How to help a teenager with anxiety and depression

Watching your teen struggle is hard, and it's normal to worry about saying the wrong thing. You don't need to be an expert to help. Here's what the guidance says works, and when to bring in a professional.

Signs to watch for

Depression in teens can show up as (HealthLink 811):

• More anger, irritability or losing their temper
• Pulling away from school, friends or activities
• Changes in appetite or sleep
• Often saying they feel sick
• Low confidence, feeling they can't do anything right
• Trouble focusing

Anxiety often looks like worry that's out of proportion to the situation, plus (Canadian Paediatric Society):

• Physical complaints: stomach aches, headaches, trouble sleeping, a pounding heart
• Avoiding situations, withdrawing socially, or dropping activities they used to enjoy
• Irritability, restlessness or mood swings

The two often overlap, and irritability can be easy to mistake for "attitude."

How to talk with your teen

• Let them know you're there. Listen without interrupting, and don't follow up with a barrage of questions or a lecture (HealthLink 811).
• Name the feeling. Something like "You seem worried. Is something on your mind?" (CPS).
• Validate before you problem-solve. "That sounds really hard" goes further than "You'll be fine."
• Pick calm moments. Don't argue in heated moments; calm down first, then talk (CPS).
• Keep one-on-one time going, and stay interested in their friends and life.

What helps at home

• For anxiety, small brave steps. Break the feared thing into small, practical steps and praise each one. Praise the effort, not just the outcome (CPS).
• Gently prevent avoidance. Empathize with the fear, but use gentle, firm encouragement so avoidance doesn't become the default (CPS).
• Support the basics. Regular sleep, healthy meals and exercise (HealthLink 811).
• Talk openly about alcohol and drugs, which can make depression worse (HealthLink 811).
• Work with the school so supports or accommodations are in place if needed (CPS).
• Model coping. Let them see you use deep breathing, positive self-talk or taking a break (CPS).

What to avoid

• Avoiding hard topics. Raise them gently instead.
• Reinforcing fears, for example by letting them skip everything that makes them anxious.
• Lecturing, comparing them to others, or telling them to "just snap out of it"
• Waiting for it to pass on its own when it's lasted weeks

When to get professional help

• Symptoms of depression last two weeks or more: contact your teen's health care provider (HealthLink 811).
• Fears interfere with daily life (school, sports, friendships), your teen is often very anxious, or has frequent physical symptoms (CPS).
• You're not sure: in Nova Scotia you can call 811 to speak with a registered nurse, 24 hours a day (HealthLink 811).

Anxiety disorders are treatable. Options include education, therapy such as cognitive behavioural therapy (CBT), family-based approaches and, in some cases, medication (CPS). Counselling combined with medicine often helps depression (HealthLink 811). For finding the right person, see How to choose a therapist, and for low-cost options, Is therapy free for minors in Canada?.

If you're worried about suicide or self-harm

Take it seriously and act right away. HealthLink 811 advises (HealthLink 811):

• Contact crisis supports if your teen has thoughts of suicide: call or text 9-8-8, or the Nova Scotia Provincial Mental Health and Addictions Crisis Line, 24/7, at 1-888-429-8167 (Dalhousie Student Union).
• Get emergency care for serious thoughts of suicide or harming others. Call 911 if there's immediate danger.
• Make home safer: remove alcohol and any weapons, and lock up prescription medicines.
• Make a safety plan with your teen and a professional.

Frequently asked questions

About the author

Courtney Cribb, MEd, RCT, CCC, is a Registered Counselling Therapist in Nova Scotia who works mostly with teens and young adults. Her research on teens and sexting is published in the Canadian Journal of Counselling and Psychotherapy. She offers online sessions by video or phone across Nova Scotia and, where permitted, elsewhere in Canada. Learn about teen therapy with Courtney.