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Just leave me alone”

            Another door slam, another day in the life of a teen parent. Ever wonder why your teenager is so moody…or grumpy? Does it seem like their mood can change on a dime somedays? Ask any parent and they’ll tell you that teens and mood swings go hand-in-hand. To some extent, it’s just another ‘fun’ part of puberty- and parenting! However, there are legitimate reasons that you have a moody teen and they are not just related to hormones.

            Let’s talk about something that’s been in the headlines recently, rising cases of depression in teens and adolescents.  The pandemic has caused a spike in the need for mental health care for many and some teens are really struggling. It’s been a long year of disruption, loneliness, mounting anxiety, and stress. Teenagers missed proms, dates, field trips, sporting events, and weekends with friends so it’s easy to see the cause of a bad mood.

            Depression vs. Bad Mood

            Parents often have questions about what’s “normal” and what’s not when it comes to their teens. Sometimes it’s a very fine line! As a rule of thumb, moodiness that comes and goes can be chalked up to those hormones. It’s ok if your teen had a bad night and is irritable but in a good mood for the rest of the week (inserting all of the eye rolls here).

            However, depression is more than just a bad mood and it might not always be something you can easily distinguish as a parent. Depression and other mental health disorders have signs other than moodiness and irritability which makes working with your primary care physician or pediatrician an essential part of diagnosing and treating your teens’ mental health concerns.

            Increased Awareness & Education for Teen Providers

            Depression is so complex. And depression in young people is easy to overlook. Unfortunately, many primary care providers receive limited training on adolescent depression and management. According to the American Academy of Pediatrics, as many as 1 in 5 teens experience depression during adolescence. These statistics present an opportunity for pediatricians to spot problems and provide guidance for families at a younger age.

            Furthermore, other studies suggest that more education about teen suicide for providers could save significantly more lives – and quickly! Did you know that a large percentage of teens visit a primary care physician within a month of their suicide? So, the better physicians can spot the signs, the greater the impact they can collectively have on preventing suicide attempts.

            Many teens will seek out their doctor to address physical issues, but the following physical signs could indicate depression:

            Weight change

            The first sign that physicians can look for in teens (and all patients) is a major change in their weight. More specifically, a loss or gain of over 5% of their weight per month is a signal. With this, doctors can also aim to detect changes in appetite.


            Physicians can look closely for signs of self-harming behavior, including fresh cuts, scratches, burns, or bruises. Although these signs will seldom be apparent, physicians can look to see if their teen patient is picking at a wound or scab, rubbing an area of their skin excessively, or wearing long sleeves or pants in hot weather.

            Fatigue or sleep problems

            Mental health issues like depression can contribute to sleep problems on either end of the spectrum. If a patient notes fatigue and changes in sleep, it is worth exploring whether their insomnia or excessive sleep is a symptom of depression.

            Drug use

            Drug use and depression share some similar signs, such as changes in sleep patterns and appetite. Because drug use is a common risk factor for suicide, physicians can also note poor personal grooming, bloodshot eyes, slurred speech, or impaired coordination.

            Eating disorder

            Fluctuations in weight in either direction can indicate an eating disorder, contributing to or worsening depression. Physicians should make note of menstrual irregularities, gastrointestinal complaints, dental problems, dry skin, or swelling around salivary glands.

            Other physical signs

            The following physical signs should be discussed with the teen’s provider and could indicate something more:

  • Gut issues (digestion problems or stomach pain)
  • Headaches
  • Slow physical movement
  • Slow thinking
  • Constant tiredness
  • Joint or limb pain

            Positive responses to brief screening tools and questions prompt primary care physicians to evaluate their patients further. Yet not all depressed teens will answer positively to questions about feeling down, hopeless, or apathetic. In this case, physicians can still ask additional questions when they have a patient who appears depressed.

            When more primary care physicians can collectively and effectively identify the signs of mental health issues in teens, they provide a unique opportunity to provide a safe space for teens to talk about what is happening with their minds and bodies.

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