Depression and Anxiety in Teenagers | Social & emotional signs

Adolescent mental health is a major concern in the UK, with statistics from the NHS estimating that 20.3% of 8- to 16-year-olds in England had a likely mental health disorder in 2023. Adolescence is a critical period of development and is marked by rapid physical, emotional and social changes. During adolescence, teenagers face a number of pressures that can affect their mental health, including the hormonal changes associated with puberty, increased academic expectations, changing social dynamics, social difficulties and personal identity struggles.

Adolescence is the most common age of onset for mental health conditions and the Mental Health Foundation estimates that 50% of mental health difficulties manifest before the age of 14 and 75% manifest before the age of 24. It is, therefore, vital to recognise and address mental health difficulties, including depression and anxiety, as quickly as possible. Mental health difficulties can have a profound impact on a teenager’s overall well-being and affect their academic performance, relationships and quality of life.

There is a rising concern about mental health issues in adolescents. Untreated mental health difficulties in adolescence can have life-long consequences for a young person and can result in more severe long-term mental health difficulties that affect many areas of a person’s life. Early identification and intervention are essential, as they can significantly improve outcomes and help teenagers build resilience and coping skills. By being attentive to the signs and symptoms of depression and anxiety, adolescents can receive the necessary support and treatment to help them manage their mental health difficulties.

Understanding Teenage Depression and Anxiety

Depression and anxiety are prevalent mental health difficulties that can affect adolescents from all backgrounds. Depression in teenagers is characterised by persistent feelings of sadness, hopelessness and a lack of interest in activities they once enjoyed. Anxiety, on the other hand, involves excessive worry, fear and nervousness that can interfere with daily functioning. Both depression and anxiety can lead to significant emotional and behavioural changes and impact a teenager’s ability to cope with the demands of everyday life. Depression and anxiety can occur due to a complex interplay of genetic, biological and psychological factors. For teenagers, the pressures of academic performance, social relationships and the developmental transitions they are undergoing can act as significant stressors, contributing to the onset or exacerbation of these mental health issues.

Depression in adolescents is more than just a temporary bout of sadness or a reaction to life’s challenges. It can affect every aspect of a teenager’s life, including their emotional well-being, physical health and overall functioning. It can interfere with their ability to perform in school, participate in extracurricular activities and maintain healthy relationships with family and peers. Adolescents with depression may struggle to find motivation or pleasure in daily activities and can experience profound impacts on their self-esteem and outlook on life.

Anxiety disorders in adolescents are characterised by excessive fear or worry that is disproportionate to the situation at hand. These fears can be related to various aspects of life, such as academic performance, social interactions or future events. Anxiety can be pervasive and debilitating, affecting teenagers’ ability to participate fully in school, social activities and family life. Adolescents with anxiety may avoid certain situations or activities to manage their fears, which can lead to further isolation and impact their development and well-being.

Both depression and anxiety can have long-term effects on a teenager’s development. They can impair cognitive functions such as concentration, decision-making and memory, which are crucial during the formative years of education and personal growth. These conditions can also affect physical health, leading to issues such as chronic fatigue, sleep disturbances and a weakened immune system. Socially, teenagers may withdraw from interactions, which can lead to loneliness, social isolation and increased stress.

Awareness and early intervention are essential as recognising the symptoms early allows for earlier support and treatment, which can prevent mental health conditions from worsening. Mental health awareness among parents, teachers and peers is essential, as they are often the first to notice changes in a teenager’s behaviour. Early intervention, which may include therapy, counselling and support groups, can help teenagers develop healthy coping mechanisms, improve their emotional regulation and enhance their overall well-being.

By addressing mental health issues earlier, teenagers can be given the tools they need to manage their mental health effectively and lead fulfilling lives. Schools, families and communities play a vital role in creating supportive environments that encourage open conversations about mental health, reduce stigma and provide access to resources and professional help.

Emotional Signs

Recognising the emotional signs of depression and anxiety in teenagers is important for early intervention and support. These signs often manifest in various ways and understanding them can help caregivers and educators identify when an adolescent might be struggling with their mental health.

