New guidelines say all teens should be screened for depression

American Academy of Pediatrics says 20% have experienced depression

New guidelines from the American Academy of Pediatrics say all teenagers should be screened for depression.

The academy says 20 percent of teens experience depression at some point during adolescence, but parents often miss the clues.

With the new guidelines, pediatricians are being asked to more carefully screen patients ages 12 and over during their annual checkups.

Also, pediatricians are encouraged to speak to teenagers alone, then with their parents.

If the doctor determines the teen has moderate or severe depression, he or she can offer treatment or consultation with a mental health specialist.

According to the Mayo Clinic, teen depression symptoms include emotional and behavioral changes.

Emotional symptoms could include:

  • Feelings of sadness, which can include crying spells for no apparent reason
  • Feeling hopeless or empty
  • Irritable or annoyed mood
  • Frustration or feelings of anger, even over small matters
  • Loss of interest or pleasure in normal activities
  • Loss of interest in, or conflict with, family and friends
  • Low self-esteem
  • Feelings of worthlessness or guilt
  • Fixation on past failures or exaggerated self-blame or self-criticism
  • Extreme sensitivity to rejection or failure, and the need for excessive reassurance
  • Trouble thinking, concentrating, making decisions and remembering things
  • Ongoing sense that life and the future are grim and bleak
  • Frequent thoughts of death, dying or suicide

Behavioral symptoms could include:

  • Tiredness and loss of energy
  • Insomnia or sleeping too much
  • Changes in appetite -- decreased appetite and weight loss, or increased cravings for food and weight gain
  • Use of alcohol or drugs
  • Agitation or restlessness -- for example, pacing, hand-wringing or an inability to sit still
  • Slowed thinking, speaking or body movements
  • Frequent complaints of unexplained body aches and headaches, which may include frequent visits to the school nurse
  • Social isolation
  • Poor school performance or frequent absences from school
  • Neglected appearance
  • Angry outbursts, disruptive or risky behavior, or other acting-out behaviors
  • Self-harm -- for example, cutting, burning, or excessive piercing or tattooing
  • Making a suicide plan or a suicide attempt

The Mayo Clinic says it can be difficult to tell if changes are just part of the normal ups and downs of adolescence or if they might be indicators of depression. According to the Mayoc Clinic website, the key is whether the teen seems capable of managing challenging feelings or if life seems overwhelming.

To read the new AAP guidelines, click here.