Expressions of ‘teen angst’ may be an early warning sign of depression

Teens will rarely use the word 'depressed' to describe negative emotions, but other expressions of teen angst can be a signal of more serious, pre-depressive symptoms.

New research, funded by the National Institutes of Mental Health in the US, has revealed that teenagers are more likely to use terms such as 'stressed' or 'down'. The findings, presented at the annual Paediatric Academic Societies Meeting in San Francisco, were based on a sample of screening interviews with 369 teens between the ages of 13 and 18 at risk for depression, who participated in the Promoting Adolescent Health Study (PATH). For the PATH study, adolescents who reported feeling down, irritable, or hopeless, during the previous two weeks (in private, written responses to screening questions) received a call from the study team. During the call, researchers used validated measures to screen for those at risk for depression. Dr Daniela DeFrino, an assistant professor of research in the University of Illinois at Chicago College of Medicine and College of Nursing, says that teenagers rarely labelled themselves as depressed:

"Much of what a teen is feeling and experiencing is easy to attribute to the ups and downs of teen angst. But, sometimes, there is so much more under the surface that can lead to depression. Teens rarely stated they were depressed, but described bursts of feeling stressed and sad that often came and went."

DeFrino says the teens who took part in the mental health research often noted school pressure related to homework and expectations to succeed as sources of stress and difficulty. Arguments with parents, verbal and emotional abuse, divorce, separation, neglect, sexual abuse and moving house were the major reasons teens gave for low mood. The young participants also attributed feelings of sadness to deaths from illness and suicides of family members or friends. The research team noted that, unrelated to feelings of depression, two-thirds of the teenagers had visited their doctor for physical illnesses such as ulcers, migraines, stomach pains and fatigue. Dr DeFrino says that these visits could provide the perfect opportunity for doctors to check in with their patients about mental health concerns:

"Teens may be experiencing a lot of internal turmoil and difficult life stresses that we can easily overlook if we don't probe with sensitive questioning and understanding. Reframing these feelings as outward symptoms of pre-depression by the primary care provider would allow for connection to and discussion about the importance of mental health with the teen and parent."