Some of the emotional signs of depression and anxiety in adolescence include:

Persistent sadness: Teenagers with depression often feel an overwhelming sense of sadness that does not go away. This sadness can persist for weeks or months and impact their overall outlook on life. They might cry frequently or feel empty and unable to find joy in activities they previously enjoyed.
Irritability: Unlike adults, teenagers with depression may not always appear sad. Instead, they may become easily irritated or frustrated. This irritability can lead to frequent arguments with family and friends, as well as difficulty handling minor annoyances.
Mood swings: Sudden and unexplained changes in mood can be a sign of emotional distress. Teenagers may shift from being very happy to very sad or angry without any apparent reason. These mood swings can be confusing and distressing for both the teenager and those around them.
Feelings of hopelessness: A common emotional sign of depression is a persistent sense of hopelessness or helplessness. Teenagers might express a bleak outlook on the future, feeling that things will never improve or that their situation is beyond their control.
Difficulties articulating emotions: Teenagers often struggle to express their emotions verbally. They might not have the vocabulary or the confidence to talk about their feelings which can lead to frustration and further emotional turmoil. This can result in withdrawal, increased emotional difficulties and outbursts of anger and frustration.
Low self-esteem: Depressed teenagers often have low self-esteem and feelings of worthlessness. They may be overly critical of themselves, focus on their perceived failures and believe that they are not good enough. This can severely impact their motivation and engagement in daily activities.
Excessive guilt: Feeling guilty about things that are not their fault or feeling that they are a burden to others can be a sign of depression and anxiety. This guilt can exacerbate feelings of sadness and worthlessness.
Anxiety and worry: For teenagers with anxiety, excessive worry about various aspects of their lives, such as school performance, social interactions or future events, is common. This worry can be all-consuming and lead to constant stress and fear.

Understanding these emotional signs is important because teenagers often do not have the experience or emotional tools to articulate what they are going through. By recognising these signs, caregivers, teachers and peers can provide the necessary support and encourage teenagers to seek professional help if needed. Early intervention can significantly improve their emotional health and overall well-being.

Behavioural Signs

Being able to identify the behavioural signs associated with poor mental health is essential for recognising the signs and symptoms of depression and anxiety in teenagers. These signs can manifest in various ways and often indicate underlying emotional distress.

Some of the behavioural signs of depression and anxiety in adolescents include:

Changes in sleep patterns

One of the most noticeable behavioural signs of depression and anxiety is a disruption in sleep patterns. This can include:

Insomnia: Difficulty falling asleep, staying asleep or waking up too early and being unable to go back to sleep.
Oversleeping: Some teenagers may sleep excessively, using sleep as an escape from their emotional pain. They may struggle to wake up in the morning and feel tired throughout the day despite getting what seems like adequate rest.

Appetite changes

Depression and anxiety can significantly affect a teenager’s eating habits:

Loss of appetite: Some teenagers may lose interest in food, leading to noticeable weight loss and nutritional deficiencies.
Increased appetite: Others may turn to food for comfort which can result in overeating and potential weight gain. Both extremes can be harmful and signify underlying mental health issues.

Decreased interest in previously enjoyed activities

A marked decrease in interest or pleasure in activities that were once enjoyable is a common behavioural sign. This can include:

Hobbies and sports: Teenagers might stop participating in hobbies, sports or other activities they used to love.
Social withdrawal: They may isolate themselves from friends and family, avoid social interactions and prefer to spend time alone.
School activities: There might be a noticeable drop in engagement with school-related activities, including clubs, sports and school events.

Changes in academic performance

Depression and anxiety can impact a teenager’s ability to concentrate, remember information and complete tasks. This often leads to:

Declining grades: A sudden or gradual drop in academic performance.
Incomplete assignments: Failing to complete homework or projects on time.
Frequent absences: Increased absences from school, sometimes due to a lack of motivation or fear of social interactions.

Physical agitation or slowness

Behavioural changes can also include noticeable physical symptoms, such as:

Agitation: Restlessness, fidgeting or an inability to sit still (sometimes known as psychomotor agitation).
Slowed thoughts and physical movement: Moving or speaking more slowly than usual, a sign often associated with severe depression (also known as psychomotor retardation).

