Why they are more vulnerable than #boys, and what signs and symptoms you should look for

Writer: Ron J. Steingard, MD

Clinical Expert: Ron J. Steingard, MD

What You'll Learn

- What does #depression look like in #teenage #girls?

- What does #anxiety look like in #teenage #girls?

- What treatments are available for #teenage #girls with #mooddisorders?

- Quick Read

- Full Article

- Symptoms of #depression in #teenagers

- Symptoms of #anxiety

- Why early intervention is critical

- Other disorders

- Treatments for #anxiety and #depression

#Kids of any #gender can experience #depression and #anxiety. But by the #teenage years, #girls are much more likely to be diagnosed with those #mooddisorders. Experts don’t know for sure why this is, but it could be because #girls sometimes gain emotional maturity more quickly and may be more emotionally sensitive.

An early sign of both #depression and #anxiety is withdrawing from things they usually enjoy. You might notice other changes in your daughter’s mood, like sadness or irritability. #Girls dealing with #depression may start eating or sleeping much more or much less. They may start doing worse in #school. #Girls with #anxiety often structure their lives around avoiding things that they’re afraid of, like new activities or social situations. If you notice any of these signs getting in the way of your daughter’s daily life and not going away over time, she may have a #mooddisorder.

If you think your daughter may have #depression or #anxiety, it’s important to get her help early. Over time, #mooddisorders can have negative impacts on friendships and academic success. Sometimes the same symptoms can also be signs of a different #mentalhealthchallenge, like an #eatingdisorder, #self-harm or #druguse.

A #mentalhealthprofessional can help you figure out what is going on. For #depression and #anxiety, the most common treatment is a therapy called #cognitivebehavioraltherapy (#CBT). #CBT can help #teenagers recognize and change negative thought patterns. It is often very effective for both #depression and #anxiety. Sometimes antidepressant medication is also prescribed alongside therapy.

#Anxiety and #depression occur in both #genders, but by the #teenage years, #girls are much more at risk than #boys. Before puberty, the prevalence of #mooddisorders is about the same in #boys and #girls—3 to 5 percent. But by mid-#adolescence #girls are more than twice as likely to be diagnosed with a #mooddisorder as #boys, with the prevalence at #adult levels, 14 to 20 percent.

Why such a big disparity in #mooddisorders? We know from looking at brain scans that there are differences in the way #girls and #boys process emotional stimuli. #Girls mature, in terms of their emotional recognition, faster than #boys—and that sensitivity could make them more vulnerable to depression and #anxiety.

It’s plausible that that these #gender differences around the time of puberty can be traced to evolutionary advantages: #Girls may be wired to tune in earlier to emotional stimuli because it was advantageous for nurturing babies; for young #men, given their roles as hunters and tribe protectors, emotional responsiveness might have been an important attribute not to have.

The argument that the differences in emotional sensitivity are hard-wired is underscored by the fact that even as women’s lives have clearly changed—with many more #women living professional, competitive, Type-A lives—the rate of #depression hasn’t dropped. Even the participation of far more #girls in #sports and other intense physical activities hasn’t reduced the rate of #depression, though physical activity is important to emotional wellbeing, and one effective way to help jumpstart recovery in someone who’s depressed.

Symptoms of #depression in #teenagers

In #adolescent #depression, the thing people tend to notice first is withdrawal, or when the #teenager stops doing things she usually likes to do. There might be other changes in her mood, including sadness or irritability. Or in her #behavior, including, appetite, energy level, sleep patterns and academic performance. If several of these symptoms are present, be vigilant about the possibility of #depression.

This is especially important because by the time family members and other people around a #teenager note her lack of interest in most things, or what we call #anhedonia, she’s usually been depressed for some time. #Depression is an internalizing disorder, i.e. one that disturbs a patient’s emotional life, rather than an externalizing one, which manifests in the form of disruptive or problematic #behavior. As such, it takes a while not only for others to recognize it, but often for the #patient herself to realize that her thinking, and emotional responses, are disturbed.

Note that there are actually two kinds of #depression. In major depressive disorder—the most familiar form of #depression—the cluster of symptoms that define #depression occur in what may be severe episodes that tend to last from seven to nine months. But there is also another form of #depression called #dysthymicdisorder, in which the symptoms are milder, but they last longer, measured in years. So while the experience of #dysthymia may be less debilitating for the #child at any given moment, the risk is that there is more accrued damage, more time in which the #child is kept out of the healthy development process.

