What are mood disorders in teens?

Mood disorders are a group of mental health problems. They are sometimes called affective disorders. These are the most common types:

• Major depression. A teen with this type has a depressed or irritable mood, along with other signs, for at least 2 weeks. They may also lose interest or pleasure in normal activities.

• Persistent depressive disorder (dysthymia). A teen with this type has a long-lasting, low-grade, depressed, or irritable mood for at least 1 year.

• Bipolar disorder. This type causes a mix of manic episodes and depressed periods, or times of flat or dulled emotional response.

• Disruptive mood dysregulation disorder. A teen with this type has ongoing grouchiness or irritability. They have a hard time controlling behavior.

• Premenstrual dysmorphic disorder. This type causes depressive symptoms, grouchiness, and tension before a menstrual period.

• Mood disorder caused by a health problem. Many conditions can set off symptoms of depression. These include cancer, injuries, infections, and chronic illnesses.

• Substance-induced mood disorder. These are depression symptoms from the effects of medicine or other forms of treatment, drug abuse, or exposure to toxins.

What causes mood disorders in a teen?

What causes mood disorders in teens is not well understood. Certain chemicals in the brain called neurotransmitters impact mood. Mood disorders may be caused by a chemical imbalance in these neurotransmitters. This can happen on its own. Or it can be caused by environmental factors, such as unexpected life events or long-lasting stress.

Mood disorders also run in families. Researchers believe that many factors play a role. The factors that produce the trait or condition are often both inherited and environmental. They include a mix of genes from both parents.

Which teens are at risk for mood disorders?

Anyone can feel sad or depressed at times. But mood disorders are more intense and longer lasting. They are harder to handle than normal feelings of sadness. Teens who have a parent or other relative with a mood disorder have a greater chance of also having a mood disorder. It's not definite that this will happen. But hard life events and stress can expose or exaggerate feelings of sadness or depression. This makes the feelings harder to manage.

Sometimes life’s problems can cause depression. Hard situations for a teen include:

• A parent losing a job

• Parents getting divorced

• A death in the family

• Family having money problems

• Problems with peers

It can be hard for a teen to cope with these situations. These stressful life events can bring on feelings of sadness or depression. Or they can make a mood disorder harder to manage. It depends on your teen’s coping skills and their ability to rebound from rough times.

What are the symptoms of mood disorders in a teen?

Teens don’t always have or show the same symptoms as adults. It's harder to spot mood disorders in children and teens. That’s often because they are not always able to say how they feel.

Teens may show different symptoms than adults or small children. It depends on their age and the type of mood disorder. These are the most common symptoms:

• Ongoing feelings of sadness

• Feelings of despair, helplessness, or guilt

• Low self-esteem

• Feelings of not being good enough

• Feelings of wanting to die

• Loss of interest in normal activities or activities once enjoyed

• Trouble with relationships

• Sleep problems, such as insomnia

• Changes in appetite or weight

• A drop in energy

• Problems focusing or making decisions

• Suicidal thoughts. Take any comment about suicide seriously. Contact your teen's healthcare provider right away.

• Suicide attempts. This is any type of self-harm aimed at ending the person's life that does not succeed. This is an emergency. Get help right away.

• Frequent physical complaints, such as headache, stomachache, or extreme tiredness (fatigue)

• Running away or making threats of running away from home

• Sensitivity to failure or rejection

• Being grouchy, hostile, or angry

In mood disorders, these feelings seem stronger than teens normally feel from time to time. It's also of concern if these feelings last over a period of time. Or if they interfere with a teen’s interest in being with friends or taking part in daily activities at home or school.

Contact your teen’s healthcare provider right away if your child expresses any thoughts of suicide. Call or text 988 if they have a plan to harm themselves or others and the means to carry out the plan. In this situation, don't leave your teen alone, even for a moment. When you call or text 988, you will be connected to a trained crisis counselor at the 988 Suicide & Crisis Lifeline. An online chat choice is also available at www.988lifeline.org. You can also call Lifeline at 800-273-TALK (800-273-8255). Lifeline is free and available 24/7.

Other signs of possible mood disorders in teens may include:

• Not doing well in school

• Constant anger

• Rebellious behaviors

• Trouble with family

• Trouble with friends and peers

These symptoms may seem like other conditions or mental health problems. Make sure your teen sees their healthcare provider for a diagnosis.

