Negativity, feelings of worthlessness, and persisting fatigue are not uncommon. Teens may lose or gain weight, sleep more or less than usual, and complain that they simply "don't care anymore." Feelings of not being understood, sulking, reluctance to cooperate in family plans, and refusing to leave their bedrooms are frequent symptoms. In some cases, morbid or suicidal thoughts occur. Teens who suddenly give away their prize possessions or say goodbyes are sending red flags for possible self-destructive behavior. Adolescents also may express macabre or suicidal ideas in their creative writing, diaries, or drawings. Many, if left untreated, begin to self-medicate with alcohol and/or drugs. School difficulties are extremely common. According to the clinical literature, teenage girls are about five to seven times more likely than boys to develop depression.

What first steps should be taken if you suspect your teenager is depressed?

As always, the first step is speaking directly to your teen. Ask if she is feeling discouraged, apathetic, sad, or bad about herself. Share your observations of her change in mood, attitude, and behavior. Encourage her to talk about her real feelings, whatever they are, without judging or trying to talk her out of them (e.g., "You shouldn't feel that way; you should be happy that..."). If in doubt about whether girls are truly depressed, parents should ask school guidance counselors for feedback on how they are doing in school and whether teachers have noticed any changes in their concentration, performance, appearance, or behavior. The best course of action, however, is to consult a mental health professional who can make a thorough, individual assessment of whether a teen is truly depressed.

Is there something that can be done to avoid depression?

Although depression tends to run in families, it doesn't mean your teen or her siblings will definitely develop the disorder. It's probably helpful to be aware of an increased familial risk so you can be on the alert for early symptoms. As always, it is crucial to maintain a close, trusting relationship with your daughter that will encourage her to express whatever feelings she has�good or bad�rather than bottling them up. With your love and support, your teen is best able to face whatever problems she has in order to develop good coping and problem-solving skills. Girls today are often becoming depressed when stressed-out by unrealistic expectations and pressures for success. Chronic feelings of being overwhelmed by never-ending work and exhausting commitments leads to girls believing they are�and never will be�good enough. So parents need to monitor the level of pressure their daughters are experiencing, support them in setting reasonable goals, and make sure they get plenty of rest and down time. Fortunately, depression is highly treatable.

If a teenager has a friend they think is having suicidal thoughts, what should she do?

This is one situation when teenage girls must put the health and well-being of their friend ahead of their typical, loyal promises to keep secrets. If there is any suspicion a girl may be at risk for suicidal behavior, friends have to act fast. First take her to a school guidance counselor or school psychologist, professionals who are trained to deal with potential crises. If a friend refuses to see school personnel, girls should see a parent, trusted teacher, or guidance counselor on their own to get advice on handling this serious problem. Teens who have friends who are depressed and/or suicidal are often preoccupied and weighed down by their concerns; they need adults with more experience to help shoulder this burden and get their friends whatever assistance they need. If your daughter is afraid her friend will get angry at her if she divulges her problems, she should know that when suicidal people get treatment and feel better they are invariably grateful for such expressions of love and support. It is no exaggeration to say that telling someone about a friend's suicidal thoughts can save her life.

For more information on depression and suicide:

The National Institute of Mental Health (NIMH)
Suicide Fact Sheet

Additional Resources

Teen Depression
A comprehensive site for troubled teens, and parents of teens, about the warning signs, and various treatment options available for depression.
http://www.teendepression.org/

DepressedTeens.com
An educational site offering help to teenagers and their parents to understand the signs and symptoms of teenage depression, and resources for those looking for help.
http://www.bpkids.org/site/PageServer?pagename=index

AboutTeenDepression.com
From the difficulties in diagnosing teen depression, to adolescent depression symptoms, treatment options, and teenage depression statistics, this site has answers for both teens and their parents.
http://www.about-teen-depression.com/

Each month, 25% of eighth graders drink, and 100,000 teens engage in binge drinking. For the first time, the rate at which teen girls are starting to drink equals or surpasses that of boys. Teen girls are targeted more often by magazine ads for alcohol and also are more susceptible than boys to the influence of friends who drink. In general, teen girls are tempted to drink to appear cool, feel grown up, act rebellious, and decrease self-consciousness and anxiety in social situations. Alcohol relaxes girls who worry about their looks or how well they fit in with peers. So teen girls who lack self-confidence and social acceptance are especially vulnerable to the temptations of underage drinking.

What are the risks of underage drinking?

Because the adolescent brain is still developing, alcohol is metabolized differently in teens than adults. Not only do teens get drunk faster, but also alcohol damages the teen brain’s ability to function. The consequences can be devastating and long-term. Studies show that teens with Alcohol Use Disorder (AUD) are less able to learn new skills. Their problem-solving, verbal and nonverbal retrieval, visuospatial skills, and working memory are impaired. Plus, because alcohol decreases inhibition, teens who drink are likely to use poor judgment and self-control, increasing the prevalence of accidents, risk-taking behavior, and sexual assaults. The younger the age when drinking begins, the greater the chance of teens becoming addicted to alcohol. In fact, about 40% of children who begin drinking before age 15 will become alcoholics at some point in their lives. Those who wait until age 21 are four times less likely to develop an addiction to alcohol.

