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Depression and the Teenage Brain: What’s Really Happening?

Author:
Jemma Strain
Jemma Strain
B.S. Psychology
Editor:
Emma Loker
Emma Loker
B.S.
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Many people think of depression as just a “mental problem” – involving only feelings and emotions. While, yes, depression affects how we think and feel, this is often a symptom of what’s happening below the surface: Depression physically changes the structure of the brain. 

Teenagers with depression have persistent or intense feelings of sadness, which can interfere with their ability to lead a full life. Over time, if depression is left untreated, the changes in the brain that cause these feelings can worsen – making these changes more challenging to manage. However, the good news is that, with effective treatment, it is possible to reverse depression’s effects on the brain. 

If you or someone you know is experiencing the symptoms of teen depression, its impact doesn’t have to be permanent – there is information, support, and treatment available to you. 

This article can help by covering:

  • What teenage depression is
  • How depression affects the teenage brain 
  • Depression’s long-term effects on a teen’s brain and mental health
  • Treatment options for teenage depression
  • When to seek help
Depression and the teenage brain

What Is Teenage Depression?

We all have days when we feel low or “out of sorts.” These days are normal responses to everyday events such as stress, conflict, and hormonal shifts. However, depression is a long-lasting mood disorder that affects how we feel, think, and act.1

Depression can affect teenagers in different ways. Some may experience “mild” symptoms such as an ongoing low mood and irritability. Others with more severe depression might battle against feelings of worthlessness and hopelessness for the future.2 Either way, depression is not something that a teenager can just “snap out of.” 

There are many forms of depression in teenagers, including:

  • Major depressive disorder
  • Persistent depressive disorder
  • Bipolar disorder
  • Seasonal affective disorder
  • Atypical depression
  • Disruptive mood dysregulation disorder
  • And others…

Regardless of the type of depression a teen has, it can cause structural changes in their developing brain. If you or someone you care about is showing the signs of depression, knowing how it can affect the brain could increase understanding of a teen’s behaviors. This awareness may encourage you to take the first steps toward healing and recovery.  

How Depression Affects the Teenage Brain

The first signs of depression often occur in adolescence.3 It can be difficult to determine whether depression triggers changes in the brain – or if they already exist. For instance, such changes may start in childhood as the result of early experiences and genetics and lead to depression in adolescence.4,5

However, regardless of whether early brain changes lead to depression or vice versa, one thing is clear: Early intervention is important in managing the effects of depression. 

Based on evidence from research, the following are ways that depression could affect the teenage brain. It’s good to bear in mind that the extent of these effects may depend on factors such as a teen’s age and severity of depression symptoms.6,7

Changes to the brain that affect teens’ memory and concentration:

When depressed, our bodies tend to enter “fight or flight” mode. In our ancestors’ time, fight or flight mode was protective of our safety. However, in depression, it can cause a state of “arrest.” 

Fight or flight mode might make us feel emotions such as anger to fight against a threat or a sense of fear that prompts us to flee. Yet, in depression, this is a response to our own thoughts and feelings. In other words, we feel “stuck” and stressed because we can neither fight nor flee from our own minds. But what effect does feeling stuck in this way have on the brain?8

When we feel stuck in fight or flight mode due to depression, our bodies release excess cortisol over a long time. Unfortunately, when the brain receives too much cortisol, it can prevent growth in the areas of the brain responsible for memory (the hippocampus). This means that depression can cause concentration and memory issues for teenagers in the short and long run. These memory problems include recalling both positive and negative memories.9

Changes to the brain that impact teens’ emotions:

While reducing the size of the part of the brain responsible for memory, depression can also increase the size of the area in charge of regulating emotions (the amygdala) – especially if depression goes untreated. There are some inconsistencies in findings, but the majority of studies report that the increase in the size of this area could, at least partly, be to blame for increased sensitivity towards negative emotions. Further, this effect may be more pronounced in the early stages of depression – such as in young adolescents.7

In other words, depression may change the structure of the brain to make teenagers more aware of their negative feelings. This may mean that teens with depression may feel anxious, guilty, or hopeless, and they may lack the motivation to engage in activities they used to enjoy. 

Changes to the brain that affect teens’ mood and learning abilities:

Adequate oxygen supply is necessary for the brain to function at its best and to meet high energy demands. To put it another way, if we don’t get enough oxygen to our brains, we might struggle to perform and concentrate, affecting our mood and ability to learn. 