Risky or reckless behaviour

Some teenagers may engage in risky or reckless behaviours as a way to cope with their emotions or as a cry for help. This can include:

Substance abuse: Using drugs or alcohol to self-medicate.
Self-harm: Engaging in self-harm behaviours, such as cutting or burning.
Impulsivity: Making hasty decisions without considering the consequences, such as running away from home or engaging in unsafe sexual practices.

Avoidance of responsibilities

Depression and anxiety can lead to a lack of motivation and interest in everyday responsibilities, for example:

Neglecting personal hygiene: A noticeable decline in grooming and personal care.
Avoiding chores or tasks: Ignoring household chores, school assignments or other responsibilities.

Recognising these behavioural signs is vital for early intervention. When teenagers exhibit such changes, it is important for caregivers, teachers and peers to approach the situation with empathy and support. Encouraging open communication and seeking professional help can make a significant difference to a teenager’s mental health and overall quality of life.

Depression and anxiety can have profound effects on a teenager’s social interactions and academic performance. These impacts can further exacerbate their mental health issues and create a negative cycle. Understanding these signs can help in identifying and supporting teenagers who are struggling.

Social and academic signs of depression and anxiety in adolescents include:

Social withdrawal: Teenagers with depression or anxiety often withdraw from social interactions. They may avoid spending time with friends and family, preferring to be alone. This isolation can stem from feelings of worthlessness, fear of judgement or simply a lack of energy to engage socially.
Avoidance of social activities: Activities that once brought joy and excitement may no longer interest them. They might skip extracurricular activities, clubs or social events they used to participate in regularly. This avoidance can lead to increased feelings of loneliness and exclusion.
Changes in communication: Depressed or anxious teenagers might communicate less frequently or less openly. They may become quieter, more reserved or exhibit changes in how they interact with others, such as becoming more irritable or easily frustrated in conversations.
Fear of social situations: Anxiety, particularly social anxiety, can make everyday interactions overwhelming. Teenagers might fear speaking in class, attending parties or even interacting with peers during school breaks. This fear can lead to significant avoidance behaviours.

Academic Signs

Decline in academic performance: Depression and anxiety can severely impact a teenager’s ability to perform academically. This can result in lower grades, missed assignments and a general decline in academic achievement. The lack of motivation and energy often associated with these conditions can make it difficult for teenagers to keep up with their studies.
Difficulties concentrating: Both depression and anxiety can impair concentration and focus. Teenagers might find it hard to pay attention in class, follow instructions or stay engaged with their coursework. This can lead to incomplete assignments and poor test performance.
Procrastination and incompletion of work: Struggling with these mental health issues can cause teenagers to procrastinate, often because they feel overwhelmed by their tasks. This can result in a backlog of incomplete work and increasing stress levels.
Frequent absences: Teenagers dealing with depression or anxiety might frequently miss school. They may feel too exhausted or unmotivated to attend or they might avoid school to escape social interactions or academic pressures.
Decreased participation in class: Previously active students may become disengaged and stop participating in class discussions or activities. Their relationships with teachers may also decline. This withdrawal can be a response to feeling overwhelmed, anxious or uninterested.

Understanding these signs is important for parents, teachers and peers to provide timely and effective support. Open communication, a supportive environment and professional help are key to helping teenagers navigate these challenges and improve their mental health and overall well-being.

Physical Signs

In addition to the emotional and behavioural symptoms, depression and anxiety can also manifest in various physical signs. These physical symptoms are often overlooked or attributed to other causes, but they can be indicative of underlying mental health issues. Recognising these signs is essential for identifying and supporting teenagers who may be struggling with depression or anxiety.

