TEENAGE ANGST VS. DEPRESSION & ANXIETY

Adolescence is one of the most memorable times in our lives. Unfortunately, not always for positive reasons. There are fun, timeless experiences intertwined with cringe-worthy, confusing, awkward memories. The teenage years are a time of experimentation, discovery, and finding out where one fits in the world around them. It involves learning about our bodies, sexuality, friendship, and romantic relationships. It is a time to move further away from our immediate family and closer to our peers. Our brains are developing and growing, more notably, puberty is the beginning of major changes in the limbic system. Our limbic system deals with our emotional processing, emotional reactions, sexual arousal, our fight or flight response systems and much more. Teens experience intense emotions due to the limbic system’s development and hormonal changes. Like a baby bird clumsily flying/falling when first leaving the nest, it takes us most of our adolescence and young adulthood to learn to manage our emotions like the smooth flight of a seasoned bird.

How do we know when our adolescent is experiencing mental health difficulties versus the difficulties of being a teenager?

This is often a difficult question to grapple with.  There have been plenty of teenagers in counseling who are simply experiencing the difficulties of their developmental stage in life, which we could argue is not such a bad circumstance. Conversely, there have been many teenagers suffering from clinical depression and anxiety that have not been treated until later in their lives. Often, their mental health symptoms are chalked up to be “teenage angst.”  Parents often struggle with the balance between avoiding pathologizing their teenager’s behaviors and ensuring they receive appropriate mental health support.

Below are some symptoms and behaviors that may seem like “teenage angst” on the outside, however, may be a mental health issue that would require further assessment from a mental health professional:

• Depressed mood: feeling sad, feeling agitated, empty, hopeless, tearful (almost daily, for large portions of the day)

• Not finding pleasure or showing interest in recent hobbies or activities

• Social isolation: with both family and especially friends

• Inscesent skin picking or pacing

• Recurrent thoughts of death or suicide

• Cutting, burning, or any self-harm (unfamiliar wounds that don’t look natural or don’t fit the explanation given for their origin)

• Avoiding activities (school, friends, leisure activities) due to fear or worry

• Panic attacks: learn more about panic attacks here

• Excessive worry with difficulty controlling worry

• Constant feelings of stress or feeling overwhelmed

• Disrupted sleep: recurring difficulty going to sleep or sleeping a lot (more than 9-10 hours per day

• If any of the above symptoms or behaviors negatively affect school performance, work performance, family life, and social relationships

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Below is a list of some developmentally appropriate teenage behaviors followed by general symptoms of depression and anxiety:

Typical Teenage Behaviors

• Random mood swings e.g. agitation, tearfulness, anger caused by an increase in hormones

• Spending less time with family and wanting more time with peers

• Struggle with self-esteem and feeling uncomfortable in their body

• Changes in body weight and height due to physical development

• Increased sleep, typically staying up later and sleeping in later (this change in sleep schedule is both biological and by choice)

• Increased desire to be independent

• Changing identities in attempt to find their own identity and role in their approaching adulthood

• Difficulty concentrating

• Depression and Anxiety for a short period after ending relationships

Depression Symptoms

• Depressed mood - feeling sad, feeling agitated, empty, hopeless, tearful (for no reason).

• Not finding pleasure in most things throughout the day, especially favorite hobbies, activities, food, etc.

• Social isolation - from anyone (both family and friends)

• Significant change in weight both gain or loss (not related to growth spurts).

• Sleeping more than 8-10 hours per day or difficulty sleeping

• Pacing back and forth, picking skin regularly, constantly bouncing legs or moving hands

• Fatigue without any exercise, loss of energy nearly every day

• Feelings of worthlessness or guilt

• Difficulty thinking or concentrating

• Recurrent thoughts of death

Anxiety Symptoms

• Excessive worry, with difficulty controlling worry

• Restlessness or feeling keyed up or on edge

• Difficulty concentrating, mind going blank

• Irritability

• Muscle tension (discomfort in hands and arms)

• Pacing back and forth, picking skin regularly, constantly bouncing legs or moving hands

• Sleep disturbance (difficulty falling asleep)

• Panic attacks

The symptoms and behaviors discussed here are are non-exhaustive, should you have any other concerns please consult a mental health professional.