Recognizing the Hidden Signs of Teen Depression

Koren Hudson, MA, LPC, NCC

Credit: Horizon Recovery

Teen depression doesn’t always look like what people expect. While many associate it with sadness or tears, depression in teens can show up as irritability, withdrawal, or sudden changes in sleep, appetite, or motivation. According to Koren Hudson, MA, LPC, NCC, executive clinical director at Horizon Recovery, understanding these differences is key to helping teens get the support they need. In recognition of World Mental Health Day and National Depression Screening Day, The Educated Patient is spotlighting how depression often looks different in teens — and what parents, teachers and peers can do to support young people who may be struggling. Recognizing the signs early can make all the difference in helping a young person navigate depression and begin to heal.

Teen depression doesn’t always look like sadness. What are some of the most common signs you might notice in yourself or your friends?
Koren Hudson, MA, LPC, NCC: A lot of times, depression in teens doesn’t show up as sadness but often shows up as constant irritability, frustration or anger. Parents or teachers may notice that the teen has been withdrawing from friends, family or activities they once enjoyed. Changes in sleep and eating habits are also common, including oversleeping, insomnia, overeating or loss of appetite. Many teens will complain of physical symptoms such as headaches or stomach aches that have no clear medical cause. A drop in school performance, noticeable lack of motivation or increased risk-taking behaviors can also be red flags.
Why does depression often show up differently in teens compared to adults?
KH: Adolescents experience depression differently than adults because of where they are developmentally. The parts of the brain responsible for emotional regulation and decision-making are still developing, which means emotions may feel more overwhelming and harder to manage. Teens are also navigating identity, peer relationships and independence, which makes them more vulnerable to stressors. Teens often act out through irritability, anger or withdrawal because it feels safer or easier than admitting they are depressed.
How can you tell the difference between normal teenage moodiness and something more serious?
KH: Depression tends to last longer and disrupt daily functioning, unlike typical mood swings that come and go. If moodiness persists for more than two weeks, or is present most days, it is a good idea to seek out further evaluation. Moodiness that escalates into hopelessness, persistent irritability or talk about worthlessness is beyond typical development. Any mention of self-harm or suicidal thoughts should always be treated as a mental health emergency.
What should you do if you think you might be struggling with depression?
KH: First, start an open, supportive, nonjudgmental and loving conversation with your teen, letting them know you are available and want to listen. Families should normalize seeking help and schedule an appointment with a pediatrician or mental health professional for further assessment. It is important to notify the school counselor so additional support can be provided in the academic setting. At home, families can help by maintaining routines, family time and encouraging healthy sleep and eating patterns. Parents should encourage family time weekly that consists of connecting as a family through mutually enjoyable activities that encourage disconnecting from phones and having face-to-face connection.
What role can schools and teachers play?
KH: Teachers and school staff are often the first to notice when a student’s behavior, participation or academic performance begins to change. Schools can provide a safe, nonjudgmental adult connection for students who may not feel comfortable opening up at home. Teachers and school staff should communicate concerns to school counselors or mental health staff, who can connect families to resources. In the classroom, teachers can offer understanding, flexibility and support, while schoolwide mental health awareness can help reduce stigma and encourage students to ask for help.
What message would you share with other teens who feel overwhelmed but aren’t sure if it’s depression?
KH: The most important message to share with teens is that they are not alone and that what they are experiencing is valid. Feeling overwhelmed does not mean they are weak or broken, and help is available. Depression is treatable, and with the right support through therapy, healthy coping strategies, and sometimes medication, things can improve. Teens should be encouraged to reach out to a trusted adult, whether at home or school, and reminded that they deserve support and healing.