How Do You Help A Depressed Teenager?

Yesterday I promised to come back and talk about helping teenagers cope with depression. Here I go.

At one point in my training, I spent an entire year working on a child and adolescent inpatient psychiatric unit. It’s not real easy to get institutionalized these days. I say this to point out that in order to end up hospitalized on an inpatient unit things have to be pretty bad. The teenagers who reach this level of severity usually arrive there for suicide attempts. I didn’t keep official statistics because I saw so many kids while I was there, but I would guess that at least 70% of the teenagers I saw had tried to commit suicide at least once. Some of them had multiple attempts.

Here’s the biggest mistake that parents and others working with teenagers who are severely depressed make: Trying to convince them that their feelings are temporary and that things will get better.

What? Did I just really say that? Yep. I did.

Most of you are probably wondering how I ever got a degree. You’re asking, “Shouldn’t we be trying to show them that their feelings won’t last and that high school is not the real world?”

I would say no. You really shouldn’t. Approaching their feelings in this way only leads to them feeling more alienated from you and reinforces their belief that you don’t understand them or know what they are going through. The first thing almost everyone says to a teenager who is really struggling is “You’re going to get through this. It’s going to be okay. I promise. You won’t always feel this way.”

This is intuitive for us and it comes from a great helping place. Not to mention that it’s true! We know they will get through it and that they won’t always feel the way they do. However, they don’t know that. And because of where they are in their brain development, they actually don’t have the cognitive abilities developed yet to be able to think this abstractly.

For example, toddlers’ brains are very similar to teenagers’ brains. Imagine if your three year old child was really upset and crying. And you told them, “It’s okay. You won’t feel like this when you’re six.” They would look at you completely baffled. They would have absolutely no idea or comprehension of what you were talking about. It’s the same principle with teens.

When it comes to teens, the current status of their life is the only life they can see and the future doesn’t even exist. Ultimately, they just want you to hear them. They just want to be understood.

I can’t tell you the number of times I watched teenagers shrink away from their parents well intentioned promises of better days and alternately, the relief that came when their parents finally got it. When they started meeting them exactly where they were. Just how do you do that?

Start by saying, “I understand this must be really hard for you…” And stop there. Don’t say the next part. Stay in the current day with them because this is the only day they see.


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31 Responses to How Do You Help A Depressed Teenager?

  1. Danielle says:

    That’s very insightful and so so true! Thanks for the great advice.

  2. Meagan says:

    Hmm… I dunno. I WAS a depressed teen. I think there’s a major problem in saying that high school problems aren’t “real,” but I think I needed to know/hear, that “It gets better.” I think that’s a tiny bit different from being told my feelings were temporary, but I can’t explain the distinction. Whether I could hear anything helpful at all from a parent is another question entirely, but ideally, there are other adults.

    For me, the worst thing a parent/teacher could (and did… frequently) say was that if I “thought” I had problems then, I should wait until I was an adult and experience real problems. I haven’t dealt directly with any DEPRESSED teens, but I’ve dealt with plenty of unhappy teens. I tell them all the same thing. Middle school sucks. The only good thing about high school is that it isn’t middle school. Being an adult is way WAY better.

    • Mommy Psychologist says:

      Thanks, Meagan. I hope you don’t think I was implying that high school problems aren’t real problems. I was not saying this at all. Quite to the contrary, high school problems are very, very real. And you are absolutely correct in that middle school totally sucks. I cannot even imagine having to do it again. Yuck, yuck, and more yuck.

      • Meagan says:

        No, I didn’t think you were saying that the problems weren’t real. I am just trying to articulate (poorly) that to me, the temporary nature of adolescence is important, and “it gets better” is kind of the opposite of “you think you have problems now? Just wait until you’re an adult.” It was so awful being that age, I really needed to hear that life could and would get better. I’m not being very clear here.

