How to help a teen through holiday depression - Part 2

12% of teens have experienced a period of depression in their lives.

There are a variety of factors that contribute to teen depression.

If you see warning signs, intervene early by talking to your teen and seeking professional assistance.

We present the second part of our two-part interview with Kathryn Anderson, LMHC, a family therapist at Providence Sacred Heart Children’s Hospital in Spokane, WA, about the prevalence of teen depression, its causes, and what you can do to help. Read part one.

Is teen depression heightened over the holidays?

When it comes to a teenager who has already had a depressive episode, the holiday time can both be a period where you have lower risk for experiencing a crisis and a higher risk for a strong resurgence of depression after the holidays.

What I mean is this: during the holidays we often tend to try to put aside our depressive symptoms — not necessarily in a healthy way — because family is coming around, we’re about to get presents, for all the good cheer, for all the fun stuff, and we’re out of school. We tend to kind of bear down and get through the holidays in order to enjoy them.

We can also suppress anxiety. There’s pressure to do that. It’s the most wonderful time of the year, right? But then with all that suppressing and “putting it aside” for the sake of Christmas, after the holidays we already have that natural let down — Halloween, Thanksgiving, Christmas, New Years are over — so it can feel like there’s nothing else to look forward to now. 

So, if you’ve already been working hard to hold off your feelings, there could be an even bigger crash after the holidays. We see a decrease in adolescent mental health admissions right around the holidays, and a resurgence right after them. Teens and families want to put their issues on hold: I don’t want to miss Christmas and be in the hospital, so I’ll keep my feelings to myself; or, we don’t want you to miss Christmas, let’s just take care of it as a family. And then afterwards things fall apart.

On the flip side, the holidays can create another type of pressure and frenzy that can impact our mood whether you’ve had depression or not. Our society, with the more-is-better mentality, continually upscales the holidays — more is better, fancier is better, let’s make everything perfect, let’s make it amazing and pack all sorts of wonderful things into this finite period of time.

An important part of the Christmas break is the second word — a break, a chance to breathe and recharge. But if we’ve got all of these friends and family who want to do all these different special traditional events with us, and our friends want to have all these adventures, that can really exhaust us, and it exhausts our emotions, too. Unrealistic expectations can absolutely impact our mood in a negative way, even if we’re not going into the holidays pretending we’re feeling better than we actually are.

How can parents help prevent holiday depression in teens?

I recommend trying to slow things down over the holidays. Try to go for quality over quantity of activities you do as a family. Pick a few really important traditions and stick to those. Try not to pack your schedule or have overwhelming amounts of stuff. Just try to slow things down and build in time to connect with each other as a family, keeping in mind that your teen’s need to connect with friends is not going to pause over the holidays. Allow time for kids to be on social media for a bit or go hang out with their friends. That’s going to be a nice way to moderate your teen’s mood — and then call them back to connect as a family. Simplify, slow it down, quality over quantity.

The same applies to nutrition. The holidays are a period of amazing, rich, heavy foods that goes on for a month or more. That can impact all our moods. Maintain a decent amount of sleep and pay attention to nutrition. Build in family good cheer by getting outside and getting active together.

If parents are noticing the warning signs of depression, what should they do?

What is developmentally appropriate for a teen is to have a say in their lives. They are actively working to build their independence. It’s going to be really important to do everything you can to partner with your teen.

First, speak directly with your teen if you are noticing depressive symptoms. Try and have it be a one-on-one, or if there are two parents in the home, have both parents participate. You, the parents, should get yourselves in a place where you can be calm, available, and responsive to the kids. You aren’t accusing, you’re expressing concern, and you’re trying to open up a conversation because chances are that if you’re noticing it, something is out of place.

You want to create an environment where the teen’s natural tendency to disagree with you on all things, go at it themselves, or turn to their friends is set aside. Give them a signal that “you’re not in trouble”, “I’m not the expert on you”, “I am a partner on this”, and “how can we work on this together?” That is what tends to have a higher degree of success: one on one, calm, caring, concerned conversation.

Ideally, the teen will be open to pursuing some help. A good first place to start with getting help is talk to your primary care physician or pediatrician.

With teenagers and children, either a combination of medication and counseling, or starting with counseling before turning to medication, can be effective. Early intervention can be very effective. So, if you notice depression, you don’t have to hesitate. You don’t have to panic and rush, but start the conversation promptly.

Teenagers, understandably, may have a hard time wanting to go to counseling. Sometimes it can help for a parent to say this is something we are going to work on together, it’s not all on you. Parents can offer to go with the kid. Sometimes, family therapy is a better starting point.

Five Warning Signs of Teen Depression:

If your teen is prone to severe depression, you may want to have the number for the National Suicide Prevention Lifeline: 800-273-TALK (8255). If you want to find a health care provider to talk with about a mental or emotional health issue, visit:

AK: Providence Medical Group Behavioral Health Services

CA: Providence Psychiatric Services

MT: Providence Behavioral Health

OR: Providence Behavioral Health

WA: Providence Psychology, Spokane; Providence Medical Group, Olympia Psychiatry; Swedish Behavioral Health

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Bringing suicide out of the darkness: Raising awareness, removing stigma

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.