Symptoms of #anxiety

#Anxiety is a normal adaptive system that lets the body know when it’s in danger. But #anxiety becomes a problem when it’s out of proportion to the situation, and interferes with a person’s ability to function. An overly anxious #teen might withdraw from activities because she’s too scared or anxious, and her #anxiety doesn’t go away with reassurance.

A #teenager who has been anxious since #childhood may have a lifestyle built around her anxieties: the activities and environments she chooses and those she rules out, the friends she is comfortable with, the expectations and limitations she has trained her family, friends, and #teachers to accept. That’s why it’s more challenging to treat #anxiety the longer a #child has lived with it, and developed unhealthy coping mechanisms to manage it.

Why early intervention is critical

When a #child is depressed or anxious, her suffering isn’t the only reason it’s important to get help.

In addition to the disorders themselves, there are add-on effects that may cause lifelong issues. With #depression comes low energy and poor concentration, two factors that are likely to have a significant impact on social and academic functioning. #Anxiety, and the withdrawal that may accompany it, is likewise a detriment to social and academic progress.

It’s easy to see the effects of poor academic functioning: falling behind in #school undermines a child’s confidence and #self-image, and can impact her future if it’s prolonged. But social learning is just as critical as academic learning in #childhood and #adolescence. This is a time when a #girl would normally be learning such things as how to be a daughter, a sister, a friend; with either #depression or #anxiety, she may miss or fall behind on these critical kinds of learning. These deficits not only put her behind her peers, but in themselves they can compound her #depression or #anxiety.

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Other disorders

It’s important to understand that #anxiety and #depression often occur in the same #teenager, and may need to be treated as two separate disorders. #Anxiety is more likely to occur without #depression than #depression without #anxiety. It may be that depression leads to #anxiety—the negative state of mind of a depressed #teenager lends itself to uncertainty. If you’re not feeling good about yourself, or confident, or secure, or safe, #anxiety may find fertile ground. It may also be because the regions of the brain affected by #anxiety and #depression are close together, and mutually affected.

Two serious problems that are directly associated with #teenage #depression and #anxiety are suicidal thinking (or #behavior), and #substanceabuse. #Suicide is the third leading cause of death among #adolescents and young #adults aged 15 to 24, and we know that most #kids who commit #suicide have been suffering from a psychiatric illness. Especially at risk are #teenagers who hide their #depression and anxiety from #parents and friends. That’s why it’s important to be alert to signs of these disorders—withdrawal, changes in #school performance, eating habits, sleeping patterns, things she enjoys doing—even when #teenagers aren’t forthcoming about how they feel. Similarly, the majority of #teenagers who develop #substanceabuse problems also have a #psychiatricdisorder, including, most commonly, #anxiety or #depression, which is another important reason to get treatment in a timely way.

Two other problems associated with #teenage #girls—that is, occurring with greater frequency in #girls than #boys—are #eatingdisorders and #selfinjury, or cutting. While both of these can overlap with #depression, the common assumption that they’re caused by #depression is not borne out by research. #Girls who have #eatingdisorders often show no signs of #depression; indeed, they are often very high-functioning, competitive #girls who have a distorted body image, but not the symptoms of #depression. Similarly, self-injurious #behavior is a kind of dysfunctional coping mechanism #kids get into to alleviate emotional pain, or numbness they’ve developed as a result of that pain. It can occur with, and be complicated by, a #mooddisorder, but isn’t thought to be a result of the latter. #Antidepressants, the medication of choice for #mooddisorders, don’t usually alleviate eating disorders or cutting, which receive different kinds of treatment.

Treatments for #anxiety and #depression

Fortunately, early involvement of #healthcareprofessionals can shorten the period of illness and increase the likelihood of her not missing important life lessons.

The most common treatment a #mentalhealthprofessional is apt to use is some form of #cognitivebehavioraltherapy, and depending on how young the #child is, it may involve teaching the #parents as well. #Cognitivebehavioraltherapy is based on the idea that a person suffering from a #mooddisorder is trapped in a negative pattern of thought. Depressed #kids tend to evaluate themselves negatively, interpret the actions of others in a negative way, and assume the darkest possible outcome of events. Similarly, a #child suffering from #anxiety is overwhelmed by fears of negative outcomes long before events occur. In #CBT, we teach sufferers to challenge those negative thoughts, to recognize the pattern and train themselves to think outside it. And in many cases we see real improvement in #teenagers with #depression and #anxiety.

If the #anxiety or #depression is moderate to severe, treatment may involve medications such as antidepressants. For both #anxiety and #depression, a combination of psychotherapy and medication usually works better than either alone.
https://standingabovethecrowd.com/2023/07/jamesdonaldson-on-mentalhealth-mooddisorders-and-teenage-girls/