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Depression
Think about a time when you felt “down” or “blue” in your life. Maybe it was when you were a teenager and everything felt new and confusing, or maybe it was following the loss of a friendship or pet. There was likely an identifiable reason “why” and your normal coping strategies helped you feel better. Occasionally experiencing low moods is normal and part of what makes us human.
However, for kids and teens with Clinical Depression a heavy feeling is there almost everyday, and they are not able to identify a reason for the feelings. As a parent, it can be difficult to watch your child retreat to their inner world without knowing how to help them. When dealing with Clinical Depression you often need external support, like therapy and/or medication, to help.
- For parents of teens, it can be difficult to distinguish between expected teenage sadness and irritability and what might be a deeper, underlying concern. When individuals report feelings of being constantly down, exhausted, short tempered, and disinterested in things they usually enjoy for more days than not during an average week, therapists usually look into if this person is experiencing a Major Depressive Episode, part of a larger diagnosis of Major Depressive Disorder (MDD) or commonly known as Clinical Depression.
- A major depressive episode extends past the “moodiness” people associate with teenagers. You might notice heightened frustration with adults, arguments with siblings/friends, sleeping more than usual, or no longer finding activities they used to enjoy. If your teenager is consistently experiencing low moods, expressing feelings of hopelessness/despair, and are missing out on typical engagements (school, sports, etc.), they might be experiencing Clinical Depression.
MAJOR DEPRESSIVE DISORDER (MDD)
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SEASONAL AFFECTIVE DISORDER (SAD)
- Nearly everyone experiences a “dip” in mood during the winter months. This can often look like feeling sleepy, wanting to stay inside the house more, general sadness, and feeling less social than normal. However, sometimes these symptoms are more severe than feeling down every once in a while. Some people experience a pattern where every winter there is a notable slump in moods that mimics criteria for Depression (see info above on Depression), but then symptoms naturally seem to resolve during the Spring/Summer months.
- When these symptoms become problematic and interfere with daily functioning like hygiene, going to school, attending extracurriculars, it could be Seasonal Affective Disorder (SAD). For a more in-depth discussion of SAD, please see our blog post titled “When the Days Grow Dark: A Guide to Understanding SAD”.
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- Bipolar Depression is characterized by transitioning between the two “poles” of emotional experience: severe depression (the low pole) and uncharacteristically elevated or manic mood (the high pole). It is important to note that a person with Bipolar Depression will often stay in that mood state for an extended period of time (e.g., multiple days in a row).
- Unlike typical depression, where mood remains consistently low, Bipolar Depression includes these alternating phases of high energy, impulsivity, and extreme optimism, followed by periods of profound sadness, fatigue, and a sense of hopelessness. These shifts can be dramatic and disruptive. The manic or hypomanic phases often involve risk-taking behaviors, poor judgment, and a decreased need for sleep, which can significantly affect an individual’s day-to-day functioning.
- For females, if there is a pattern of low or dysregulated mood that significantly worsens during the week(s) leading up to the beginning of the menstrual cycle, it could be a condition called Premenstrual Dysphoric Disorder. Therapists at Ballard Clinic can assist with psychoeducation around PMDD as well as coping strategies to help alleviate the distressing symptoms.
BIPOLAR DEPRESSION
OTHER CONSIDERATIONS
Treatment for Depression
Depression is a condition that affects how people feel, think, and act, and there are many ways to treat it. Some therapies focus on changing negative thoughts, activating their body, managing emotions better, and improving relationships with others.
- CBT is an intervention that focuses on the idea that thoughts impact feelings/emotions and behavior. Using CBT, therapists assist clients in identifying and restructuring their unhelpful thoughts and behavior patterns. Sometimes it can be helpful to view CBT as learning how to wear a different colored lens in your “glasses”.
- In relation to depression, CBT can be used to identify negative thoughts about the self and the individual’s environment. Restructuring thoughts can set a strong foundation for emotional and behavioral improvements. Similarly, CBT can be used to build positive habits and routines which improves depression symptoms through behavioral activation (e.g., getting out of the house, doing fun things).
Cognitive Behavioral Therapy (CBT)
Dialectical Behavioral Therapy (DBT)
- Therapists use DBT when treating depression to improve coping skills, increase distress tolerance, and improve interpersonal relationships. DBT differs from CBT by helping the individual improve their support system and interpersonal skills. Often times, depression is accompanied by a sense of isolation, so increasing connectedness can decrease symptoms.
- DBT can be especially helpful when treating clients who are experiencing depression and self-harm (see our emotional distress and self-harm page).
interpersonal Psychotherapy (IPT)
- IPT is a short-term therapeutic intervention that can be effective in providing relief for clients experiencing mild/moderate depression. IPT focuses on how interpersonal struggles can influence depression symptoms. When using IPT, therapists focus on current interpersonal relationships rather than focusing on past experiences. IPT is focused on creating solutions and enacting interpersonal change to improve relationship quality and overall wellbeing.
- While IPT can be helpful in providing more immediate relief for depression symptoms, it is most effectively used in conjunction with more long-term therapy to prevent re-emergence of depressive symptoms.
