Most teens have periods of "the blues." But what happens when "the blues" persist? Could this be a sign of something more serious? Could it be clinical depression?

Teenagers face a host of pressures, from the changes of puberty to questions about who they are and where they fit in. The natural transition from child to adult can also bring parental conflict as teens start to assert their independence. With all this drama, it isn't always easy to differentiate between depression and normal teenage moodiness. Making things even more complicated, teens with depression do not necessarily appear sad, nor do they always withdraw from others.

Whether the incident of teen depression is actually increasing, or we're just becoming more aware of it, the fact is that depression strikes teenagers far more often than most people think. Unlike adults, who have the ability to seek assistance on their own, teenagers usually must rely on parents, teachers, or other caregivers to recognize their suffering and get them the treatment they need. So if you have an adolescent in your life, it's important to learn what teen depression looks like and what to do if you spot the warning signs.

These are the symptoms and signs of depression in teens:

"¢ Sadness or hopelessness "¢ Irritability, anger, hostility

"¢ Tearfulness; frequent crying

"¢ Withdrawal from friends

"¢ Loss of interest in activities

"¢ Changes in eating and sleeping habits

"¢ Restlessness and agitation

"¢ Feelings of worthlessness and guilt

"¢ Lack of enthusiasm and motivation

"¢ Fatigue or lack of energy

"¢ Difficulty concentrating

"¢ Thoughts of death or suicide

"¢ Excessive sensitivity to criticism

If you're unsure if a teen in your life is depressed or just "being a teenager," consider how long the symptoms have been present, how severe they are, and how different the teen is acting from his or her usual self. While some "growing pains" are to be expected as teenagers grapple with the challenges of growing up, dramatic, long-lasting changes in personality, mood or behavior are red flags of a deeper problem.

An alarming and increasing number of teenagers attempt and succeed at suicide. According to the Centers for Disease Control and Prevention (CDC), suicide is the third leading cause of death for 15 to 24-year-olds. For the overwhelming majority of suicidal teens, depression or another psychological disorder plays a primary role. In depressed teens who also abuse alcohol or drugs, the risk of suicide is even greater.

The first thing you should do if you suspect depression is talk to your teen about it. In a loving and non-judgmental way, share your concerns with your teenager. Let him or her know what specific signs of depression you've noticed and why they worry you. Then encourage your child to open up about what he or she is going through. If your teen claims nothing is wrong, but has no explanation for what is causing the depressed behavior, you should trust your instincts. Remember that denial is a strong emotion. Furthermore, teenagers may not believe that what they're experiencing is the result of depression. If you see depression's warning signs, seek professional help. Neither you nor your teen is qualified to diagnose depression or rule it out, seek out a specialist, such as a clinical social worker. Expect a discussion with the specialist you've chosen about treatment possibilities for your son or daughter. There are a number of treatment options for depression in teenagers, including one-on-one talk therapy, group or family therapy, and medication. Talk therapy is often a good initial treatment for mild to moderate cases of depression. Over the course of therapy, your teen's depression may resolve. If it doesn't, medication may be warranted. However, antidepressants should only be used as part of a broader treatment plan.

As the depressed teenager in your life goes through treatment, the most important thing you can do is to let him or her know that you're there to listen and offer support. Now more than ever, your teenager needs to know that he or she is valued, accepted, and cared for. The road to your depressed child's recovery may be bumpy, so be patient. Rejoice in small victories and prepare for the occasional setback. Most importantly, don't judge yourself or compare your family to others. As long as you're doing the best to get your child the necessary help, you're doing your job.

Glenn Wolff is a licensed clinical social worker with Family Centers. Serving Greenwich, Stamford, Darien, New Canaan and Westchester County, NY, Family Centers is a United Way, New Canaan Community Foundation and Community Fund of Darien partner agency that offers counseling and support programs for children, adults and families. For information, call 203-869-4848 or visit www.familycenters.org.