Some of the most common physical signs of depression and anxiety in teenagers are:

Headaches and migraines: Chronic headaches or migraines are common physical symptoms of depression and anxiety in teenagers. These headaches may be tension-related or migraine-like in nature and can significantly impact the teenager’s ability to concentrate and function normally.
Stomach aches and digestive issues: Digestive problems such as stomach aches, nausea, diarrhoea or constipation can occur as a result of heightened stress and anxiety. The gut-brain connection means that emotional distress can manifest physically in the form of gastrointestinal symptoms.
Fatigue and low energy: Feeling constantly tired, fatigued or lacking energy is a common physical symptom of depression. Teenagers may struggle to get out of bed in the morning, feel exhausted even after a full night’s sleep or find it challenging to complete daily tasks due to low energy levels.
Changes in weight: Depression and anxiety can affect appetite and eating habits and lead to fluctuations in weight. Some teenagers may experience a significant decrease in appetite, resulting in weight loss and malnutrition. Others may turn to food for comfort, leading to overeating and weight gain. These changes in weight can be drastic and noticeable over a relatively short period.
Muscle aches and tension: Chronic muscle tension, body aches and pains are physical manifestations of stress and anxiety. Teenagers may experience tension in their neck, shoulders, back or jaw, leading to discomfort and stiffness. This physical tension can exacerbate feelings of stress and contribute to a cycle of pain and discomfort.
Sleep disturbances: As mentioned earlier, changes in sleep patterns are common symptoms of depression and anxiety. Teenagers may experience difficulty falling asleep, staying asleep or waking up too early and being unable to go back to sleep. These sleep disturbances can further exacerbate feelings of fatigue and low energy during the day.
Dizziness and light-headedness: Feeling dizzy or light-headed can occur as a result of heightened anxiety or panic attacks. These physical sensations may be accompanied by a rapid heartbeat, sweating, trembling or shortness of breath and can contribute to feelings of anxiety, distress and discomfort.
Physical health complaints: Teenagers with depression or anxiety may frequently visit the school nurse or complain of vague physical symptoms such as headaches, stomach aches or fatigue. While these complaints may seem unrelated to mental health at first, they can be a manifestation of underlying emotional distress.
Increased heart rate: Anxiety can trigger the body’s fight or flight response and lead to an increased heart rate or palpitations. Teenagers may experience a racing heart, chest tightness or sensations of fluttering or pounding in the chest during times of heightened stress or anxiety.
Shortness of breath: Difficulty breathing or a sensation of being unable to catch one’s breath can occur during panic attacks or periods of intense anxiety. This symptom can be distressing and may exacerbate feelings of anxiety and fear.
Sweating: Excessive sweating, especially in situations that do not warrant it, can be a physical manifestation of anxiety. Teenagers may experience sweaty palms, underarm sweat or profuse sweating during anxiety-provoking situations.
Trembling or shaking: Trembling or shaking of the hands, legs or other parts of the body can occur as a result of heightened anxiety. This physical symptom may be noticeable to others and can contribute to feelings of embarrassment or self-consciousness.
Dizziness or fainting: Feeling light-headed, dizzy or faint can be a physical response to anxiety or panic. Teenagers may experience sensations of vertigo or instability, which can be particularly alarming during stressful situations.
Gastrointestinal distress: In addition to stomach aches and digestive issues, teenagers with depression and anxiety may experience other gastrointestinal symptoms such as acid reflux, bloating or indigestion. These symptoms can further contribute to discomfort and distress.
Increased sensitivity to pain: Some research suggests that individuals with depression and anxiety may have a lower pain threshold or heightened sensitivity to physical discomfort. This can result in an increased perception of pain, even in response to minor injuries or illnesses.
Changes in appetite or eating habits: While changes in weight were mentioned earlier, it’s important to note that fluctuations in appetite or eating habits can also be physical signs of depression and anxiety. Some teenagers may experience cravings for specific foods, changes in taste preferences or a loss of interest in eating altogether.
Skin problems: Stress and anxiety can impact the skin and lead to various skin problems such as acne, eczema flare-ups or worsening of pre-existing skin conditions. These physical changes can further contribute to feelings of self-consciousness and distress.
Immune system suppression: Prolonged stress and anxiety can weaken the immune system, making teenagers more susceptible to infections and illnesses. They may experience frequent colds, flu-like symptoms or other health issues as a result of compromised immune function.

Recognising these physical signs, alongside the emotional and behavioural symptoms, is essential for identifying and addressing depression and anxiety in teenagers. Caregivers, teachers and teenagers themselves should take these physical symptoms seriously to allow for earlier identification and treatment and appropriate support and intervention, to help teenagers manage their mental health and overall well-being.

