Q. My 13-year-old daughter has lost interest in things she used to love to do. She doesn’t seem to have much energy. She’s irritable much of the time. Could she be depressed, or is this some sort of phase that girls go through at this age? Should I take her to see a mental health professional?

A. Several symptoms you mention are suggestive of depression. Most of us don’t think about irritability in regard to childhood and adolescent depression, but these age groups often show their depression in irritability. Lack of energy and loss of interest in activities are also common depressive symptoms. You don’t mention other symptoms, but here are some: loss of appetite, weight loss, sleeping too much or too little, feelings of worthlessness, too much or inappropriate guilt, inability to concentrate, indecisiveness and recurrent thoughts around dying.

Of course, your daughter doesn’t have to have all these symptoms for a mental health professional to identify that she is depressed. A person can have a depressed mood without a formal diagnosis described in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) book we mental health professionals use.

On the other hand, there are many possible causes for the symptoms your daughter displays. She could have a physical health problem, such as severe allergies. She could have had a traumatic experience or suffer from fears she hasn’t shared with you.

While teenagers are a serious challenge to parents at times, I wouldn’t assume this is just a phase your daughter is going through. I would advise you to:

  1. Get your daughter a physical checkup to be sure she isn’t experiencing a medical problem that mimics depression.
  2. If the exam doesn’t identify a medical cause, make an appointment with a psychiatrist or nurse practitioner who specializes in the care of adolescents.
  3. Follow up with a therapist who works with 13-year-olds. The therapist should provide you with some insight into your daughter’s behavior and some strategies for helping her.
  4. Make opportunities for your daughter to talk with you. If she talks more in the car or when you take her out for a snack, then make these opportunities happen. Your job is to listen and encourage her to talk by using phrases such as “go on” or “give me an example.” It’s helpful sometimes to say, “Let me think about that,” rather than rushing to offer advice or telling her how to solve something.
  5. Consider medication such as an antidepressant approved for this age group, if the mental health professionals recommend it.

I want to point out that the mental health professionals I know don’t push medication unless it seems to be needed. Personally, I don’t bring up the idea of medication if there is some other way to deal with symptoms. There are kids who deal with these issues without medication. And then there are kids who fail without the aid of medication. In my opinion, the kids who are not succeeding due to depression deserve a prescribed and closely monitored trial of medication to see if it increases the chance of success in school, home and other areas.

I’m sorry to leave you still wondering what is going on with your daughter, but by following some of the suggestions above, you will get to the cause of her behavior and learn how to help her.

Betty Richardson, PhD, RNC, LPC, LMFT, is an Austin-based psychotherapist.

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