What is the correlation between underage drinking and premarital sex?

Because alcohol impairs judgment and self-control, teens who drink are far more vulnerable to engaging in unplanned, unwanted, and risky sexual behaviors, including having unprotected sex and multiple sexual partners. Studies have shown, in fact, that cheap beer is associated with an increase in sexually transmitted diseases. It is estimated that about half of nonconsensual sexual interactions are alcohol-related. After binge drinking, teen girls may not remember their sexual activities; if they do recall sexual activities, they are often regretful. Attending unsupervised parties where alcohol is served increases the opportunity for early and risky sexual encounters.

What can parents do to prevent their teens from abusing alcohol?

Fortunately, there is plenty parents can do to decrease the chance of teens abusing alcohol. Since the average age of a first drink is 12, parents need to start talking to children when they are young about the dangers of alcohol use. It is also important that parents discuss the temptations that their children will likely experience—as well as effective strategies for resisting them. Parents should communicate clearly and directly their beliefs about when drinking is appropriate for their children. Family rules should be spelled out. Alcohol-free social activities such as dinners and dances should be sponsored in the community. Parents can encourage their children to host social gatherings by providing a safe, fun environment in their own homes. It is crucial, however, for parents to supervise the goings-on to insure that teens and their friends adhere to house rules. When young teens are invited to other homes, parents should call ahead to confirm that parents will be providing such supervision. Once teens are old enough to drive, there should be a zero-tolerance policy for drinking and driving, including riding in the car of an individual who has had any alcohol. Parents also need to model responsible alcohol use—that is, moderate drinking and avoidance of alcohol to manage stress. Finally, to prevent tragedies parents should establish with their teens a safety procedure such as the opportunity to call home at any time to ask for help—with no questions asked and no punishments imposed.

How can a teenager help a friend who has a drinking problem?

Teenagers who see their friends binge drinking, experiencing blackouts, and engaging in high-risk behaviors may be tempted to think such occurrences are within the norm. It is hard for adolescents to know when experimentation crosses the line into problem drinking. That is why it is important for parents to speak with their teens about red flags for alcohol abuse. Just as crucial, because such worries can burden and even overwhelm teens, they should be encouraged to speak to a trusted adult as soon as possible. Along with teachers, school counselors, religious leaders, coaches, and mentors, parents should convey that they are always available to discuss their children’s concerns about their friends without being judgmental. While teens may be reluctant to betray secrets about peers for fear of being disloyal, they need to understand that the opportunity to prevent a tragedy or save a life justifies divulging this important information.

For more information:
The National Council on Alcohol and Drug Dependency at: www.ncadd.org
The National Institute on Alcohol Abuse and Alcoholism at: www.niaaa.nih.gov or
http://alcoholism.about.com/od/teens/Teens_and_Substance_Abuse.htm

Additional resources:

FamilyDoctor.org
Great site for quick answers for teens about the dangers of alcohol use.
http://familydoctor.org/online/famdocen/home/common/addictions/alcohol/273.html

Focus Adolescent Services
Information, help and support for many issues facing teenagers today.
http://www.focusas.com/Alcohol.html

Because a first sexual experience can strongly influence a girl’s feelings about herself, her partner, and future relationships, it behooves her to determine whether or not she is ready.

Some issues she should consider are:
* Is she feeling pressured by her partner?
* Does she think that having sex is a way to get or to keep a boyfriend?
* Is she hoping that becoming sexually active will make her more popular?
* Is she feeling left out among more sexually experienced friends?
* Does she want to “get it over with” to figure out what the hype is about?
* Is she in a trusting, mutually respectful relationship?
* Does she experience emotional intimacy with her partner?
* Can they discuss openly sexual issues, including protection from pregnancy and sexually transmitted disorders?
* How will she feel if she has sex and the relationship ends?

What are the tools a parent can give their teen to help them make the right choices regarding sex?

The most important tool parents can give their children is themselves: developing close, trusting relationships that encourage honest discussion. Despite myths to the contrary, parents are their teens’ number one influence, more powerful than their peers. Yet studies show that many teens are unsure how their parents feel about sex. That is why parents must first be clear in their own minds about their attitudes and values, and then convey these principles to their teens. Parents can educate their daughters about the powerful effects of hormones on sexual desire. Girls should know that sexual urges are normal and okay, but should only be acted upon when it is appropriate. Parents must be able to spell out their expectations: for example, at what age and under what conditions they would like their daughters to enter sexual relationships. All parental interactions with teens should empower girls to value themselves, protect their bodies, and make conscious, healthy choices. Girls should be taught that a sexual partner should know and respect them before being granted the privilege of knowing their bodies. Sex should be a two-way street; a girl should expect her partner to care about her pleasure, too, rather than simply expecting to receive pleasure from her. Parents should discuss facts about STDs and pregnancy, dispelling any myths girls might have. Since the majority of girls have sex for the first time in their own or their partners’ homes, parents should be aware that supervision is crucial. Providing guidelines such as dating boys no more than two years older than herself also reduces the possibility of a girl feeling pressured to have sex prematurely. Above all, no matter what their decisions about sexual relationships girls should feel they can come to their parents for help in keeping themselves safe.