        You said, “When it comes to teens, the current status of their life is the only life they can see and the future doesn’t even exist. Ultimately, they just want you to hear them.” I really don’t think that’s true. A teen who is actually depressed needs much more than to just be heard. I remember GRASPING for the idea of future, trying to see that I had a future. If “the current status of their life is the only life they can see” were true, I would have killed myself, the end. I had so many people telling me that life as an adult is WORSE, HARDER. Fortunately I didn’t believe them.

        • Mommy Psychologist says:

          I think we are both coming from the same place with just a slightly different approach. Part of the reason that it was so difficult for you to grasp the idea of a future is because one, not being able to think you will ever feel differently is one of the core features of depression and two, you were an adolescent so it really was difficult for your brain to be able to grasp onto the idea of a future. It’s one of the reasons we see SO much risk taking behavior in teens as well. Parents would ask- what were you thinking?? Most teenagers shrug and say, Nuthin. And it’s partly true. They weren’t thinking about how getting kicked out of school might effect their college applications. We don’t develop this thinking skill until much later.

          • Meagan says:

            Yeah and I guess I don’t disagree with you in the inability to see the future, it’s just that I think teen-me, or any depressed teen (or maybe just any depressed person, I don’t know), needs a PROMISE of future to get through depression. Which is tricky, because nothing in life is certain enough to convincingly make that kind of promise. This issue is what made me think about that book… It doesn’t talk directly about the future at all really, and only touches on depression as one of the many teenage “issues” the authors are seeing, but it talks about how to empower teens, build relationships with non-parent adults, and find things to be passionate about. I’m really not describing it well. The conversation made me think of it, because I think all the solutions they talk about in the book can be seen as giving teens an unconscious feel for the future, though it’s not stated that way.

          • Mommy Psychologist says:

            I’m definitely going to check out this book.

  3. Rach says:

    Thank you (and Meagan) for the insights. I hope I can remember this if/when the time comes.

  4. Meagan says:

    If you haven’t read it yet, I HIGHLY recommend the book “Escaping the Endless Adolescence.” I’ve never read a book that rang so true for me about my own adolescence, and the things in my life at the time that helped me get through it.

  5. Peg says:

    As someone new to the whole teenager thing, thanks for the awesome post and great advice. Simpky acknowledging Emma’s feelings often goes better tgan trying to offer a solution.

  6. Jennifer says:

    Children who are raised in households where communication and involvement are emphasized don’t suddenly become depressed — the parents quickly pick up on signs and, hopefully, address them as soon as possible. Undermining and underestimating your child’s abilities to communicate at any age will undermine the likelihood that you will be able to help them when real trouble comes up. This isn’t to say that parents are to blame, but parents can intervene much earlier, and much more successfully, if they have learned their child’s preferred communication style at a young age and remained in communication throughout adolescence.

    • Mommy Psychologist says:

      Thanks, Jennifer. I agree, however, there are many times that once adolescence is reached, children stop communicating with their parents. It’s a common complaint. It’s tough when the teens no longer want to communicate with their parents. I can’t tell you how many times parents are absolutely heartbroken at the changes that take place within their kids once adolescence is reached.

  7. Carolyn says:

    I was very fortunate to be raised in a house where I was close to my parents. I knew that they loved me no matter what and would always be there for me. Despite being close with them, and them knowing how I was badly bullied, they still didn’t know (and I’m not sure I really knew) how badly depressed I was. I thought about giving up and killing my self many times. The “it will get better” and “it’s not your fault” didn’t help me…. the future seemed so far away and with everyday passing, things just seemed to get worse, not better! Fortunately I stopped just short of jumping off an overpass…. because I couldn’t hurt my parents like that. I knew they were the only ones who would miss me, and my death would tear them apart. So I’m still here, 15 years later, and I can tell you that acknowledging a depressed teens feeling, and getting them professional help it the only way I can thing of really helping them out.