Depression can affect the brain’s ability to absorb and use oxygen, which can cause inflammation and even lead brain cells to die – a condition known as “hypoxia.” The brain’s sensitivity to hypoxia can depend on a number of factors, such as the severity of depression symptoms. However, a lack of oxygen can still cause the body to feel like it’s suffocating, potentially leading to increased stress and depression.10,11

Other effects caused by depression’s impact on the brain:

Due to an increase in cortisol in the brain, depression can affect appetite, causing teenagers to lose the desire to eat. Also, how the brain communicates between different areas in depression can result in a loss of pleasure in foods that were once enjoyable to a teen.12

Plus, an imbalance in brain chemicals that influence pain and mood may cause a teenager to experience physical pain as a result of depression. This physical pain can manifest as stomach aches, headaches, and muscle tension.13

Finally, depression can affect an area of the brain which can lead to menstrual irregularities in people who menstruate. This effect can cause increased sensitivity to pain, increased stress levels, and lower mood.20,21

Depression’s Long-Term Effects on the Adolescent Brain and Mental Health

Depression, if left untreated, can have a range of consequences for a teenager’s life, including for their emotional and physical well-being. Although depression’s effects can vary from person to person, the following are some of depression’s potential long-term effects:

The following information can help you tell the difference between normal teenage mood swings and depression.

Mental Health Conditions

Untreated depression can lead to a variety of other mental health conditions – which can continue into adulthood. These conditions can include more severe forms of depression, anxiety disorders, and even self-harm and risks to life.14

Relationship Problems

Depression’s impact on the part of the brain responsible for emotions (the amygdala) may negatively impact relationships in long-term ways. For instance, not being able to manage difficult emotions may cause a teen to lash out in anger at loved ones and friends. They might also lose interest in socializing and withdraw from others. These actions can cause conflict and damage to relationships, as well as impact the ability to make meaningful bonds as adults.14,15

Chronic Pain

Depression’s effects on the brain chemicals responsible for stress and pain management can lead to chronic issues such as muscle and joint pain, headaches, and gastrointestinal issues – potentially lowering a teen’s quality of life. What’s more, untreated depression is linked to long-term health issues such as heart disease.16,17

Academic Success

As the size of the area of the brain responsible for memory and learning (the hippocampus) is reduced in depression, teenagers may struggle with concentrating on and absorbing new information. Combined with the emotional difficulties caused by an increase in the area in charge of emotions (the amygdala), a teen with depression may lack the ability or drive to succeed in school. This may lead to dropout or absenteeism – affecting a teen’s future prospects.18

As is clear, the long-term effects of untreated depression on a teenager’s brain and mental health can cause a wide range of problems. However, there is always hope. Seeking help and treatment for depression can prevent long-term impacts on a teenager’s life – allowing them to see that there is light at the end of the tunnel. 

Teenage girl struggling with teen depression

Are Depression’s Effects on the Teenage Brain Permanent?

While untreated depression can have a serious effect on the structure of a teenager’s brain, the good news is that the brain is very responsive to treatment – so these effects don’t have to be permanent.19

There is a process called “neuroplasticity,” which describes the brain’s ability to form and change neural connections – especially when learning new information or recovering from injury. Depression can affect neuroplasticity, which explains why it causes difficulties coping with emotions, memory issues, and learning problems. However, once depression is recognized and treated, the brain can repair itself – creating new, healthy connections.6,20 

The “gold standard” of treatment for teenage depression is considered to be professional mental health support – and medication if necessary. If you or someone you care about is showing signs of depression, reaching out for support can help you heal depression’s effects on the brain. 

Treatment Options for Teenage Depression

If you suspect that you or someone you love is depressed, it’s important to take it seriously. Depression’s effects on the brain can cause long-term damage if left untreated. Talking to a teen about what they’re going through and letting them know you’re there for them can be a huge help – but it’s not always enough.  

If depression is affecting a teen’s ability to lead a happy, fulfilled life, it may be important to seek support. A mental health professional can discuss suitable options for treatment and medication with you, including the following options.

