Depression is a mood disorder. This means that it affects your child’s mood and behavior. No one is exactly sure what causes depression. It's associated with changes in levels of certain chemicals in the brain. These chemicals affect the ability to feel and experience pleasure. Depression may run in families.A teen may be more likely to become depressed if someone else in the family has had depression.

Depression is aseriousillness, just like diabetes or heart disease. And like those illnesses, depression is not something a teen can just "snap out of." Treatment is needed.

Depression is diagnosed by its signs and symptoms. A teen may not have every symptom. But it's important to talk with a healthcare provider about any symptoms that are severe or that get in the way of daily life. In teens, common signs and symptoms of depression are:

• Loss of interest in family, friends, or activities that they once enjoyed

• Talking about feeling hopeless or worthless

• Increase in reckless or risk-taking behavior

• Talk of suicide or death

• Drop in grades

• Being fearful, anxious, restless, or irritable

• Excessive crying

• Big changes in appetite or weight

• Eating or sleeping more or less than usual

• Having trouble remembering, concentrating, or making decisions

• Aggressive or hostile behavior

• Drug or alcohol use

• Causing self-injury (cutting, burning, or bruising oneself on purpose)

You’ve taken your child to a healthcare provider and gotten a diagnosis of depression. What now? Left untreated, depression can cause many problems. It can lead to drug and alcohol abuse and risk-taking behavior. It can make the development of other mental health problems more likely. And it's a risk factor for suicide. But treatment can help. Your child’s healthcare provider may refer your teen to a mentalhealth professional for evaluation and treatment.

The two most common treatments for depression are medicines and talk therapy. Both methods can take a few weeks to start working. But both can work very well and are often used together.

• Medicines for depression are called antidepressants. They affect the balance of certain chemicals in the brain.This helps them return to normal levels. Medicine can be very helpful. But finding the best one for your teen may take time. If medicines are prescribed, follow the instructions carefully. Let your healthcare provider know how your child is doing and whether you see any changes. Never let your teen take more, take less, or stop a medicine on their own without talking with the healthcare provider first. Also, never give your child herbal medicines along with antidepressants without talking with your healthcare provider first.In teens and young adults, antidepressants can sometimes cause increased thoughts of suicide. If this happens, talk with your teen’s healthcare provider right away. Make certain your teen knows that it is unsafe to share the medicines with anyone.

• Talk therapy for depression involves talking with a counselor or other trained professional. Different counselors use different methods for talk therapy. But all therapies aim to help change thoughts and feelings about problems. Therapy is often done one-on-one. But it can also be done in a group with other teens or with other members of the family.

Recovery from any illness takes time. Getting better from depression is no different. While your teen is recovering, here are things that can help them feel better:

• Let your teen know that depression is a serious illness that is not their fault.

• Check your child’s social media activity. Cyberbullying is common and those who experience it report high levels of depression. Sincethey cannot see their abusers, they are more likely to feel alone and helpless.

• Work with your child to develop mutually acceptable electronic media rules. Include a plan for what to do if they are cyberbullied or know someone else who is. Technology is not going away, so think about ways to maximize its benefit and minimize your child’s risks.

• Keep up-to-date on new devices and websites. Talk with your child about sites they are using and check the sites yourself.

• Encourage your child to talk with you and share their feelings.
• Change your schedule so you can spend uninterrupted time with your child. Don't allow electronic devices during this time for either of you.

• Be understanding of your teen. Your teen's behavior may be hard at times, but they are just trying to cope. Your support can make a huge difference.

• Encourage your teen to spend time with friends and loved ones.

• Encourage your teen to exercise regularly. Regular exercise has been shown to help relieve symptoms of depression.

• Keep in mind that helping your child manage this illness affects the entire family. Think about joining a support group for parents and siblings of teens who have depression. Your family healthcare provider and your teen's school counselor should be able to give you a list of online and community resources.

Call the healthcare provider if your teen:

• Has side effects from a medicine

• Has depression that gets worse

• Becomes very aggressive or angry

• Shows signs or talks of hurting themselves (see below)

Depression can fill your child’s head with thoughts so bad that killing themselves can seem like the only choice. If you are worried that your child may be thinking about suicide, don't hesitate to ask your child about it. Asking about suicide does NOT lead to suicide. Suicidal thoughts or actions are not a harmless bid for attention. They are a sign of extreme stress and should not be ignored. If your child becomes more isolated, starts giving possessions away, suddenly acts very happy or relieved, or talks about suicide, act right away! If you know someone who is talking about suicide and is able to carry it out: Don't leave the person alone. Take action.

If your teen is in immediate danger of harming themselves or others, call or text 988. Do not leave them alone. When you call or text 988, you will be connected to trained crisis counselors at the National Suicide Prevention Lifeline. An online chat option is also available at www.suicidepreventionlifeline.org. Lifeline is free and available 24/7.

• National Suicide Prevention Lifeline,  800-273-TALK (800-273-8255), www.suicidepreventionlifeline.org

• National Alliance on Mental Illness, 800-950-6264, www.nami.org

• National Institute of Mental Health, 866-615-6464, www.nimh.nih.gov

• American Academy of Child and Adolescent Psychiatry, 202-966-7300, www.aacap.org