Mood Disorders in Teens

Mood disorders are a group of mental health problems. They are sometimes called affective disorders. These are the most common types:

• Major depression. A teen with this type has a depressed or irritable mood, along with other signs, for at least 2 weeks. He or she may also lose interest or pleasure in usual activities.
• Persistent depressive disorder (dysthymia). A teen with this type has a long-lasting, low-grade, depressed or irritable mood for at least 1 year.
• Bipolar disorder. This type causes a mix of manic episodes and depressed periods, or times of flat or dulled emotional response.
• Disruptive mood dysregulation disorder. A teen with this type has ongoing irritability and has a hard time controlling behavior.
• Premenstrual dysmorphic disorder. This type causes depressive symptoms, irritability, and tension before a menstrual period.
• Mood disorder caused by a health problem. Many conditions can trigger symptoms of depression. These include cancer, injuries, infections, and chronic illnesses.
• Substance-induced mood disorder. These are depression symptoms from the effects of medicine or other forms of treatment, drug abuse, or exposure to toxins.

What causes mood disorders in teens is not well known. Certain chemicals in the brain are responsible for positive moods. Other chemicals in the brain (neurotransmitters) control the brain chemicals that affect mood. Mood disorders may be caused by a chemical imbalance in the brain. This can happen on its own or along with environmental factors, such as unexpected life events or long-lasting stress.

Mood disorders can run in families. Researchers believe that many factors are involved. The factors that produce the trait or condition are often both inherited and environmental. They involve a mix of genes from both parents. If a mother passes a mood disorder trait to her children, a daughter is more likely to have the disorder. If a father passes a mood disorder trait to his children, a son is more likely to have the disorder.

Anyone can feel sad or depressed at times. But mood disorders are more intense. They are harder to handle than normal feelings of sadness. Teens who have a parent or other relative with a mood disorder have a greater chance of also having a mood disorder. It is not definite that this will happen. But hard life events and stress can expose or exaggerate feelings of sadness or depression. This makes the feelings harder to manage.

Sometimes life’s problems can cause depression. Tough situations for a teen include:

• A parent losing a job
• Parents getting divorced
• A death in the family
• Family having money problems

It can be hard for a teen to cope with these situations. These stressful life events can bring on feelings of sadness or depression. Or they can make a mood disorder harder to manage. It depends on your teen’s coping skills and his or her ability to rebound from rough times.

Teens don’t always have or show the same symptoms as adults. It is harder to spot mood disorders in children and teens. That’s often because they are not always able to say how they feel.

Teens may show different symptoms. It depends on their age and the type of mood disorder. These are the most common symptoms:

• Ongoing feelings of sadness
• Feelings of despair, helplessness, or guilt
• Low self-esteem
• Feelings of not being good enough
• Feelings of wanting to die
• Loss of interest in usual activities or activities once enjoyed
• Trouble with relationships
• Sleep problems, such as insomnia
• Changes in appetite or weight
• A drop in energy
• Problems focusing or making decisions
• Suicidal thoughts or attempts
• Frequent physical complaints, such as headache, stomachache, or fatigue
• Running away or making threats of running away from home
• Sensitivity to failure or rejection
• Irritability, hostility, anger

In mood disorders, these feelings appear stronger than teens normally feel from time to time. It is also of concern if these feelings last over a period of time, or if they interfere with a teen’s interest in being with friends or taking part in daily activities at home or school. Contact your teen’s healthcare provider right away if your child expresses any thoughts of suicide.

Other signs of possible mood disorders in teens may include:

• Poor performance in school
• Constant anger
• Rebellious behaviors
• Trouble with family
• Trouble with friends and peers

These symptoms may seem like other conditions or mental health problems. Make sure your teen sees his or her healthcare provider for a diagnosis.

A mental health expert often diagnoses a mood disorder after a mental health evaluation. He or she may also evaluate the family and talk with teachers and caregivers.

Treatment will depend on your teen’s symptoms, age, and general health. It will also depend on how severe the condition is.

Mood disorders can often be treated. Treatment may include one or more of the following:

• Medicines. These can be very helpful, especially when combined with talk therapy.
• Talk therapy (psychotherapy). This treatment helps teens change their distorted views of themselves and the environment around them. It also finds stressors in the teen’s environment and teaches him or her how to stay away from them. He or she will also learn how to work through hard relationships.
• Family therapy. Parents play a vital supportive role in any treatment.
• School input

Teens with mood disorders are at risk for other problems. These include:

• Substance abuse
• Anxiety disorder
• Disruptive behavior
• Suicidal thinking

Experts don’t know at this time how to prevent mood disorders in teens. But early detection and treatment are vital. They can ease symptoms and enhance your teen’s normal growth and development. They can improve your teen’s quality of life.

You play a key role in his or her treatment. Here are things you can do to help:

• Keep all appointments with your teen’s healthcare provider.
• Take part in family therapy as needed.
• Talk with your teen’s healthcare provider about other providers who will be involved in your teen’s care. Your child may get care from a team that may include counselors, therapists, social workers, psychologists, and psychiatrists. Your teen’s care team will depend on his or her needs and how serious the depression is.
• Tell others about your teen’s mood disorder. Work with your teen’s healthcare provider and school to develop a treatment plan.
• Reach out for support. Being in touch with other parents who have a teen with a mood disorder may be helpful.
• Take all symptoms of suicide very seriously. Seek treatment right away. Suicide is a health emergency. Talk with your teen’s healthcare provider for more information.

Call your healthcare provider right away if your teen:

• Feels extreme depression, fear, anxiety, or anger toward him or herself or others
• Feels out of control
• Hears voices that others don’t hear
• Sees things that others don’t see
• Can’t sleep or eat for 3 days in a row
• Shows behavior that concerns friends, family, or teachers, and others express concern about this behavior and ask you to seek help

Call 911 if your teen has suicidal thoughts, a suicide plan, and the means to carry out the plan.

• Mood disorders are a group of mental health problems. They include all types of depression and bipolar disorder.
• Mood disorders can run in families.
• They are caused by both genetic and environmental factors. Stressful life events can raise a teen’s risk for one.
• Symptoms include feelings of despair and helplessness. A teen may also have low self-esteem and sleep problems.
• Take symptoms of suicide seriously. Call your teen’s healthcare provider right away if he or she shows signs of suicidal thinking or behavior.
• Treatment includes medicines and therapy.

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.