Is my son depressed, or just lazy?

“Is my son depressed, or just lazy?” I have been asked this question by many parents with sons in middle and high school. In fact, it’s often the question that brings a family in for an initial appointment with a psychotherapist. Although I mostly hear from mothers worried about their sons, my thoughts apply well to fathers and daughters, too.

A mother will express concern that her son has been withdrawn, holed up in his room, eyes glued to his Xbox. He seems more irritable. Also, his grades may be lower than last year, he doesn’t spend as much time with friends, and it’s like pulling teeth to get him to do his household chores—let alone get ready for school in the morning.

So does the son have a psychiatric condition that needs treatment? Or is he just pulling a fast one to get out of doing work? For parents, this often leads to another question: do I respond with concern or with discipline?

First, let’s review the typical signs of clinical depression. These include:

• Irritability, tearfulness or sadness
• Loss of interest in important activities like schoolwork, sports or play
• Changes in appetite or weight
• Problems sleeping
• Being overly restless or unusually tired
• Messages of worthlessness or guilt, such as “I’m such an idiot”
• Statements about suicide or harming oneself, or signs of self-harm

It is important to remember that—aside from statements about suicide or evidence of self-harm—it’s perfectly normal for anyone to experience one or two of these things from time to time. Happiness would be meaningless without sorrow. We start talking about depression only when the symptoms are ongoing and excessive, and they cause clear problems with a child’s functioning at home or school.

So let’s say your child is showing some signs of depression. You can be a positive influence. For starters, drop the word lazy from your vocabulary. The best way to change a child’s behavior is to encourage the behavior you want, not criticize the behavior you don’t want. Using negative labels like “lazy” is more likely to discourage your son and may even confirm thoughts that he’s not living up to your expectations.

The bottom line is that good parenting involves a constant dance between concern and discipline. This dance is challenging, and no parent is always going to get it right. If you suspect your pre-teen or teenage son is depressed, consider the following responses:

• Think of discipline as teaching, not punishment. Keep a calm, neutral tone when setting and enforcing rules.
• Help your son make a plan for coping positively with sadness or stress. For example, consider using art, writing, music, exercise, relaxation, or outings.
• Share how you deal with feelings that arise in your life, such as how you cope with frustration after a hard day at work.
• Limit factors in your son’s environment that seem to trigger negative feelings. For example, if you feel the Xbox is not helping, relocate it to the living room and limit his use.

Other circumstances, such as grief, drug use or a medical condition called hypothyroidism can cause symptoms similar to depression. These should be ruled out and treated appropriately.

Seek out a psychotherapist for additional help if needed. Don’t be afraid to ask lots of questions! Ultimately, through your time, attention, and example, you’ve got the most power to affect your child’s life for the better.

If you have a crisis situation, help is readily available:

• In an emergency, call 9-1-1
• King County 24-Hour Crisis Line – 1 (866) 427-4747
• National Suicide Prevention Lifeline – 1 (800) 273-8255