Behind classroom doors across Tennessee, many teens are carrying more than backpacks and homework. They are carrying sadness, hopelessness, and, for some, thoughts of ending their lives. According to the 2023 Tennessee Youth Risk Behavior Survey, 42.7% of high school students reported feeling sad or hopeless almost every day for at least two weeks, while 27.8% said their mental health was most of the time or always not good. Most alarming, nearly one in four Tennessee high school students seriously considered attempting suicide in the past year.

A Vanderbilt Health poll that surveyed 1,000 Tennessee parents in late 2025 found that one in three parents said their child has been diagnosed with a mental or behavioral health condition. Anxiety and depression ranked most common among adolescents (19%).

So what can parents do if they suspect their child may be experiencing depression, and how can they better equip themselves to respond with care?

Depression in Adolescents vs Adults

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest, according to the Mayo Clinic. However, the way depression presents itself in adults and in adolescents differs tremendously. We’re used to associating depression in adults with low mood, a lack of interest in things we once loved, and feelings of worthlessness. But for adolescents, it can present as poor energy, appetite and weight changes, insomnia, and heightened irritability, according to Psychiatry Redefined. There can also be a withdrawal from family or friends, fatigue or low motivation, sensitivity to rejection, and non-suicidal self-injury, such as self-cutting or burning.

A national study on depression found that “vegetative symptoms” were more common in cases of adolescent depression than adult cases. Adults are more likely to lose concentration and withdraw from their friends and family.

However, according to Olivia Dowling, a therapist at the Knoxville Embrace U location, irritability and anger are considered two of the most misunderstood and missed signs of depression in adolescents.  

“Rather than always appearing sad or withdrawn, a child or adolescent may appear angry, irritable, frustrated, or easily overwhelmed,” said Dowling.

Adolescent Depression or Teen/Pre-Teen Angst?

Since signs for adolescent depression often present differently than in adults, it could be easy to miss the signs if your child is struggling. Adolescent depression can be passed for typical teen and pre-teen angst, especially considering that anger and irritability are typically overlooked. However, the way to tell if your child is experiencing depression is based on two things: the duration of the symptoms they’re presenting and the impact it’s having on their daily functioning.

According to Dowling, it becomes concerning when the behavior is paired with “school avoidance, withdrawing from family and friends, withdrawing from hobbies and activities, suicidal ideation, or self-harm.” If these behaviors are consistently presenting and lasting longer than two weeks, then it might be time to consult with a therapist.

Possible Contributing Factors to Adolescent Depression

While each child is affected differently, there may be some common factors that can contribute to their adolescent depression, such as trauma, grief, family conflict, sleep deprivation, academic pressure, discrimination, social isolation, or social media comparisons.

Relationship dynamics play a huge role in children’s lives, especially around age 10 when a child goes through their second stage of separation and peer approval becomes very important. At this stage, adolescents will want to spend all their free time with their friends, and as a result, can feel the potential negative effects if those relationships aren’t going well.

“Adolescents need to feel securely attached to their parents as they move through this stage,” said Dowling. “Relationships are a huge part of helping children feel that they matter, that they are not alone, and that they are enough.”

Another important factor to note is school or academic pressures. Sometimes the stressors of school performance can bring up thoughts like, “I am not good enough,” “Nothing will ever get better or change,” or “I am worthless because I can’t excel at school.” 

“When children begin to tie their worth to their academic performance, that can have a significant impact on how they see themselves,” said Dowling.

A final important factor is how social media has created a platform for teens and pre-teens to compare themselves to their peers. This can create unrealistic standards that adolescents feel they need to live up to. Social media can also make young people feel unvalidated or unaccepted, when their posts don’t get many likes or someone leaves a negative comment.

When supervised and time-managed, social media can be a fun tool to find inspiration, curate a feed that is authentic to the person interacting with it, and maintain long-distance family or friend relationships. However, there is also so much misinformation potentially shown to impressionable children to, so “it can be a lot for a developing brain to understand and process,” said Dowling.

How Can Parents Best Support Their Child Dealing with Depression?

If you are worried about your teen or pre-teen showing signs of depression, it’s best to begin without judgement and by listening.

“I always share with parents that we need to name it to tame it,” said Dowling. “I would suggest directly naming the concerning behaviors they are observing and approaching the conversation with curiosity. Then, listen and validate without judgment.”

It’s extremely important to ask direct, calm questions coming from a place of sincere curiosity, and validate whichever feelings are brought up. Reducing shame around mental health and helping your child access professional care is just as important.

“The goal is not to fix or solve everything in that moment. It is to help the child feel seen, heard, and safe enough to share what they are experiencing,” said Dowling.

What Should Parents Avoid Doing?

Emotionally shutting down is common for teens and pre-teens, but how can you prevent your child from responding that way? Sometimes, the most helpful thing to do is listen. Avoid invalidating, problem-solving too quickly, comparing to other situations, or minimizing what’s being experienced.

“Children and adolescents don’t always need us to immediately fix the problem,” said Dowling. “They need to know that we can sit with them in what they are experiencing and that their feelings matter.”

When to Seek Professional Help

Families should seek professional help when they are noticing changes that are significantly affecting a child’s safety, relationships, or daily functioning.

Some important safety concerns include:

• Self-harm
• Suicidal ideation
• Significant isolation or withdrawal
• School refusal
• Substance use
• Physical or verbal aggression
• Low self-worth and low self-esteem

“When there are concerns about a child’s immediate safety, especially suicidal thoughts or self-harm, it is important to seek help right away,” said Dowling.

How Embrace U Can Help You          

Embrace U provides intensive outpatient programs (IOP) and partial hospitalization programs (PHP) to adolescents struggling with their mental health at all six of our locations across Tennessee. Embrace U programs incorporate group, individual, and family therapy sessions within a 12-week curriculum to ensure your child learns the coping skills and tools to work through their depression.

Group therapy sessions allow for children to be seen by their peers and feel that they are not alone in their struggles.

“Children can learn skills, receive psychoeducation, and experience being understood by other young people who may be going through similar things,” said Dowling.

While group therapy allows for camaraderie and shared experiences, individual therapy is so our teens and pre-teens can work one-on-one with their therapist to work on specific goals and create a plan for what the adolescent needs to process and explore.

Lastly, the family therapy session provides additional psychoeducation paired with parenting skills as well as support for understanding how to better respond to and support children in need.

“Family sessions also create a space for everyone to come together, work on communication, address difficult topics, and have hard conversations in a supported environment,” said Dowling.

There Is So Much Hope in Connection

Depression can make a child feel isolated, misunderstood, or convinced that things will never get better, but the steady presence of a caring adult can be a powerful first step toward healing. Parents do not have to have all the answers. What matters most is noticing the signs, listening without judgment, asking direct questions, and seeking professional support when needed. And if your child is experiencing negative self-thoughts and thinking about self-harm, call or text 988 for immediate crisis support. With the right care, support, and connection, adolescents can learn that they are not alone and that help is available.

“Kindness matters, and connection is the foundation for our mental health,” said Dowling. “Watching a child realize that they are not alone, that someone understands them, and that they matter is incredibly powerful. There is so much hope in connection.”

Contact Embrace U today at 833-733-4325 or use our contact form to get more information about our intensive outpatient programs that help adolescents facing depression.