Is it possible to be an adolescent girl and not be depressed at some point in time? Probably not. But true depression, the clinical kind, requires parental vigilance and medical intervention. Lack of those things in a case of true depression can be catastrophic.

Signs of Depression in Girls

It's a hard thing to separate. True, the chances of depression increase as girls go through puberty, but could it just be a mood swing? Signs of depression are much more prolonged and visible than any short mood swing you may see. Signs include loss of appetite (or large increase in appetite), loss of sleep (or oversleeping), irritability, and an inability to be rational about a situation. Just about every parent of a teen girl can take pause here because almost every girl has her moments. But if you see it over a prolonged time, it's time to take action. More drastic symptoms can include a marked decrease in success at school (and with grades), a remarkable change in a social situation (she used to go out all the time; now she just sits and listens to “emo” music), or even thoughts or mention of suicide. All or any of these require immediate action.

What to Do

It's hard to not just think, “I was miserable in high school (or middle school) too.” But it's better to treat your daughter as a unique individual. As unhappy as you may feel your time was then, your daughter deserves happiness now. And today's society is more in tune with good psychological health that most were in the past. That said, you won't want to ship her off at the first signs of the blues. Instead, try to talk to her about what is at the center of her depressive actions. Find out: Did something change in her social life? Is she upset about your divorce? Has her body image changed in a way that worries her (more on body image coming later in this chapter). You may find it is near impossible to get your daughter to open up to you. This is not because she does not love you; it is because she does. Drive home the point that you are there to help her address any of her fears, worries, and disappointments. That is what makes your relationship rich.

If she is unable to put her finger on it or to rationalize and move on from it with your help, it's time to find counseling. Ironically, this is not easy to do. Counselors specializing in teen girls are flooded with requests for appointments, and you may find it takes some time to get a good one. When you do, make sure your daughter (within reason) is comfortable with the choice. Chances are that at first she'll balk at almost anyone. But if after four appointments she's still balking, ask her for input on what type of person she is looking for and renew your search. Better that she open up to someone than continue being closed mouthed to someone she is not at ease with.

Suicidal Thoughts

She's at the end of her rope and she screams, “I'd rather be dead at this point!” How is a parent to know when it really means something? Put simply, while you don't need to call 911, no threat to her own body should ever not be taken seriously. The first time your daughter says such a thing, be sure to drive home the power of those words. Tell her to explain to you exactly what she means. If she backs down and says she did not mean it, let her know that from there on, if she uses those words, you'll have to take them seriously and keep her from harming herself. Here's a staggering statistic: girls with suicidal thoughts who have few friends are three times more likely to act on them than boys are. This makes sense. Girls, for the most part, are more socially oriented and internalize things more. In other words, if you've noticed your daughter has a smaller and smaller social circle and becomes more and more withdrawn, you are not out of line to step in and take action, using medical and specialized help.

If you know your daughter is considering suicide or has considered it, you need to make sure she is not in a situation where she can undertake the act. True, this is a time in your life when you thought she'd want more freedom, but in the end, she needs less. She needs support and yes, a watchdog (you) until she's received the mental health help she needs to get through this time. Some warning signs of suicide include but are not limited to the following:

• She says she wants to kill herself or says things like, “You'll never have to worry about me again.”

• She has a suicide plan.

• She shows signs of sudden alienation from the family.

• She exhibits a sudden loss of interest in a faith or religion she once cherished or at least accepted.

• She hears voices or sees visions telling her to kill herself. She gives away her possessions.

• She is preoccupied with music, movies, art, or writing centered around death.

Bipolar Disorder

While it requires a book of its own, bipolar disorder — and the increase of diagnosis of it in girls — requires mention here. While bipolar disorder is still diagnosed most often in adults, experts are getting better and better at diagnosing it earlier; even in the teen years. Signs of bipolar disorder include excessive mood swings (from giddy to despondent), swings from being overly talkative to being unresponsive, feelings of “superpowers” and then of helplessness. If you suspect any of these signs in your daughter, your medical team needs to know. References to books on the issue can be found in Appendix A of this book.