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Teen depression like adult is quite common and very treatable. Adolescence is always an unsettling time, with many emotional, psychological, physical, and social changes (MHA, 2017). According to the National Comorbidity survey, the prevalence of depression in adolescence is approximately 20 % by eighteen years of age (Gladstone, Beardslee, & O'Connor, 2011).

As with any disorders of adolescence, depression and depressive disorders have inherit risk factors. The adolescent period is often met with confusion, increased responsibilities, pressures of school and is largely influenced by peers. In the case of adolescence depression, the strongest influence is having a parent with a depressive illness. These youth are two to four-fold increased risk for depression and mood disorders.

(Gladstone, Beardslee, & O'Connor, 2011). Other contributing factors include, female, those with body image disturbances, limited support, and inadequate coping skills. Non-specific risk factors contributing to adolescence depression include, exposure to violence, poverty, child maltreatment and family instability (Gladstone, Beardslee, & O'Connor, 2011). Parents, close family members, school teachers, administrators, and health care professional all have the responsibility in observing for signs and symptoms of depression in adolescents. This vulnerable group is not well known for their ability to express themselves or how they are feeling emotionally.

Objective symptoms may include withdrawing from friends and activities, lack of enthusiasm, overreaction to criticism and indecisiveness. Subjectively teens may report doing poorly in school, feelings of anger or rage, restlessness or agitation, suicidal thoughts, and changes in eating and sleeping habits. Teens may also express their depression through hostile risk-taking behaviors, experimenting with drugs or alcohol and sexual promiscuity (MHA, 2017).

Overall improved mental health is the target of prevention. Primary prevention of teen depression is knowledge. We need to extend resources to the vulnerable population with education in schools and through youth centers on the signs and symptoms of depression, when and where to seek help before depression is escalated to point of injury to self or others.

As for secondary prevention, adequate and routine screening of adolescents in a comfortable, non-punitive environment with each encounter. Early intervention with medications and or therapy should be initiated with positive screenings. Therapy can help teens understand why they are depressed and how to cope with stressful situations (MHA, 2017).

Tertiary prevention begins with follow-up to ensure these teens are functioning at a better overall level. Continued therapy and monitoring of therapies as the teen encounters other stressors is key. Professional treatment can have a dramatic impact on their lives, putting them back on track with hope for the future.

Many state and local resources exist in prevention and treatment of adolescent depression. The California Youth Crisis line is a statewide, confidential, 24 hour, toll-free hot line for teens and young adults age 12-24.

In our community we also have something called the Community Emergency Response team (CERT), they offer emergency services, peer support and a 24 hour hot line for teens.

Beyond referring a teen to one of these services, the nurse could listen to the teen. Most often the teen is crying out for attention, in need of someone to listen to them and to hear them.

Build rapport with them, so they can entrust in you. Finally educate all teens on every encounter the warning signs, when and whom to seek help from.

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