    • Mommy Psychologist says:

      Thanks for sharing your experience, Carolyn. You made a key point in that you were really close to your parents. I think sometimes parents can fall under the mistaken assumption that if they remain close to their child up until their teenage years that depression can somehow be avoided or easily dealt with. Like you said, you had great parents and you were still at a loss. I think this is why many parents hesitant getting their teens help because they are afraid someone will think they are not good parents. I try to stress to every parent that good parents can have a depressed teen. Mental illness does not discriminate.

      • Carolyn says:

        Sadly mental illness doesn’t discriminate. I wonder how many parents suffer from bias that it couldn’t happen to their child. That their child couldn’t be that depressed, or it’s just a teen being moody….
        To all the parents, or anyone who is close with children and teens, please don’t be afraid to get help for a child/teen you are concerned about. You might be that one person who takes them seriously and makes a difference.

  8. T. says:

    Uhm. An interesting topic, but I can’t totally agree on the idea that teenagers grasp the concept of future as much as toddlers.
    Here is the thing: are you sure it is not a “cultural thing”?
    To explain: I am Italian. In our culture, there are various kind of High School: you can do Classical Liceo, Scientific Liceo, Artistic Liceo, Conservatorio -for musical talented kids-, and various kind of techical-oriented high school (eletrotecnical, technological, agraricultural, exceteram exceteram). The choice you make at 13 is very, very important. It can be changed (and often is, of course), but it stay important. I am not far from being a teenager and I have an above-averange memory, and I remember very well how we were talked about our choices and our future. At times we may have been overhelmed by the present, but we knew there was a future.
    Here is the thing: on the whole, we were rather aware that yes, we had a future and we had to plan about it from back then. I shared your toddler metaphor to my younger sister (still a teenager) and her friends and all have claimed that it was not true (also, they were slightly offended :P)
    I don’t know if there are studies about the differences in suicide-rate in adolescents between our countries, and if there were I would be doubtful of them (different way to gather datas, I fear).
    Still, worthy the though I suppose.

    • Mommy Psychologist says:

      I’m really going to like having you around, T:) I am absolutely certain that there are cultural differences. There are studies that you have mentioned and there is a great degree of variability in suicide rates among countries. I’m gonna find the statistics because now I’m really curious myself. I’ll get back to you…stay tuned.

  9. T. says:

    Hello to you 😀
    T. is short for Tiziana :) *extend virtual handshake*
    Yes, I have read of studies linking culture with suicide (say, I know that Japanese tends to have an higher suicide rate because, culturally, it goes far, far behind in their history that it is an honorable way to behave in some situation) but I can’t tell you anything about the connection, if there is one, between a culture of encouraging teenagers to actually “perceive” their future and the suicide rate…
    Can’t really say. Though I agree, it is interesting!
    It came into my mind reading your blog :)

  10. T. says:

    Hello to you 😀
    T. is short for Tiziana :) *extend virtual handshake*
    Yes, I have read of studies linking culture with suicide (say, I know that Japanese tends to have an higher suicide rate because, culturally, it goes far, far behind in their history that it is an honorable way to behave in some situation) but I really don’t know anything about the connection, if there is one, between a culture of encouraging teenagers to actually “perceive” their future and the suicide rate…
    Can’t really say. Though I agree, it is interesting!
    It came into my mind reading your blog :)

  11. Heather says:

    I was in a moderately small suburban school district (same kids from K-12 basically, graduated in a class of 130). Everyone knew everybody. I was bullied in elementary school, and pretty much one of the “uncool” kids pretty much all through grade school. I had a small group of friends that pretty much “kicked me out” of their group literally 3 times, in a pretty dramatic fashion, 3 years in a row. I kept crawling my way back into the group because, frankly, I didn’t have anybody else. The last (and most painful) incident was in 9th grade, when the one particular girl in that group that I was the most close to [who I later found out was suffering with an un-diagnosed bipolar disorder] tried to kill herself. The other people in the group wrote me a nasty letter basically telling me that it was my fault. I spiraled into a pretty severe depression, with thoughts of suicide, but I never came close to doing anything about it. I think, despite how hopeless things seemed, I just didn’t have faith that death would make things better.