Therapy Options for Teen Depression

Cognitive Behavioral Therapy (CBT)

CBT is effective for depression in teens as it can help identify and understand negative thoughts. It can also target how to challenge these thoughts, build healthy ways of coping with them, and transition these skills into the world outside of therapy.

Eye Movement Desensitization and Reprocessing (EMDR)

If previous experiences are contributing to a teen’s symptoms of depression, EMDR can help them process these in a safe, supportive environment. EMDR changes the way trauma is stored in the brain and helps a teen build more positive self-beliefs and ways of coping with life’s challenges.

Interpersonal Therapy

This form of therapy helps teens understand how problems in relationships can contribute to their feelings – and healthy ways to work through these issues. Interpersonal therapy can also help a teen figure out the issues behind behaviors and how to manage these for better mental health. 

Transcranial Magnetic Stimulation

TMS can be effective in treating treatment-resistant depression. It’s a non-invasive treatment that uses magnetic fields to activate nerve cells in targeted areas of the brain – improving outlook and mood.

Each of these therapies can be used to treat different types of teen depression in both residential mental health treatment programs and outpatient programs, depending on a teen’s needs. 

Medication for teen depression

Medications, such as antidepressants, work by changing the chemicals in the brain that affect stress and emotions. As a result, they can lower inflammation and help the brain form new connections. While medications have an important place in the treatment of depression, it’s important to monitor their use and regularly check in with a doctor to assess progress. Additionally, medications have been shown to be most effective when used in combination with talk therapy. 

Boy receiving therapy for depression and the teenage brain

When to Seek Help for Depression in Teenagers

If you’re concerned about depression in a teen, it’s important not to wait to seek help. Depression can change a teenager’s brain, affecting how they think, feel, and act – and these effects can have long-term impacts on their quality of life. Talking about depression might seem scary, but a mental health professional can get you the support you need. 

Here’s where Mission Prep can help. We offer comprehensive and personalized depression treatment for teenagers, in various locations, which aims to get to the root of the problem. Instilling a sense of hope, connection, and belonging in our clients, we help teens with depression realize that they are not alone and can achieve their goals. Contact us today for information and support. 