Are there resources available to teenagers struggling with this decision?

For more information, teens and their parents might try:
www.StayTeen.org
www.teenpregnancy.org
or the new book, The Talk, by Sharon Maxwell, Ph.D., to be published in April 2008 by Avery/Penguin, New York.

Additional Resources

MedicineNet.com
Sex Education programs delay Teen Sex
http://www.medicinenet.com/script/main/art.asp?articlekey=85986

WebMD.com
How to Talk to Your Kids About Sex
http://www.webmd.com/parenting/news/20080116/how-to-talk-to-your-kids-about-sex

WebMD.com
Teen Pregnancy Prevention Program
http://www.webmd.com/video/teen-pregnancy-prevention

At the same time, teens benefit when their parents remain interested and supportive of their education. As a start, parents can ask about what teens are learning in school and what particularly intrigues them—rather than simply focusing on grades and test scores. Parents can also provide structure for good study habits, such as by setting guidelines for television, computer, and telephone use during the school week. Teens appreciate when parents do their part by making available resources such as quiet study spaces well-stocked with necessary school supplies. Parents can also attend school events, meet their teachers, and support the school community. If teens begin to struggle in school, parents can help them figure out where they are going wrong as well as how to find solutions. When conflicts arise between students and their teachers, wise parents encourage their high school age students to advocate for themselves by resolving problems directly and appropriately. In general, teens whose parents allow them to make—and to learn from—normal missteps and stumbles are that much more prepared to deal with challenges once they leave school.

How can parents empower their children to take responsibility for their grades?

Teens who are most motivated to perform well in school have internalized their parents’ high expectations, believe in their abilities to succeed, and are given the opportunity to focus on their work. They achieve for internal reasons: because they are interested in school, doing well is necessary to reach their goals, or getting good grades is gratifying to them and makes them feel good. It is difficult for parents to instill or maintain strong motivation with external incentives such as privileges or rewards (e.g., money). That is why parents who wish to empower their children should focus on how doing well in school makes them proud of themselves and gives them more opportunities—rather than on how a good report card pleases parents or makes them proud of their children. While parents can ask if teens want help, they should only offer (not insist) and then give only as much help as their children actually need. When a students’ report card is less than stellar, parents should react by becoming curious rather than angry or punitive. The focus should be on what poor grades are telling the student she needs to do differently. What is she learning from her experience? Do poor grades signal a possible learning difficulty? Asking teen girls—rather than telling them—about what they can do to improve further instills a sense of personal responsibility in their education. Plus, they are likely to be more invested in solutions they suggest. When parents serve as sounding boards and support teens in making good choices for themselves, girls are less likely to rebel by sabotaging their own school performance.

What are some tips on relieving stress from the pressures of a competitive school environment?

Teens perform best academically when they are well-matched with their schools—that is, when they believe they are as capable as their classmates of succeeding. Parents must insure that girls are placed appropriately. Studies show, for example, that students who feel like small fish in big ponds (competitive schools) are less motivated and get poorer grades. So attending a prestigious school is not always a good choice for a girl who struggles there. She may well do better in a less academically demanding school in which she believes she can excel. Parents can also use these stress-reducing and resiliency-building strategies:

Help teens create sensible schedules that give them much-needed down time.
Girls should have at least one free period during the school day and a day or two per week without extracurricular commitments.
Teach teens to strive for a balance of work, play, and rest.
Encourage girls to get enough sleep.
Make sure they are eating regular, healthy meals and snacks, including breakfast.
Help girls assess their true strengths and weaknesses. Give them the message that no one can be great at everything.
Don’t compare teens to their siblings, classmates, or parents; evaluate each girls’ performance on its own merit.
Teens should take classes that are appropriate to their level of ability.
Focus on who she is (her attributes and positive personality traits), not what she does (school and extracurricular performance).
Encourage her to make mistakes.
Rather than filling family time with sports, tutors, and other extracurricular activities, make the dinner hour sacred—and stress-free.
Refrain from using scare tactics to encourage achievement.
The majority of girls in high school are already worried about the college application process; they don’t need their parents to remind them.
Parents should avoid giving advice based on their own experiences as teens; times and circumstances are likely to have changed.
The temptation to micromanage should be resisted, as parental over involvement exacerbates stress and actually reduces performance.
In light of the developing adolescent brain, teens often need the gift of time. With maturation, they usually master what is now too challenging.
Instead of trying to live vicariously through their children, parents need to help girls find their own passions and allow them to star in their own lives.

For more information:

Stressed-out Girls: Helping Them Thrive in the Age of Pressure, by Penguin, 2006.

Additional Resources

StressManagementTips.com
Learn how to help yourself or your teenager handle the stresses of school.
http://www.stressmanagementtips.com/school.htm

University of Minnesota
See how adolescent stress and depression often go hand in hand, and what steps can be taken to avoid this path.
http://www.extension.umn.edu/distribution/youthdevelopment/DA3083.html