The pandemic & depression in teens

Contributor: Elise Herman, MD, KVH Pediatrics

We are all dealing in some way with the ravages of COVID-19 – isolation, financial hardships, personal illness or illness of loved ones, changes in education or work. Our kids are also being affected, and teens in particular have been noted to have a significant increase in mental health issues attributable to the pandemic.

Teens are experiencing real loss- loss of school activities, sports, and milestones such as homecoming and prom. Spending most of their time with their family can feel suffocating, with no real privacy or independence. Jobs for adolescents used to provide a sense of accomplishment and maturity, but these have largely disappeared.

Social isolation is a big factor in mental health issues related to the pandemic and especially so for teens. Social media and FaceTime may help but do not replace the “passive socialization” that typically would be happening, like having conversations in the classroom, being amongst peers in the halls, or sharing a laugh casually with fellow students or staff. Teen friendships are instrumental in maintaining self-esteem and navigating adolescence, and TikTok and Instagram are inadequate substitutes for in-person relationships.

Sadness is a normal and appropriate response to so much loss, upheaval and uncertainty. So when does ordinary sadness cross the line over to the more worrisome depression (also known as Major Depressive Disorder or MDD)? True depression is more severe, lasts longer, and may involve the loss of usual interest in friends or activities, irritability, changes in sleep, appetite or activity level. Poor self-esteem, decreased concentration and thoughts of suicide and death may also occur. If several of the above changes are noted daily for at least 2 weeks, especially if this change has been rapid, parents need to talk with their teen and take action. Obviously, any suicidal thoughts need to be addressed immediately.

Pick the right time to have a conversation with your child, when there is no time pressure, and you have privacy. Tell them without judgement what you have observed; have they also noticed this? Let them know that you care and are aware this is a hard time in view of the challenges and losses particularly for teens. If you have faced depression and feel comfortable sharing your experience and what helped, this may encourage your teen to open up.

Offer options to help such as counseling or having them talk to their health care provider. Frame the idea of counseling not as “fixing” something that is broken but rather more positively as “strength-building” or “coaching”. Medication can be very effective though this takes an in-depth discussion with your teen’s provider to make sure it is the right step. There are other actions that could be considered a mental health “prescription” such as getting outside regularly, meditation, daily exercise and having a routine schedule for sleeping and eating. And no one needs to hear, read or watch the news 24/7- minimize overconsumption which can add to stress.

If there is concern of suicidal thoughts, secure medications in a locked cabinet and remove any guns and ammunition from your home. This literally can save a life. You can temporarily give guns to a friend, or you can find an out-of-home temporary safe storage facility by looking on-line (google ‘Washington firearm safe storage map’). There are 59 of these (they are businesses or law enforcement agencies) in Washington state.

Empathizing with your teen and sharing your own challenges is important, but we also need to project a sense of strength and optimism that we know things will get better and we will get past this pandemic with all of its difficulties. As adults we must take care of ourselves so we can be there for our family, be it going for a walk, practicing relaxation techniques like yoga or meditation, or even just taking the occasional nap. We also need to do what we can to help- which right now means masking up, social distancing and having a very quiet holiday season.