Depression During Puberty

Depressed teenage boy sitting on a bed with his head in his hands
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Puberty can be a difficult time for you and your child. While your child is developing physically, he or she is also experiencing a rapid growth of psychosocial maturity. Put simply, children begin to naturally pull away from their families and connect with their peers to establish independence and individuality. Many have attributed withdrawal, moodiness and other behavioral changes to this normal developmental stage, but researchers are realizing that — in some cases — they could indicate that puberty is actually contributing to depression.

The Frequency of Depression During Puberty

It is estimated that 2% of children under age 10 experience depression, according to the American Academy of Pediatrics. However, between the ages of 10 and 14, the average age range of puberty onset, depression rates increase from 5% to 8% for children overall.

Though rates of depression are higher for boys than girls before puberty, the rate for girls becomes double that of boys during puberty.

Why Does Depression Increase During Puberty?

Several theories for the striking increase in depression during puberty exist. However, there is little agreement among researchers and clinicians:

  • Hormones: Estrogen, a female sex hormone, has consistently been linked to depression. Estrogen levels dramatically increase in girls during puberty, which may contribute to the increase in depression rates among them. Conversely, testosterone, a male sex hormone that increases in boys during puberty, has not been linked to depression.
  • Stage of Physical Development: The research of Dr. Adrian Angold and colleagues, published in The Journal of Affective Diseases in 1998, reported that physical development during mid-puberty predicted the increase in depression rates more than other any factor they studied.
  • Timing at Puberty Onset: According to Dr. Chris Hayward, author of the book Gender Differences at Puberty, the timing of puberty onset may have an impact on depression rates: Children who self-reported that they were "early" or "late developers" exhibited more depressive symptoms than those who felt they were developing at the same time as their peers.
  • Stressful Life Events: During puberty, academic work and social relationships become more complex and demanding, which can be stressful. Some children are more prone to depression as a result of stressful life events, reports Dr. Avshalom Caspi and colleagues in their study of the subject published in Science in July 2003.

    Signs of Depression

    Puberty is a unique time when changes in appearance and behavior are naturally occurring. As such, parents, teachers, and caregivers need to be especially aware of signs of depression, which may be hard to differentiate from normal behavioral changes. Moodiness, separation from parents and identification with peers are behaviors common during puberty. While thoughts of hurting self, avoidance of school, academic decline, risk-taking behaviors, persistent vague physical complaints, excessive guilt, unexplained crying, feeling misunderstood, losing interest in things of former interest, clinging to a parent, or worrying that a parent may die, sleeping difficulties, weight changes, unexplained fatigue, and difficulty concentrating and focusing may be symptoms of depression.

    Where to Get Help

    More research is needed to determine the cause of the increase in depression during puberty. Nonetheless, do not ignore behavioral and mood changes in your child, as there is clear evidence that rates of depression increase during puberty.

    Investigate any new or unexplained behaviors in your child and bring them to the attention of your child's physician. A physician can rule out other medical problems, and help decide if the behavioral changes are a normal part of puberty or a sign of depression. Early identification and treatment of depression are essential, especially for children.

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    Article Sources

    • A. Angold, C.W. Worthman. "Puberty Onset of Gender Differences in Rates of Depression: A Developmental, Epidemiologic and Neuroendocrine Perspective." Journal of Affective Disorders. 1993 29:145-158.
    • Avshalom Caspi, Karen Sugden, Terrie E. Moffitt, Alan Taylor, Ian W. Craig, HonaLee Harrington, Joseph McClay, Jonathan Mill, Judy Martin, Anthony Braithwaite, Richie Poulton. "Influence of Life Stress on Depression: Moderation by a Polymorphism in the 5-HTT Gene." Science. 18 Jul 2003 301:386-389.
    • Chris Hayward (Ed.).Gender Differences at Puberty." Cambridge: Cambridge University Press. 2003.
    • How do Children and Adolescents Experience Depression? National Institute on Mental Health. 
    • R.D. Blondell, K.C. Dave. "Disorders of Puberty." American Family Physician. 1999 60:209-224.
    • Selvi B. Williams, M.D., Ph.D., Elizabeth O'Connor, Ph.D., Michelle Eder, Ph.D. et al. "Screening for Child and Adolescent Depression in Primary Care Settings: A Systematic Evidence Review for the US Preventive Services Task Force." Pediatrics. 04 Apr 2009 e716-e735.
    • Stephen M. Stahl, M.D., Ph.D. "Natural Estrogen as an Antidepressant for Women" The Journal of Clinical Psychiatry. 2001 62
    • What are the Signs and Symptoms of Depression? National Institute on Mental Health.