Why has my even-tempered son become so grumpy and moody?

By Patrick J. McGrath, OC, PhD, FRSC

Question:

My 12-year-old son has become more and more grumpy and angry. He used to be pretty even-tempered. I don't know what is going wrong. What can I do?

Dr. Pat responds:

We all have bad patches, it could be that is what is happening. Be available for your son when he does want to talk.

Saying things like "It seems something is bothering you. You may not want to talk about it. I am here if you want to," or "I love you. It doesn't seem like you are very happy right now. If you want to talk, I am here," can leave the door open.

Snooping in his diary or e-mail or grilling him about what is going on will usually make a teen angrier.

You could speak to his coach, favourite teacher, or some other adult who has a close relationship with him. Find out if they have noticed anything amiss.

Many depressed teens are angry and easily irritated. Your son might be depressed.

Is he using alcohol? Many people, even kids, try to chase away depression with booze. Sometimes teens use drugs to fight depression.

Indicators of depression are:

Does he think life isn't worth living? Has he said he wants to end it all? Has he given away things he values? Has he made suicidal threats or gestures?

Gently see if he will share with you why he is so grumpy. Approach him at a time when he is a bit more relaxed.

Does he have a family doctor, paediatrician, spiritual leader, teacher, or guidance counsellor that you can encourage him to talk to?

If you think your son is depressed, get him help. If suicide is on his mind, get help immediately! Talk to your family doctor about your concerns with your son.

Treatment for depression

There are two types of treatment that help depression: psychological treatment and medication.

Two different types of psychological treatment work in adolescent depression: cognitive behavioural treatment and interpersonal therapy.

• Cognitive behavioural therapy teaches teens to notice their thoughts and how to change these thoughts to lessen depression. This therapy also helps teen change actions that lead to depression.
• Interpersonal therapy focuses on helping the teen deal with relationships and losses they have experienced.

Both types of therapy require special training. Social workers, psychologists, or psychiatrists may give these treatments.

The newer anti-depressant drugs, the Selective Serotonin Reuptake Inhibitors (SSRIs) and the Serotonin Noradrenaline Re-uptake Inhibitors (SNRIs), are not approved for use in children and adolescents in Canada.

However, doctors may reasonably decide to use them with certain teens.

Teens on anti-depressant drugs should be followed up carefully by their doctor. Health Canada has warned about increased suicidal thoughts, especially in the first few weeks of treatment.

St. John's wort is an herbal medication that is used for depression. It is not clear how well it works with teenagers. Check with a doctor before taking it with another anti-depressant drug.

Don't ignore depression in your teenager. Early treatment can make a big difference.

Thanks for consultation to Dr. Darcy Santor, psychologist, and Dr. Alexa Bagnell, psychiatrist, both experts in adolescent depression at the IWK Health Centre and Dalhousie University.

Patrick J. McGrath OC, PhD, FRSC is a clinical psychologist and a researcher. He is Professor of Psychology, Pediatrics, and Psychiatry at Dalhousie University and Vice President - Research at IWK Health Centre in Halifax. Read more "Ask Dr. Pat" columns Ask Dr. Pat a question