Wes: According to the National Institute of Mental Health 11 percent of teens have been diagnosed with a depressive disorder by age 18. Yet many families still imagine their kids can’t be affected by depression, leaving many undiagnosed and untreated. It’s easy to get indignant and wonder what’s wrong with those blissfully ignorant parents. Let’s not. If there’s one thing I’ve learned over the years, clinical depression is among the most difficult disorders to accurately assess in children and teens.

Given the complex array of emotions most teens experience, it can be hard even for mental health providers to pick out which teens are depressed and which are just going through the necessary emotional upheaval of normal growth and development. For the untrained parent’s eye, depression is even harder to recognize, particularly if kids aren’t very open about how they’re feeling. Moreover, symptoms may not manifest themselves in the same way for kids as they do for adults, and they’re often secondary to conditions like anxiety, ADHD, and mood dysregulation disorders.

For teens, a one-time psychiatric evaluation, drop-in doctor’s appointment and a bottle of pills isn’t usually a great way to approach this problem. It takes a lot of fairly deep and at times, probing conversation in a relaxed and trusting environment to figure out what’s what. So, except in the most exigent circumstances (e.g., risk of suicide), start by finding an outpatient therapist. If things don’t improve after a few weeks, NIMH and every adolescent and psychological professional association agree that a combination of therapy and medication is the next step.

If things are more severe or if they start to get that way, I now recommend intensive outpatient therapy (IOP), an approach that increases the number of hours per week that the client is seen for four to six weeks. Awakenings, Dr. Maria Davila’s program, is new and (thankfully) now available in Lawrence.

Inpatient hospitalization is an extreme, but occasionally necessary, next step in preventing self-harm. It’s rarely a good experience for teens, but for those who cannot make and keep a self-harm safety plan, it can be a life-saving option.

Kyra: According to research, the average age of onset for teen depression is between 13 and 15. According to parents everywhere, the average age of onset for “moody teenager” is about the same. So, Wes is right, distinguishing between the two can be difficult. Here’s what you need to know to try and sort out the differences:

Know the signs: There are numerous symptoms of teen depression, including a loss of interest in activities; a belief that life is meaningless; self-deprecating behavior; poor performance in school; and significant changes in weight or appetite.  The more of these that show up, the more likely that depression is the cause.

Friends matter: As Wes notes, teens aren’t always willing to share how they feel with their parents. That’s why friends can make the critical impact when a teen starts hitting bottom. You might feel like a snitch, but if your friend isn’t cheering up or joking around like he or she used to, tell somebody. That somebody can be your friend’s parent, a school counselor or another trusted adult.

Know the risks: Untreated depression can lead to or perpetuate negative behaviors. Depressed teens are more likely to exhibit anxiety, substance abuse, self-mutilation or eating disorders. They are also more likely to commit suicide, particularly if their depression leans toward the bipolar spectrum.

Know the difference: Depression isn’t just feeling bummed occasionally. That happens with everyone. Keeping with a tried and true cliché, teenage moods are like an emotional roller coaster — up and down at a moment’s notice. But when that roller coaster drops and stays there for days or weeks, it’s time to take action.

On the Air: Catch Dr. Wes and Free State junior Fiona McAllister on the podcast of yesterday’s Up to Date with Steve Kraske for more tips on coping with teen depression.

Join Dr. Wes and Kyra live at 7 p.m. Aug. 21 for Five Crises That Heal, a keynote address to the Health and Spirituality Conference in Independence, Mo. It’s free to the public, but advanced reservations are required.

Go to www.dr-wes.com for details on both programs.

Wes Crenshaw, Ph.D., ABPP, is author of “I Always Want to Be Where I’m Not: Successful Living with ADD & ADHD.” Learn about his practice Family Psychological Services at dr-wes.com. Send your confidential 200-word question on adolescence and parenting to ask@dr-wes.com. Double Take opinions and advice are not a substitute for psychological services.