Ask! When to worry about teenage angst?

Q. My 16-year-old daughter has recently become even more moody than usual. She comes home from school, stays in her room, and only talks to her friends even though she used to talk to the family about almost everything. I’ve also noticed that she has started to complain more about stomachaches and headaches, but our family physician has found nothing physically wrong with her. Is this just normal 16-year-old behavior, or could something more be wrong?

A. The teen years are certainly a challenging time. From the changes of puberty to trying to figure out who they are and where they fit in, teenagers are confronted with numerous pressures. Because they are trying to establish a sense of self, gaining independence by pulling away from parents and guardians is a normal part of the process. Most teens, however, balance these challenges with positive friendships, extracurricular activities, and new hobbies. Occasional bouts of frustration, sadness, or moodiness are

normal and to be expected, but depression is different. In general, these normal negative feelings become overwhelming, and hopelessness about their future can lead to despair and anger. The following are signs and symptoms of depression in adolescents:

  • Irritability, aggression, and rage can be more pronounced than sad mood when teens are depressed. They may not appear sad or have crying spells like most adults with depression, but they may display anger that seems to linger excessively and act out aggressively toward others or have angry outbursts.
  • Similar to adults, loss of interest in activities and inability to experience joy are hallmarks of depression. Most teens try out various hobbies and activities and may lose interest rather quickly; however, with depression, teens find little to nothing interesting or fun anymore.
  • Dramatic or long-lasting changes in personality and behaviors can be a sign of a deeper problem, such as a teenager who once cared about good grades and getting into college suddenly stops attending classes and no longer mentions future plans.
  • An increase in unexplained aches and pains can signal depression in teens. If a physical exam rules out medical issues, then the ailments may indicate depressed mood.
  • Depressed teens, similar to adults, have deep feelings of worthlessness, which makes them particularly vulnerable to criticism, failure, or rejection. Extreme sensitivity to criticism, coupled with frequent negative statements about their self-worth, can signal depression.
  • Unlike adults, who often isolate themselves from everyone when depressed, most teens maintain some friendships and contact with others. However, teens with depression often socialize less than before, may change peer groups, and may pull away significantly from family members with whom they were once close.

The mom of the 16-year-old mentioned in the question should consider how long those symptoms have

been present and how severe they are. Try talking to her in a nonconfrontational and supportive way, asking if she is experiencing a specific problem or facing a particular challenge. You mention that your daughter is acting different from her usual self, has had an increase in physical complaints, and has begun to withdraw from family members. With this combination of issues, she may benefit from talking to a mental health professional and being assessed further.

-- Dr. Julia Messer

Dr. Julia Messer is a psychologist with Orenstein Solutions. She specializes in helping teens and adults with depression and anxiety, substance abuse, and anger management issues.