Professional Support and Resources

Accessing professional support and resources is essential for helping teenagers effectively manage the symptoms of depression and anxiety. There are multiple different sources that can provide support, including:

Mental Health Professionals:

General practitioners (GPs): GPs can provide initial consultations, assessments and referrals to specialised mental health services.
Child and Adolescent Mental Health Services (CAMHS): CAMHS is a multidisciplinary service providing mental health support for children and young people up to 18 years old. CAMHS teams include child and adolescent psychiatrists and psychologists, nurses, social workers and therapists.
Psychologists and psychotherapists: Psychologists and psychiatrists are mental health professionals who offer therapy and counselling, including cognitive behavioural therapy (CBT), which is often effective for treating depression and anxiety in adolescents.
School counsellors: Some high schools in the UK employ school counsellors who specialise in working with young people and provide support, guidance and referrals to external mental health services.

Crises Helplines:

Childline: 0800 1111: Childline offers a free, confidential helpline that is available 24/7 for children and young people to discuss any issue they are facing. Online counsellors are available for 1-2-1 online chats or via email for young people more comfortable with messaging, rather than talking on the phone.
Samaritans: 116 123: Samaritans provide 24/7 support for anyone in distress, struggling to cope or at risk of suicide. Alternatively, young people can contact Samaritans by email, letter, online chat and face-to-face in some Samaritan branches.
Papyrus HOPELINE247: 0800 068 4141 or text 88247: Papyrus specialises in the prevention of young suicide. They offer confidential support and advice services for young people under 35 who are experiencing thoughts of suicide and for anyone concerned about a young person. Support is available 24/7.
Shout: Text 82858: Shout is a confidential text messaging service that is free and available 24 hours a day. Anyone who is struggling and needs to talk can contact Shout for help and support.

If you or someone you know is in need of urgent help or you are worried about suicide, you should call 999 or go straight to A&E.

Online Resources:

YoungMinds: YoungMinds is the leading charity in the UK for youth mental health. They offer information and advice on mental health, training and resources and mental health support for young people and their parents/carers.
Mind: Mind provides mental health resources and support to people in England and Wales who are experiencing mental health problems, including young people. Mind has been providing mental health support for more than 60 years and offers information and advice, online peer support and mental health tips. They also run Local Minds who support local communities and offer drop-in centres, counselling and befriending.
The Mix: The Mix is the leading online charity in the UK for people under the age of 25. They offer help and support online and via text, email and social media. They also have a helpline, one-to-one chat, crisis messenger service, online support groups and discussion boards.

School and Community Resources:

School mental health services: Many schools offer on-site mental health support through school counsellors or partnerships with local mental health organisations.
Youth clubs and community centres: Organisations such as The Prince’s Trust and local youth clubs often provide mental health support and resources.
Local NHS services: Local NHS trusts provide various mental health services, including counselling and therapy for young people.

Encouraging teenagers and their caregivers to make use of these professional support services and resources can help them to manage depression and anxiety, promote mental health and improve overall well-being. Early intervention and continuous support are necessary for addressing the mental health needs of young people.

Conclusion

Recognising and addressing mental health issues such as depression and anxiety in teenagers is of paramount importance. Adolescence is a critical period of development and mental health challenges during this time can have profound and lasting impacts on a young person’s life. By being aware of the emotional, behavioural, social, academic and physical signs of depression and anxiety, parents, teachers and caregivers can play a vital role in early identification and intervention.

Access to professional support and resources is essential in providing the necessary care and assistance to teenagers struggling with these mental health issues. Whether through mental health professionals, crisis helplines, online resources, support groups or school and community services, there are many ways young people can receive the help and support they need. Utilising these resources can significantly improve the mental health and well-being of teenagers, helping them to overcome any difficulties they face and build resilience.

Ultimately, creating an environment of understanding, empathy and support is essential for supporting adolescent mental health. By breaking the stigma surrounding mental health and encouraging open communication, adolescents will have access to a supportive network that empowers them to seek help and take proactive steps towards supporting their mental health. With the right support and resources, teenagers can overcome the difficulties of depression and anxiety and thrive during this pivotal stage of their lives.

Recognising Signs of Depression and Anxiety in Teenagers

In this article

Understanding Teenage Depression and Anxiety

Emotional Signs