Distinguishing depression from normal adolescent mood swings

Ann MacDonald

Contributor, Harvard Health

Parents often wonder how to distinguish normal teenage mood swings and rebellions from actual symptoms of depression. I asked Dr. Nadja N. Reilly, a member of the editorial board of the Harvard Mental Health Letter, for some advice on this topic.

Dr. Reilly has a particular interest in finding ways to identify and prevent youth depression. A practicing psychologist, she is also the director of the Swensrud Depression Prevention Initiative at Children’s Hospital Boston. This program, named for the family foundation that funds it, provides school-based training and an ongoing curriculum so that participants can incorporate what they’ve learned about depression into a system for monitoring and intervention.

Dr. Reilly recommends that parents and school officials pay attention to three key areas in order to distinguish normal teen angst from something more serious:

Severity. Symptoms of teen depression encompass changes in mood (anger, sadness, irritability), behaviors (sleeping or eating more or less than usual, taking drugs or alcohol, acting out; withdrawing from friends and family), feelings (loneliness, insecurity, apathy), thoughts (hopelessness, worthlessness, thoughts of suicide), and perceptual disturbances (pain, hallucinations). The more pronounced these symptoms, the more likely that the problem is depression and not a passing mood.

Duration. Any notable deterioration in behavior or mood that lasts two weeks or longer, without a break, may indicate major depression.  Children and adolescents can also suffer Dysthymic Disorder, or minor depression.  In this type of presentation, symptoms can appear for more days than not, for at least one year.

Domains. Problems noticed in several areas of a teen’s functioning — at home, in school, and in interactions with friends — may indicate a mood disorder rather than a bad mood related to a particular situation.

You can find more information about how to recognize and prevent depression in youths through the following organizations:

The Swensrud Depression Prevention Initiative at Children’s Hospital Boston;

Adolescent Wellness, Inc., a nonprofit organization, offers information about school curricula developed by clinicians at Children’s Hospital Boston and McLean Hospital; and

The School Psychiatry Program at Massachusetts General Hospital provides online links to a variety of screening tools and advice about various psychiatric problems.


  1. Godlove

    very helpful article as i once had depression.

  2. Jack

    Sometimes we don’t notice it, but most cases of depression in teenagers are from break ups or rejection from someone. The main factor that leads us to think that there could be some other reason is that we just can’t believe how a so very young person could be suffering from love troubles, but each day younger people are involving sentimentally with someone else and breaking up too. The difference is that they are young and don’t want to talk about their problems and stay shut, sometimes because of they are afraid their parents would know about it. In my blog, which is intended for helping depressed people looking for sad quotes which express their feelings, I can see each day younger people is visiting it. Of course they are welcome and I hope we can help them with their problems, but sometimes I’ve been surprised to know that 80 percent or more of the visitors are younger than 16 years old. This should be a main factor to give depression treatment to a teenager, or even pre-adolescent ones.

  3. LeQuan

    Thanks a lot for this article, I was having some trouble trying to understand if my son, LeQuan’s behavior was something more serious then what it really was, He got caught with a gun at school, and stealing money from a register at work. I didn’t bring up no dummy and dis article made me realize that I need to get this boy some help before his life turns to the streets for good SMH

  4. Anonymous

    Thoughtful article, all parents should watch out for this, as Depression in teenage years can lead to later episodes if not treated correctly. One thing to watch out for is complete Apathy “can’t be bothered”. That is not normal behaviour if it is a permanent feature and not just the normal ups and downs of teenage years. Also be VERY careful about any anti-depressants for teenagers as they now have warnings that they have a much higher suicide rate than older people as their brains are not fully developed. I really recommend trying a natural approach first, it can be just as effective it just doesn’t make any money for the big companies!

  5. copingdepression

    thanks for the article. some teenagers are misunderstood. if they listen to metal or stay in their room the whole time then they are depressed. if they’re out with friends then they are rebelling. teenagers can be confusing but they are quite easy to understand.

  6. How To Overcome Depression

    Great post! Very informative and educational. I love this site I too have a blog trying help others with depression and I have learned so much from reading these posts!
    My sister and younger brother went through this when they were teens and it’s true parents get so darn busy they don’t pick up on this stuff. Thanks for helping!
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  7. Lee Mainprize

    I was a teen being bullied and its only now 20 years later I realise I was depressed, yet I want to the doctors and they didn’t pick this up. Great points and with busy parenting lives, it can easy to miss the subtle signs that are important to spot early on.


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  8. mind power school dude

    Well-informed post, Ann. And yes, depression or prolonged sadness is actually quite common in the United States, around 9.5 percent of the American population actually suffer from this illness, however, not all of them get to be treated, thus, depression and its ill-effects continue to be a burden to some individuals. This illness may seem quite simple to treat but in reality, it takes more than a little cheering up to actually cure depression. Constant visits to a cognitive behavior therapist is a must as well as taking all the prescribed medicines that the doctor will ask the patient to take – none of these exactly come cheap, but the amount of suffering that a person is going through because of depression is enough reason already for others to start taking notice and face depression head on.

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  9. Moshe Sharon

    When we hear about “depression” we associate this word with mental illness. However, contrary to what the drug peddling psychiatrists say about it, depression is not an illness; it’s a human condition. It’s the opposite of joy, so it is part of an emotional spectrum with extremes at both ends. Morever, when we look at the buzz words dealing with depression in the realm of popular psychology such as, “self esteem”, “self worth”, “self image”, “self love”, “self Loathing”, etc., we can get that this entire area of study is about ego-centrism. There is no room in this private domain for anyone else. Moreover, the way our society deals with this subject as a whole even encourages narcissism. Therefore, barring any chemical or hormonal imbalances which doctors can correct, the person suffering from chronic bouts of depression needs to focus on the needs of others. The best therapy is a program that encourages people to be more altruistic and less self-centered.

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  10. Wade Cockfield

    Many parents had difficulty detecting depression in teens because it can look very different from depression in adults. Irritability, overreaction to criticism and unexplained pains are some of the symptoms that teens exhibit while are usually absent in adult depression. Dr. Reilly’s three points should serve as a guide for parents and not base their assessment from adult experience and observations.

  11. Alex

    Yes, teenagers tend to dramatize too much and overly attentive parents take every dramatic moment as depressive period.
    A good parent can however, say something to the kid and notice whether he is just sad or if he is depressed.
    But the best indicators I think are duration and physical symptoms.

  12. John Schinnerer Ph.D.

    Thank you for posting such an important article. I agree with your points 100%. Lately, I have seen several adolescents (whom I consider to be depressed) who show depressive symptoms only in one environment (normally at home with a ‘better’ mood at school). Any thoughts?
    Thank you again!

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