How are mood disorders diagnosed in a teen?

After your teen's healthcare provider does a full physical exam to rule out any other health condition, a mental health provider may diagnose a mood disorder. This is based on a complete mental health evaluation. They may also evaluate the family and talk with teachers and caregivers.

How are mood disorders treated in a teen?

Treatment will depend on your teen’s symptoms, age, and general health. It will also depend on how bad the condition is.

Mood disorders can often be treated. Treatment may include one or more of these:

• Medicines. These can be very helpful, especially when combined with talk therapy.

• Talk therapy (psychotherapy). This treatment helps teens change their distorted views of themselves and the environment around them. It also identifies stressors in the teen’s environment and teaches your teen how to prevent or handle them. They will also learn how to work through hard relationships.

• Family therapy. Parents play a vital supportive role in any treatment.

• School input. You may want to talk with school administrators about possibly getting your child emotional and academic support through an Individualized Education Plan.

What are possible complications of mood disorders in a teen?

Teens with mood disorders are at risk for other problems. These include:

• Substance abuse

• Anxiety disorder

• Disruptive behavior

• Suicidal thinking or suicide attempts

• Problems with peer and adult relationships

• Problems with school performance

How can I help prevent a mood disorder in my teen?

Experts don’t know at this time how to prevent mood disorders in teens. But early detection and treatment are vital. They can ease symptoms and help with your teen’s normal growth and development. They can improve your teen’s quality of life.

How can I help my teen live with a mood disorder?

You play a key role in your teen's treatment. Here are things you can do to help:

• Keep all appointments with your teen’s healthcare provider and school personnel.

• Give medicines as prescribed. Don't change the dose unless you talk to your teen's provider. Never share the medicines or use someone else's, even if it is the same medicine and dose.

• Take part in family therapy as needed.

• Focus on your teen's strengths. Provide concrete, positive feedback. Help your teen look at problems as challenges that can be overcome using their strengths.

• Talk with your teen’s healthcare provider about other providers who will be included in your teen’s care. Your child may get care from a team that may include counselors, therapists, social workers, school psychologists, and psychiatrists. The care team will depend on your teen's needs and how serious the depression is.

• Tell others about your teen’s mood disorder. Work with your teen’s provider and school to create a treatment plan.

• Check on school resources for your teen. The Americans with Disabilities Act and Section 504 of the Civil Rights Act can help the school meet your teen's educational needs. Talk with your child’s teacher, school psychologist, and school principal about reasonable accommodations so your teen can be successful in school.

• Reach out for support. Being in touch with other parents who have a teen with a mood disorder may be helpful.

• Take all symptoms of suicide very seriously. Get treatment right away. Suicide is a health emergency. Call or text 988 if your teen has plans to harm themselves or others. In such a situation, don't leave your teen alone, not even for a moment. Have a suicide safety plan in place. Remove guns and other weapons, alcohol, medicines, and harmful household chemicals. If you can't remove them, store them safely in a lockbox.

When should I call my teen’s healthcare provider?

Call the healthcare provider right away if your teen:

• Feels extreme depression, fear, anxiety, or anger toward themselves or others

• Feels out of control

• Hears voices that others don’t hear

• Sees things that others don’t see

• Can’t sleep or eat for 3 days in a row

• Has new symptoms or current symptoms get worse

• Shows behavior that concerns friends, family, or teachers, and others express concern about this behavior and ask you to seek help

• Mood disorders can be very stressful on the family. Ask your teen's healthcare provider or school staff for resources to help your family.

Key points about mood disorders in teens

• Mood disorders are a group of mental health problems. They include all types of depression and bipolar disorder.

• Mood disorders can run in families.

• Stressful life events can also raise a teen’s risk for this type of disorder.

• Symptoms include feelings of despair and helplessness. A teen may also have low self-esteem and sleep problems.

• Take symptoms of suicide seriously. Call or text 988 if your teen has suicidal thoughts, a suicide plan, and the means to carry out the plan. In such a situation, never leave your child alone, even for a moment.

• Treatment includes medicines and therapy.

• School personnel are important members of your child's treatment team.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.