    I’d say that when people would say that it got better, I understood what they were trying to say, and to a degree I believed them (I kinda had to, otherwise I would have maybe succumb to those un-thinkable thoughts) But when push came to shove, I was just in so much pain, I didn’t care about 1, 2, 5, or 10 years down the line. I just wanted the pain to stop. I wanted to feel like I wasn’t alone. I wanted to feel like someone loved me for who I was. I just wanted peace.

    Professional help is important here, I think as a teenager (and even an adult to a degree) it’s hard to take the words of your loved ones to heart, because it’s hard to shake the suspicion that they are just telling you want they think you want to hear. Also, of course, it’s important to find the right person to talk to. The first psychologist my parents brought me to was NOT a good fit. I felt like she talked to me like a 5-year-old.

  12. dee says:

    Please help!! We are at our wits end. How do we help a 14 year old girl who shows all the signs of depression, wants to sleep all the time,cries all the time,not interested in anything and when asked why or what we can do to help the standard answer is “I dont know. She is on antidepressants but there just seems no end in sight. She sees a psychologist but either refuses to open up or cant say what is wrong. We have explored the bully road, sexual interference and everything else we can think of. She has extremely high highs and extremely low lows. PLEASE HELP!!

    • Mommy Psychologist says:

      First, I’m so sorry to hear this. It sounds like you are doing everything that you can. You’ve gotten her help and seem like you have explored lots of possible causes. A few things that I can think of. Sometimes it can take awhile to find a good fit with a therapist. Is there a possibility of exploring a different therapist? Maybe with a different therapist she would be able to open up more. It’s a possibility. Also, some of what you are describing is also similar to a teenager who is abusing drugs and/or alcohol. Have you explored whether or not she might be using chemicals?

    • Therese says:

      We took our daughter to a different physiologist as our daughter was not connecting with the first one and the 2nd lady she is seeing she totally connected to. We got lucky. Sometimes our visits my husband and I will attend for the first or last 10 minutes depending on what our daughter wants. Our daughter has been suffering for the last 2 years – she turns 16 this week and this is when she should be enjoying her teenage years instead she has suffered from self harming, depression and panic attacks that just breaks our hearts to see her go through these. Emily – her mental health worker has seen her through a lot and very much instrumental in helping our girl along. But my husband and I are very big on talking about anything they want to discuss especially when it is things you don’t want to hear…. But you LISTEN and at times you want to say you will get through it but that is not always the case and when our girl is concerned we know that talking helps but it is not the cure (unfortunately). We are scared as parents because as teens we know that they can become involved with outside influences – she tells us about her age group drinking, having sex (to be accepted sometimes) and she struggles with what her age is doing and sometimes thinks that is the way she should be – they have tv, social media…. I could go on. The only thing I think helps her is she knows she can tell us whatever and we try and not judge BUT it is hard at times. We are also seeing a physciatrist and working on mood stabilizers though so far no luck and to be honest I am scared about her going that route but she knows that we will go anyway to help her feel better. She has a very positive attitude about what is happening to her and has got involved with a group in school called the student voice and has talked about her issues and now has the school board presenting mental illness in teens throughout our board. Not saying it is easy her but she sees students suffering like her and wants to help if she can. We encourage her whether this is right or wrong… I don’t know but it helps her so can it be wrong? I find as a parent it is so hard to find the help we need. You have to wait for referrals and then you have to find the right medication – it’s a long process but we still listen to her as she goes through all of this and hopefully we will get there and as a family with 3 teens we have become a very close family and what she suffers is nothing to be ashamed off – its just in her genetics – unfortunately from my side of the family but we can help it. Sorry for going on so long but just be there for them and in saying that she still is a teenager and if she is going out with her friends dressed inappropriately we have our arguments! Keeping her room clean – might take me a week of saying clean your room – it will get done eventually and I have explained to her even though she has her struggles – I am still the parent and we will have our teenager arguments and she appreciates that!

