It’s well-recognised in psychology that depression comes in various forms. Moreover, adult and adolescent depression are closely related but show important differences in how it presents across different age groups.

One key difference between adult and adolescent depression is in “vegetative symptoms.” These symptoms include changes in sleep patterns, appetite, and energy levels.

How does adolescent depression differ from adults’?

A recent research highlighted that adolescents and adults, diagnosed with major depressive disorder, show different symptoms mainly across three areas:

Loss of energy: 97% of adolescents with diagnosed depression report a loss of energy, while only 71% of adults do.
Sleep disturbance, specifically insomnia: 87% of adolescents with depression experience sleep problems, in comparison to 63% of adults.
Appetite/weight changes: Similarly, weight change is more common in adolescent depression, with 87% reporting either substantial gains or losses, compared to 59% of adults.

These statistics show that young people with depression often experience physical symptoms like insomnia, changes in appetite and weight, and loss of energy, setting them apart from adults with depression.

Feeling down and low when depressed

While adolescents with depression had problems with appetite, weight changes, insomnia, energy loss, and low mood, adults struggled with most depressive symptoms except for weight changes. Unfortunately, both groups shared symptoms like low mood and feelings of worthlessness.

When it comes to adolescent depression, it’s not just about feeling down, however. It often comes with distinct physical symptoms, as mentioned above, and for clinicians, understanding these differences can help better identify and support adolescent children.

Loss of energy appears to be a central depressive symptom, especially among adolescents. Almost all (97%) of adolescents with major depressive disorder reported experiencing this symptom, highlighting its significance. Importantly, loss of energy appears consistently across depression research, suggesting that it is essential to screen for it. It is theorised that the loss of energy may also act as a trigger for other depressive symptoms, making it particularly relevant during the onset of depression, which often occurs during adolescence or early adulthood.

Insomnia is also a common feature of adolescent depression, with 87% of adolescents reporting sleep disturbances. However, insomnia alone is unlikely to be a good indicator of depression, unless accompanied by other depressive symptoms. Staying up late is quite normal during the adolescent years, and it is often not related to mood problems.

Irritability seems to be a shared feature across adult and adolescent depression, and this research found no evidence indicating that it is more common in adolescent depression compared to adult depression. Despite being a diagnostic criterion for depression in adolescents in the diagnostic manuals (DSM-5), it seems that irritability doesn’t play a significant role in depression among young people unless it co-occurs with depressed mood. In fact, it’s quite rare to find irritability as a standalone symptom in youth depression without it being accompanied by a depressed mood. Rather, it might be an antecedent or precursor of depression, suggesting a complex relationship between mood and irritability in young individuals.

Why is depression different in adults and adolescents?

Several factors may contribute to these variations across age groups. First, it’s important to recognise that depression is not uniform across different age groups. Some symptoms that emerge during the initial onset of depression may differ from those in recurrent episodes in adulthood. Additionally, treatment history might influence the way depression presents itself. Conversely, not receiving treatment in time might change how depression presents sometimes years later.

One key takeaway from this finding is its clinical implication: not assessing vegetative symptoms like insomnia, appetite changes, and energy loss in young individuals could lead to depression going unnoticed or misdiagnosed. Similarly, focusing on irritability may be misleading, as a consistently low mood describes depression better than the complex relationship between irritability and depression.

Understanding these nuances in depression presentation is crucial for healthcare professionals, parents, and caregivers to provide effective support and care to adolescents facing this challenging condition.

Please note that this blog post by Personal Psychology is not intended to provide professional advice. If you or someone you know is experiencing mental health difficulties, it is important to seek help from a qualified healthcare professional.