behaviors may change. For example, "fighting" behavior, no longer wanting to hang with friends or showing a tendency to isolate themselves, staying in their room for hours on end. Signs at school are very similar to those with anxiety. Serious signs include self-harm behavior, like skin cutting and alcohol or drug use. Most concerning is talk of suicide, obtaining guns and pills, and giving away valuables.

All of this to say: If something seems off in a teenager, be concerned. Parents are usually the first to notice changes in their teen's behavior and it's important for parents to speak up and act. Whether the teenager acts out, or acts different, family members can take steps to make a difference in how a teen moves forward.

First, if feelings are bottled up, they can spiral and lead to worse feelings. If the teen isn't telling anyone about their feelings, parents can make a point to ask them about feelings. Having someone be open to listening can make it easier for the teen to share. Second, be supportive. Talk about ways that the family wants to help. Provide advice if they ask for it. Third, listen. Sometimes all that's needed is an open ear and a place to feel heard.

Changing family routines can also help. If meals aren't eaten together, change that. Eating together allows for several things. It can allow for discussions about "how their day went." Family meals also offer a setting to check a teen's food choices. Eating enough of the right things – fruits, vegetables, whole grains, lean meats – provide the fuel needed to help break teens from the tiredness they might be having. Experts also recommend at least 60 minutes of exercise per day maybe in a setting that allows for making new friends. Experts point out that exercise also releases the "feel good hormones." Sleep is another area important for teenagers. A regular sleep schedule with the right amount of sleep can improve energy levels and emotions. Experts recommend teens sleep 8 to 10 hours per night.

With asking and talking, supporting, listening, and making some simple changes, families can help their teen's emotions and feelings. Sometimes, however, these approaches may not be enough and it's important to know when and where to find professional help. Some key signs that suggest a teenager needs professional care include: concerning or worsening behaviors that happen daily, a rapid decline in school grades, or large weight changes. Thoughts and actions of self-harm or suicide that require urgent care.

Once a family decides to seek mental healthcare, options range from school-based counselors, psychologists, family doctors, and pediatricians. All of these professionals can help. Family doctors and pediatricians can find local resources, make referrals, and start medications when needed. Finally, if the teen is in immediate danger due to a mental health crisis – including overdose from drugs/alcohol or a suicide attempt – get help by calling 911, take them to the emergency room, or call the National Suicide Prevention Lifeline at (800) 273-8255.

Like adults in North Dakota, North Dakota teenagers can have mental health conditions. Mental health is complicated. Mental health can be difficult to talk about and may seem even more overwhelming if finding support and care is difficult. But there is hope for teenagers with these conditions: It starts with family awareness, action, and the assistance of local healthcare providers.


About the Author

Justin Schafer is a third-year medical student at the University of North Dakota School of Medicine & Health Sciences. He was selected as the Dickinson participant for the school's ROME program, or Rural Opportunities in Medical Education. The program includes teaching student doctors the importance of rural newspapers. As a future rural healthcare leader, Schafer has written this column to provide health information for his ROME community. The information is not for diagnosis or treatment and should not be used in place of previous medical advice provided by a licensed practitioner.