As many as one in eight teens and one in 33 children have clinical depression.

Depression is a serious health problem that affects feelings, thoughts and actions, and it can appear as a physical illness. Fortunately, depression in youth is treatable.

Signs of Depression

  • Persistent sadness
  • Withdrawal from family, friends and activities that were once enjoyed
  • Increased irritability or agitation
  • Changes in eating and sleeping habits (e.g., significant weight loss, insomnia, excessive sleep)
  • Frequent physical complaints, such as headaches and stomachaches
  • Lack of enthusiasm or motivation
  • Decreased energy level and chronic fatigue
  • Play that involves excessive aggression toward self or others, or that involves persistently sad themes
  • Indecision, lack of concentration or forgetfulness
  • Feelings of worthlessness or excessive guilt
  • Recurring thoughts of death or suicide

Adolescent Depression

Depression can be difficult to diagnose in teens because adults may expect moodiness to be normal in teens. Also, adolescents do not always understand or express their feelings very well. They may not be aware of the symptoms of depression and may not seek help.

Teens may experiment with drugs or alcohol or become sexually promiscuous to avoid feelings of depression. Teens also may express their depression through hostile, aggressive, risk-taking behavior. But such behaviors only lead to new problems, deeper levels of depression and destroyed relationships with friends, family, law enforcement or school officials.


Suicide is the third leading cause of death for 15- to 24-year-olds and the sixth leading cause of death for 5- to 14-year-olds. Attempted suicides are even more common.

Left untreated, depression can lead some youth to take their own lives. If you suspect that a child or adolescent is suicidal, look for these warning signs:

  • Threats of suicide—either direct or indirect.
  • Verbal hints such as “I won’t be around much longer” or “It’s hopeless.
  • Obsession with death.
  • Overwhelming sense of guilt, shame or rejection.
  • Putting affairs in order (for example, giving or throwing away favorite possessions).
  • Sudden cheerfulness after a period of depression.
  • Dramatic change in personality or appearance.
  • Irritability.
  • Hallucinations or bizarre thoughts.
  • Changes in eating or sleeping patterns.
  • Changes in school performance.


Young people sometimes turn to alcohol and drugs to cope with life’s frustrations, to feel more adult-like, to fit in, to rebel, or to satisfy their curiosity about drugs and drinking. Teens with depression or other mental health problems are particularly vulnerable to alcohol and drug use.

Many adolescents fail to recognize that they are depressed and why they are depressed. But, when they drink alcohol or take drugs to alleviate their stress or emotional pain, they can develop or worsen depression. 

Alcohol is a drug, with serious risks and potentially harmful consequences. Marijuana and other drugs are also dangerous and often addictive. Casual use of drugs like club drugs, inhalants and steroids can cause long-lasting brain damage and impair health.

Warning signs of drug use may include:

Physical signs

  • Bloodshot eyes, pupils larger or smaller than usual
  • Changes in appetite or sleep patterns
  • Sudden weight loss or weight gain
  • Deterioration of physical appearance, personal grooming habits
  • Unusual smells on breath, body, or clothing.
  • Tremors, slurred speech, or impaired coordination.

Behavioral signs

  • Drop in attendance and performance at work or school
  • Unexplained need for money or financial problems May borrow or steal to get it.
  • Engaging in secretive or suspicious behaviors
  • Sudden change in friends, favorite hangouts, and hobbies
  • Frequently getting into trouble (fights, accidents, illegal activities)

Psychological signs

  • Unexplained change in personality or attitude
  • Sudden mood swings, irritability, or angry outbursts
  • Periods of unusual hyperactivity, agitation, or giddiness
  • Lack of motivation; appears lethargic or “spaced out”
  • Appears fearful, anxious, or paranoid, with no reason

Warning signs of alcohol abuse may include:

Physical Signs of Alcohol Abuse

  • Red or blood shot eyes
  • Persistent cough
  • Increased fatigue/sleep problems
  • Changes in weight (increase or decrease)
  • Unexplained injuries (could be caused by accidents that occur while drinking)
  • Frequent headaches, nausea, sensitivity to sound (especially in the morning due to hangover)
  • Other drug use, including cigarette smoking
  • Slurred speech/unable to communicate effectively
  • Lack of concentration
  • Blackouts - unable to account for specific periods of time

Social/Emotional Warning Signs of Alcohol Abuse

  • Withdrawal from family - spending more time alone away from family members
  • Loss of interest in previous hobbies or activities
  • Depression
  • Mood Swings - including irritability, quick to anger and overly defensive
  • Change in the choice of friends/peer group
  • Problems at school - falling grades, complaints from teachers/staff, reports of cutting class and absences
  • Problems with the law
  • Goes out with friends a lot
  • Secretive behavior
  • Lying
  • Running away


Young people sometimes hurt themselves to express emotional pain or feelings they can't put into words.

Self-injury, also known as cutting or self-mutilation, occurs when someone intentionally and repeatedly harms herself/himself. The method most often used is cutting but other common behaviors include burning, punching, and drinking something harmful, like bleach or detergent. It can be a way to have control over your body when you can't control anything else in your life. A lot of people who cut themselves also have an eating disorder.

It's estimated that about two million people in the U.S. injure themselves in some way. The majority are teenagers or young adults with young women outnumbering young men. They are of all races and backgrounds.

Some of the warning signs include:

  • Unexplained injuries, such as cuts, scratches, burns, bruises, etc.
  • Making excuses for injuries or scars if they are discovered 
  • Acting embarrassed or ashamed about injuries 
  • Wearing long sleeves even in hot weather 
  • Secretiveness or withdrawal 
  • Having trouble dealing with emotions 
  • Spending time with people who self-injure, especially on the internet
  • A history of eating disorders 
  • Having trouble functioning at work, school, and in relationships 
  • Low self esteem


Many people think of school shootings when they think of teen violence. But teen violence includes many different activities. These include extreme bullying, fights, gang violence, date rape and suicide. The victims of teen violence are most often other teenagers.

Teens who commit acts of violence are often involved in other types of risky or criminal behavior. They may use or sell drugs, carry weapons, drive recklessly and have unsafe sex.