Understanding Depression and Mood Disorders in Teens

Mood disorders and depression in teens can look similar and it can be challenging to know how to help a teen coping with these forms of mental illness. Mood disorders are any disorders that are characterized by a marked change in mood, either up or down that interferes with day-to-day functioning. 

Different types of depression fall under the mood disorder category, as do bipolar mood disorder, disruptive mood disorder, and other disorders that look similar to any of these but are connected either to substance use or health conditions. 

Mood Disorders in Teens

Mood disorders can look very different depending on the teen—your daughter’s individual personality and the type of mood disorder play a role in how the symptoms show themselves.  

“Depression in teens often manifests itself in agitation and irritability, which is often dismissed by parents. A combination of relational, developmental, and somatic therapies gives teens and parents the relational tools to create trust, vulnerability, and security to manage mood dysregulation.” says Brent Esplin, the executive director at Potomac at Hobble Creek, a residential treatment center for teens with mood disorders and other related mental illness. 

Take a closer look at some of the more common mood disorders affecting teens. 

Persistent Depressive Mood Disorder (PDD or Dysthymia) 

Persistent depressive disorder symptoms are similar to depression but not as severe as major depressive disorder. PDD is long-lasting and is a low-grade form of depression that lasts over a year. If it seems like your daughter has been sullen, fatigued, withdrawn, showing a lack of motivation, and irritable for a long time, PDD could be a possibility. Some teens describe it as trying to slog through mud all the time. Everything seems like work — even thinking and feeling. 

While it’s not as likely to carry the risk of suicide, PDD is still serious and it can’t be distinguished from major depression without a professional diagnosis. This long-term depression interferes with relationships, learning, socialization, and overall functioning. It’s easy for a teen dealing with PDD to fall behind in school and to become isolated, leaving her more at risk for a decline into major depressive disorder or other mood disorders.  

A teen with PDD or dysthymia will have the following symptoms: 

• Irritability (irritability is a more reliable symptom of varying forms of depression than sadness in teens) 
• Fatigue or low energy 
• Concentration 
• Decision-making 
• Eating (either too much or too little) 
• Sleeping (either too much or too little) 
• Feelings of hopelessness 
• Low self-esteem 

Disruptive Mood Dysregulation Disorder  (DMDD)

Disruptive Mood Disorder is a new diagnosis in the DSM-5, the manual that mental health professionals use to make diagnoses and decide what approach to take in treatment.  This disorder is not diagnosed before the age of 6 or over the age of 18.

What sets Disruptive Mood Disorder apart from most other mood disorders is that the teen is persistently irritable and angry. Even without significantly provoking her, your teen has extreme temper outbursts — maybe even gets aggressive and violent. 

Adjustment Disorder 

Adjustment disorder with differing types occurs in response to a life event. Was there a major event in your teen’s life recently? Perhaps a divorce, a move, a death — or something else that’s notable? 

Because people show their grief in different ways, adjustment disorder has several types:  

• Adjustment disorder with depressed mood 
• Adjustment disorder with anxiety 
• Adjustment disorder with depressed mood and anxiety 
• Adjustment disorder with disturbance of conduct 
• Adjustment disorder with disturbance of emotion and conduct 
• Adjustment disorder unspecified 

Adjustment disorder typically lasts for less than six months as your teen grieves whatever change or loss she has experienced. Adjustment disorder is often a cry for help as your teen needs help to cope with a challenge. During this time, adjustment disorder can interfere with sleep, social interaction (which can be a big deal if it accompanies a move), and school work — setting your daughter back academically and socially. 

If your daughter is struggling through a major change, it’s better to get help than to wait for it to just go away.  

Bipolar Mood Disorder 

Bipolar used to be called “manic depression.” A teen with bipolar has periods of depression followed by episodes of elevated mood, referred to as “mania.” During the manic stage, your teen may have  

• difficulty sleeping, and she may not even sleep for days
• problems focusing her attention
• a short temper or extreme irritability
• risky behaviors, including high-risk sexual behavior
• Feelings of elation or excessive silliness

If your daughter’s upward swing doesn’t look quite this dramatic, she could have bipolar disorder  — Type 2. The active stage is not as extreme and is called “hypomania” (hypo means low).  The “up mood” is more extreme than her normal activity, but not quite manic. 

Bipolar cycles through these stages anywhere from every couple of weeks to several months. It is treatable, but bipolar disorder isn’t curable. It’s something she’ll live with the rest of her life, though a combination of medication and therapy will help her learn to identify, process, and work with her symptoms. 

Premenstrual Dysphoric Mood Disorder 

Many teen girls get moody or agitated in the week or so before their period starts, but PMDD is more severe than PMS. PMDD hits 1-2 weeks before your daughter’s period starts and is gone within a few days of starting her cycle. The symptoms are severe enough to keep your daughter from functioning normally. Some of the symptoms include: 

• Mood changes including irritability, nervousness, anxiety, and depression 
• Crying and heightened emotions 
• Paranoia and increased sensitivity 
• Coordination issues 
• Sleep issues 
• Other symptoms common to forms of depression 
• Pain, headaches, bloating, and other symptoms common to PMS, but often more severe. 

If you’re noticing she’s increasingly depressed, agitated, or irritable –to the point that it’s interfering with her relationships or her functioning — but it happens at a regular time each month, talk to her doctor. There are several options for treating PMDD, including medication and cognitive behavioral therapy to help her identify her emotions and strategize ways to deal with her symptoms.  

Major Depressive Mood Disorder 

13% of teens have at least one episode of Major Depressive Disorder. It is treatable through therapy and possibly the addition of medications.  

A major depressive episode is identified as a depressed mood and lack of interest in things that usually bring pleasure (anhedonia) that lasts at least two weeks, though it can last a lot longer than that. In teens, it can show itself as chronic irritability more than sadness, though either are a possibility. It’s often accompanied by aches and pains that don’t have an obvious source.  

Major Depression can also have dominant types:  

Melancholic features – dominated by sadness, worsened moods in the morning, early wakening, agitation, sluggishness, and guilt. 

Anxious distress — she’s worried about loss of control over situations or events, more agitated and restless. 

Atypical depression — A person with atypical major depression is able to be cheered up by individual situations but returns back to the depressed state shortly afterward, has an increased appetite, sleeps more, and feels lethargic or heavy. 

Getting Mental Health Help for Your Teen

If your daughter is at risk of harming herself or taking her life, contact the 988 Suicide & Crisis Lifeline for immediate support by calling, texting, or chatting 988. If the risk is immediate, call 911.  

To find a therapist, use the Psychology Today search tool. 

Embark is the most trusted name in teen and young adult mental health treatment. We’re driven to find the help your family needs. If you’re looking for support, contact us today!