  13. Lynette flynn says:

    I was a teen with psychosis and depression. i had various sucide attempts. i was bullied because i was mentally and emotionally differnt from my peers. It really isolated me and hurt me. So i turn to drugs and alcohol, and i still didn’t even fit in with popular i was hanging in bad neighborhoods, because it was the only place i was accepted. i can’t even tell you all the bad things that happen to me. once the ball started rolling i was terroized i didn’t come back for years. the truth was i needed someone to understand, like you said, and know one did. so i felt isolated and alone,,and dependent on anyone who would accept me. anyways i think you’re doing a wonderful work! so many teenagers, like me get in over their heads and just want to be taken seriously and for someone to understand what kind of pain they are in. many blessings to you and you’re work, i was a messedup teen, i wish you would have been around when i was young.

    • Mommy Psychologist says:

      Thanks for sharing your experience, Lynette. I was a pretty messed up teen myself. I think it’s one of the reasons why I relate with teens so well. I know what it’s like to really be struggling and I think the only thing I really wanted during that time period was for someone to REALLY listen to me and simply understand me. I wish you well, too.

  14. Dreya says:

    Hi my 14 year old son is severely depressed. He is refusing to go to therapy. He is a genius (no, seriously) and he feels he knows better than someone who doesn’t know him. He says therapy is “stupid and pointless.” He is an Aspie, and we took him to therapy when he was 6 and 7, and he really didn’t benefit from it at all… I don’t know what to do. If we physically force him to sit in a doctor’s office, I can’t see that it will be useful… I really don’t know what to do with a depressed kid if he won’t go to a doctor or therapist about it. Advice, please? Thanks

  15. Kaleigh says:

    I’m 14. , and boy do I have a story. I’ve suffered from depression since I was 12. My father has never been in my life and my mom and stepdad work hard, rarely home. It’s me and my 5 other siblings, two of which are “Mentally Retarded”(I hate this word but I don’t know how else to explain it) , and when they are home they give all the attention to the younger ones and the two with problems. Me and my brother are in the middle. I’ve turned to the internet, sites like Facebook, Instagram, etc. Meeting guys online, they only know your name, nothiong about you. They can’t sit there and point out your mistakes and hold them against you. When I was almost 13, I started talking to this guy and he made me feel comfortable. I felt lke I could trust him. We “talked” for awhile and were almost like a couple. One day he asked me to send him a “dirty picture” promised no one else would see it. I trusted him and I sent it. It ruined me. A couple days later, he stopped talking to me, and then one of my bestfriends came over flipping out, she is the only one I had . She told me that it was a fake account. A boy in school made it to see what he could get out of people. He sent the pictures around to everybody. I got called a “hoe”, a slut, told to just kill myself. It was horrible. I cried alot. Never wanted to get out of bed, talk or see anyone. I felt like I had no one. One night I got a message from my bestfriend telling me to look at posts. I don’t know why I did, but I did. They were all saying I should just kill myself. After being hated by everyone, hearing them call me names, I started hating myself, believing everything they said. I attempted suicide. I took pills. If it wasn’t for my bestfriend ( who got worried and came to check on me, was there through everything, didn’t care that being friends with me turned people against her. She was all I had) I wouldn’t be here typing this. Since then, things have been way better. I’ve deleted that facebook account and made a new, moved to a new location, and everything is so much better. There are still those people who like to bully me, and not just me. but my bestfriend taught me to hold my head high. Stay strong. And I have. I’m happy now, I have alot of friends and am considered “one of the pretty girls” which is in no shape or form important to me. I hang out with the “nerds” I guess you could say, becase after that, I don’t care about being popular anymore, as long as I’m not alone. I still have those memories, and I still get depressed, trust me, I do. But my mom(who started staying home more after my”incident”) reminds me everyday how beautiful I am and how, even though the going get’s rough, I AM STRONGER THEN THE BULLIES. I have more going for me then they do in the future. Just hearing “the future” made me feel better knowing that it will get better. I beat my depression and bullies. I am strong.

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