3 Unexpected Ways Depression Shows Up in Teens

Recognize the patterns you may be missing to get help for your depressed teen.

Posted Mar 25, 2021 | Reviewed by Chloe Williams

  • Depression often looks strikingly different in adolescents than in adults, which can make it difficult for parents to pick up on signs of depression.
  • Anger is one of the first signs of depression in adolescents, according to research, which often appears as intense outbursts and presents a change from previous behavior.
  • Depression may also manifest as physical symptoms without underlying causes, such as complaints of headaches or stomach pain.
  • Adolescents who are depressed may demonstrate a sudden shift in their interests or academic and social functioning.

Depression is a leading cause of disability across the globe, but it impacts adults and children in very different ways. Adolescents often manifest depression strikingly dissimilar to adults, which can create barriers to recognizing and treating the underlying causes of their behaviors. Although mental illness is diverse and unique to each individual, there are some unique ways that adolescents will reflect depression:

1) Anger

Depression has been overtaken by the mainstream and is typically represented by a glum, despondent affect, paired with isolation and withdrawal. Most people can easily recognize when someone’s countenance starts to alter and they become noticeably saddened and dispirited. One of the more unexpected ways that teens can experience depression is in anger.   

Hormones and adolescent development can certainly predispose teens to increased bouts of anger and unpredictable behaviors. However, an increase in anger outbursts—often including yelling, throwing things, losing control of behaviors—that steadily rises and is in direct contrast to previous behavioral baselines can be an indicator of depression for teenagers. Initially, much research in this area pointed to an inward expression of anger in depression; however, modern science and field work are showing increasingly more episodes of adolescents experiencing anger as one of the first symptoms of depression.

This does not equate to an assumption that every angry adolescent is depressed. Anger related to depression is a symptom that presents as more intense, can be observed to have been steadily building over time, and is markedly different from prior behaviors. Most teens who experience depression and manifest this in angry outbursts typically feel remorse afterwards, which can increase feelings of guilt and their depressive cycle.

2) Physical Symptoms

Physical symptomology should be explored with the relevant professional, but when there is no underlying cause determined, it can be an outward manifestation of mental health issues. Untreated depression in adults has been shown to eventually lead to health issues, but in teenagers, this can be one of the first signs they are struggling with depression.

Abnormal psychosomatic symptoms without underlying physical causes are easily related to depression in teens. Complaints of headaches, stomach pain, gastrointestinal issues, and other aches can be an outward expression of their inward turmoil. Some studies have shown a link between psychosomatic complaints in adolescence and mental health symptoms in early adulthood as well, underscoring the importance of recognizing and addressing these concerns. Teens who struggle to put into words what they are experiencing, those ill-equipped to cope with mental health issues, and adolescents without sufficient support systems are just a portion of kids at risk for increased psychosomatic issues.

After ruling out any potential medical concerns, it is vital that youth and their parents look for a deeper cause when psychosomatic issues are present. These aches and pains will feel very real to teens and need to be addressed holistically, as opposed to in isolation. An awareness of potential underlying issues can bring relief to adolescents and their parents/caregivers in addition to helping them proactively cope with any developing mental health problems.

Source: Pixabay

3) Marked changes in activity 

Adults often withdraw from others in classic depression symptomology, which can further increase their feelings of isolation and exacerbate their struggles. Adolescents, who typically function most often in group and social settings, may demonstrate a remarkable and more sudden change in their interpersonal, academic, and social functioning if depressed.

Because the nature of adolescence involves personality development and a quest for independence, it is natural for youth in this developmental stage to seek new and different activities. Interests that were once all-encompassing can be traded for something novel, and much of the time this is a typical period of “growing up.” 

It can become more concerning, and a potential symptom of a deeper underlying issue, when it is markedly different across many domains. For example, a teenager who always excelled in school suddenly starts failing classes and withdraws from extracurricular activities at the same time – or an adolescent who has been dedicated to working with horses and engaged in clubs promoting this interest abruptly fizzles out and stops attending or caretaking their animals.

Every youth is different, so marked changes in activity must be viewed through the lens of that particular teen. The more worrisome indications will usually involve drastic transformations in more than one area of a teen’s life. Some change in interest is typical during these formative years, but consistent and unmistakable modifications are warning signals that need to be addressed. 

The overall picture of depression in adolescents is understandably daunting to parents and youth alike. During a time that is already fairly unstable, and fraught with new experiences and never before felt emotions, youth can feel completely lost and incapable of accessing help if depression is added to their plate. It is invaluable for parents and caregivers to be in tune with their children and cognizant of what may appear to be minor changes in isolation, but when combined, take on a deeper meaning. 

Obtaining help is the most important step after recognizing warning signs. Caregivers and youth who are on the lookout for more “classic” symptomology (withdrawal, subdued mood, sleep disturbances, etc.) may miss the distress signals happening right in front of them. The key to managing mental health issues in all ages is awareness, and this is glaringly true for teens – although the complex nature of adolescence in general will certainly muddy the waters.

Know yourself is a wise proverb – but teens are in the process of learning who they are, so this is not a fail-safe fallback for managing their mental wellbeing. They need someone to help monitor changes, check in with them routinely and in a supportive way, and be ready to get help when required. A basic awareness of “out of the box” manifestations of depression can be the first step to saving lives.


GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet. DOI.

Kinnunen, P., Laukkanen, E., and Kylma, Jari. Associations between psychosomatic symptoms in adolescence and mental health symptoms in early adulthood. International Journal of Nursing Practice. 2010 Feb;16(1):43-50. doi: 10.1111/j.1440-172X.2009.01782.x.