Depression is by far the most common and important emotional health problem in the western world today – so common, in fact, that it might almost be compared with the common cold. Not only does it affect adults, but also children and adolescents, often with greater intensity.

Clinical or major depression is a very serious problem and should be treated as such. Clinical depression is more than a temporary emotional slump. It involves a persistent – lasting two weeks or longer – and usually disruptive disturbance of mood and often affects other bodily functions as well. Here’s a list of the most prominent characteristics of the condition:

• Persistent sadness and/or irritability. This may include mood swings that seem out of proportion to the circumstances; episodes of moping and crying; withdrawal and isolation; fatigue and loss of enthusiasm or interest in favorite activities; poor school performance; and outbursts of anger and overt acting out.
• Painful thoughts that manifest themselves in relentless introspection, a negative self-concept, persistent anxiety and a sense of hopelessness.
• Physical symptoms such as insomnia, changes in appetite, headaches, dizziness, nausea, heart palpitations, abdominal cramps and episodes of shortness of breath
• In rare cases, a severe case of depression may also involve delusional thinking, including visual and auditory hallucinations. This is not merely depression but a form of psychosis, a serious disorder of neurochemical functions in the brain.

As you might expect, the causes of depression can be extremely complex, including a blend of genetic, biochemical, personal, family and spiritual factors. In teens, you can expect to see clinical depression unfold in three successive stages:

• Stage one: Inability to concentrate, withdrawal from friends, impulsive acts and declining academic performance. If you see these symptoms, encourage your son to talk openly and honestly with you. Tell him you’re concerned about what you see and want him to avoid further troubles.
• Stage two: Acts of aggression, rapid mood swings, loss of friends, mild rebellion and sudden changes in personality. If you see a pattern of this sort, seek outside assistance immediately from a trusted youth pastor or counselor.
• Stage three: Overt rebellion, visible depression, extreme fatigue, giving away prized possessions, expressions of hopelessness, and suicidal threats or gestures. These symptoms mean trouble. Get professional help right away. If your son is clinically depressed, he cannot pull himself out of it. He may need to be evaluated for hospitalization. Medication may also be necessary.

As you are apparently aware, many of the unique aspects of depression among young people also increase the risk of suicide. In particular, the intensity of their emotions and a shortage of life experiences may give rise to impulsive self-destructive behavior. You should be especially concerned about this possibility if any of the following predictors of suicide are present:

• A previous suicide attempt.
• A family history of suicide.
• Expressions of intense guilt or hopelessness.
• Threatening, talking or joking about suicide.
• “Cleaning house” – i.e., a sudden impulse to give away personal possessions.
• Suicide among other adolescents in your community.
• A sudden, major loss or humiliation. Parents should be on the alert to ensure that their child is not the victim of either physical or social bullying.

As we’ve already said, if you have reason to suspect that your adolescent might be seriously depressed or suicidal, seek appropriate help immediately. You may want to contact your physician for advice or a referral.

We also recommend that you seek professional counseling for your teen and the entire family without delay.+27 31 716 3300. Focus on the Family’s Counselling department can provide you with a list of qualified Christian therapists in your area who specialise in dealing with problems of this nature. Our counselors will also be happy to discuss your situation with you over the phone.

© 2010 Focus on the Family. Adapted from The Complete Book of Baby and Child Care, a Focus on the Family resource published by Tyndale House Publishers. © 1997, 2007 Focus on the Family.