Why are teens today so depressed?

This is, in fact, a very difficult question to answer with great accuracy. It is easy to point at the incredible stress we place on young people and the competitive world they are entering. But the reality is that one of the primary reasons for this phenomenon is the sorry state of our interpersonal lives, particularly our families. Young people are being exposed to abuse and exploitation at an alarming rate. And even those who have managed to avoid overt problems such as physical, sexual, or emotional abuse, are likely to have come from fractured families with excessive instability. They are then entering their adolescence feeling empty and dysregulated. The solutions our culture offers to these problems – drugs, sex, money – only intensify the problem.

How can I tell if my teen is depressed?

It is not easy to tell if a teen is depressed as they often do not manifest the symptoms that we as adults associate with this condition. A teen will often not complain of sadness, crying, or despair. Rather, they will present with irritability and aggression. Sexual acting out or drug use are very frequent signs of depression. Changes in sleep patterns, appetite, or dress are clues. Some may show up with physical complaints, such as headache or abdominal pain. Finally, the single most sensitive indicator of trouble is a sudden drop in grades.

My teen’s behavior seems a bit off lately, but it could be just normal teen moodiness. How do I know if there’s something more at play like drug use and/or mental health problems?

Well, the fact is you don’t know and it is very difficult to tell. Trust your instincts. If you have a sense that something is wrong, take the child to a professional. It is reasonable to start with your pediatrician. Recognize that done properly, the treatment and evaluation of an adolescent should include the child building a confidential relationship with a health care provider, so expect the clinician to request time alone with your child. There simply isn’t a 15- or 16-year-old on the planet that can be completely honest with his or her parent. Your child wants to please you and he or she may be ashamed of what he or she is feeling. This will be an environment for the child to be thoroughly evaluated by a professional, who not only will get more information, but also has the training and objectivity to render a diagnosis and an appropriate plan.

How do I convince my teen that smoking marijuana is more harmful than she thinks?

This is tough. If you have a child who has become addicted I have found it very useful to take him or her to a Marijuana Anonymous meeting. Marijuana addiction is remarkably uniform in its manifestations so you can be sure your child will find someone at the meeting with precisely his or her story. This individual will have thought as your child and be much more impactful addressing his or her denial. Also, it may be useful to find stories about people the child admires showing the consequences of using. Continuing to offer educational material and perhaps have the child speak with his or her medical provider if they have a close relationship are also good ideas.

I don’t want to lie to my teen about my past marijuana use. How do I talk to her about my own experiences?

Parents ask me this question all the time and I am very clear on how this should be approached. I have years of experience with patients insisting upon sharing every detail of their own adolescence in an attempt to develop rapport by being the child’s buddy.  This is anathema to the child’s needs. The child has plenty of buddies. He or she needs a parent. I guarantee you that by sharing your experiences with your child you are immediately issuing your child a license to do as you did and pick up where you left off.  After, they will tell you that you were being hypocritical. You did this, you’re fine now, and yet you won’t let me.

Here is how you should approach this. NEVER lie to your kids. But you have no obligation to answer all questions. I assure you that by saying to the child, should they ask, that your history is not what’s at issue, rather, what you expect of her is all you are willing to discuss. Reaffirm that your job as parent is to keep her safe and healthy, and as such, you have specific expectations that have nothing to do with your personal history.  She naturally will accuse you then of having perhaps engaged in all sorts of vice. By not discussing, even in the face of her accusations, you will have a dramatically different and positive effect upon your child’s behavior. The only exception to this recommendation is if you yourself are an addict in recovery. In that case, be explicit with the child about the consequences of your disease and include your child in your comprehensive treatment, which will include for the child a program called Alateen. Your child may also need a therapist of his or her own.

Dr. Drew Pinsky is an internist, board certified in addiction medicine, who serves as Medical Director for the Department of Chemical Dependency Services at Las Encinas Hospital in Pasadena, CA. He hosts the nationwide television and radio show Loveline as well as Celebrity Rehab on VH1, the first reality series on television to depict the process of overcoming addiction. He is also Assistant Clinical Professor of Psychiatry at the Keck USC School of Medicine.

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