References

  1. National Institute of Mental Health. (n.d.). Depression. https://www.nimh.nih.gov/health/topics/depression
  2. American Psychiatric Association. (n.d.). What is depression? https://www.psychiatry.org/patients-families/depression/what-is-depression
  3. Weissman, M. M., Wolk, S., Goldstein, R. B., Moreau, D., Adams, P., Greenwald, S., Klier, C. M., Ryan, N. D., Dahl, R. E., & Wickramaratne, P. (1999). Depressed adolescents grown up. JAMA, 281(18), 1707–1713. https://doi.org/10.1001/jama.281.18.1707
  4. Redlich, R., Opel, N., Bürger, C., Dohm, K., Grotegerd, D., Förster, K., Zaremba, D., Meinert, S., Repple, J., Enneking, V., Leehr, E., Böhnlein, J., Winters, L., Froböse, N., Thrun, S., Emtmann, J., Heindel, W., Kugel, H., Arolt, V., . . . Dannlowski, U. (2017). The Limbic System in Youth Depression: Brain Structural and Functional Alterations in Adolescent In-patients with Severe Depression. Neuropsychopharmacology, 43(3), 546. https://doi.org/10.1038/npp.2017.246
  5. Hasler, G. (2010). Pathophysiology of Depression: Do We Have Any Solid Evidence of Interest to Clinicians? World Psychiatry, 9(3), 155. https://doi.org/10.1002/j.2051-5545.2010.tb00298.x
  6. Liu, W., Ge, T., Leng, Y., Pan, Z., Fan, J., Yang, W., & Cui, R. (2017). The Role of Neural Plasticity in Depression: From Hippocampus to Prefrontal Cortex. Neural Plasticity, 2017(1), 6871089. https://doi.org/10.1155/2017/6871089
  7. Hamilton, J. P., Siemer, M., & Gotlib, I. H. (2008). Amygdala volume in Major Depressive Disorder: A meta-analysis of magnetic resonance imaging studies. Molecular Psychiatry, 13(11), 993. https://doi.org/10.1038/mp.2008.57
  8. Gilbert, P., & Gilbert, J. (2003). Entrapment and arrested fight and flight in depression: An exploration using focus groups. Psychological Psychotherapy, 76(2), 173-188. https://doi.org/10.1348/147608303765951203
  9. Dillon, D. G., & Pizzagalli, D. A. (2018). Mechanisms of Memory Disruption in Depression. Trends in Neurosciences, 41(3), 137. https://doi.org/10.1016/j.tins.2017.12.006
  10. Kanekar, S., Bogdanova, O. V., Olson, P. R., Sung, H., & Renshaw, P. F. (2015). Hypobaric Hypoxia Induces Depression-like Behavior in Female Sprague-Dawley Rats, but not in Males. High Altitude Medicine & Biology, 16(1), 52. https://doi.org/10.1089/ham.2014.1070
  11. Burtscher, J., Niedermeier, M., Hüfner, K., Van den Burg, E., Kopp, M., Stoop, R., Burtscher, M., Gatterer, H., & Millet, G. P. (2022). The interplay of hypoxic and mental stress: Implications for anxiety and depressive disorders. Neuroscience & Biobehavioral Reviews, 138, 104718. https://doi.org/10.1016/j.neubiorev.2022.104718
  12. Simmons, W. K., Burrows, K., Avery, J. A., Kerr, K. L., Bodurka, J., Savage, C. R., & Drevets, W. C. (2016). Depression-related increases and decreases in appetite reveal dissociable patterns of aberrant activity in reward and interoceptive neurocircuitry. The American Journal of Psychiatry, 173(4), 418. https://doi.org/10.1176/appi.ajp.2015.15020162
  13. Trivedi, M. H. (2004). The Link Between Depression and Physical Symptoms. Primary Care Companion to The Journal of Clinical Psychiatry, 6(suppl 1), 12. https://pmc.ncbi.nlm.nih.gov/articles/PMC486942/
  14. Jonsson, U., Bohman, H., von Knorring, L., Olsson, G., Paaren, A., & von Knorring, A. (2011). Mental health outcome of long-term and episodic adolescent depression: 15-year follow-up of a community sample. Journal of Affective Disorders, 130, 395–404.
  15. Goodman, R. J., Samek, D. R., Wilson, S., Iacono, W. G., & McGue, M. (2019). Close relationships and depression: A developmental cascade approach. Development and Psychopathology, 31(4), 1451. https://doi.org/10.1017/S0954579418001037
  16. Surah, A., Baranidharan, G., & Morley, S. (2014). Chronic pain and depression. Continuing Education in Anaesthesia Critical Care & Pain, 14(2), 85-89. https://doi.org/10.1093/bjaceaccp/mkt046
  17. Carney, R. M., & Freedland, K. E. (2003). Depression, mortality, and medical morbidity in patients with coronary heart disease. Biological Psychiatry, 54(3), 241–247. https://doi.org/10.1016/s0006-3223(03)00111-2
  18. Sinval, J., Oliveira, P., Novais, F., Almeida, C. M., & Telles-Correia, D. (2025). Exploring the impact of depression, anxiety, stress, academic engagement, and dropout intention on medical students’ academic performance: A prospective study. Journal of Affective Disorders, 368, 665-673. https://doi.org/10.1016/j.jad.2024.09.116
  19. Rădulescu, I., Drăgoi, A. M., Trifu, S. C., & Cristea, M. B. (2021). Neuroplasticity and depression: Rewiring the brain’s networks through pharmacological therapy (Review). Experimental and Therapeutic Medicine, 22(4), 1131. https://doi.org/10.3892/etm.2021.10565
  20. Huang, J., Lane, Y., & Lin, H. (2017). New Treatment Strategies of Depression: Based on Mechanisms Related to Neuroplasticity. Neural Plasticity, 2017(1), 4605971. https://doi.org/10.1155/2017/4605971
  21. Padda, J., Khalid, K., Hitawala, G., Batra, N., Pokhriyal, S., Mohan, A., Zubair, U., Cooper, A. C., & Jean-Charles, G. (2021). Depression and Its Effect on the Menstrual Cycle. Cureus, 13(7), e16532. https://doi.org/10.7759/cureus.16532
  22. Yu, M., Han, K., & Nam, G. E. (2017). The association between mental health problems and menstrual cycle irregularity among adolescent Korean girls. Journal of Affective Disorders, 210, 43–48. https://doi.org/10.1016/j.jad.2016.11.036

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