Depression is a serious mental health problem that can affect individuals at any age, including children and young people. It is not just about temporary feelings of sadness. While all children experience sadness as a normal part of growing up and learning to regulate emotions, depression involves a sense of sadness that persists or persistent feelings of sadness that interfere with the ability to function in daily life. Unlike normal sadness or grieving, most episodes of depression last for weeks, months, or even years.
Based on the sources I have, I want to tell you that depression is a serious mental health problem that affects children and young people, not just adults. It’s more than just temporary sadness; it involves persistent feelings of sadness or a low mood, irritability, and a loss of interest in activities that used to be enjoyable, lasting for more than a few weeks.
Other common signs include fatigue, changes in sleep or appetite, difficulty concentrating, and sometimes physical complaints like headaches or stomach aches. It’s important to take these signs seriously because depression can disrupt a child’s life, affect school and social relationships, and in severe cases, can lead to thoughts of self-harm or suicide. The good news is that help is available, and early intervention is crucial for the best outcomes.
If you’re concerned about a child, talking to them is a critical first step, and seeking help from a healthcare provider like a GP or a mental health professional is strongly recommended.
To understand the nuances of childhood depression, including specific symptoms, potential causes, how it’s diagnosed, and various treatment options like therapy and medication, I encourage you to continue reading the detailed information provided in the sources. This will give you a much deeper understanding of this condition and how best to support young people who may be struggling.
What is Depression in Children?
Depression in children is a mood disorder characterized by persistent feelings of sadness, irritability, or hopelessness. These feelings can interfere with a child’s relationships and activities. When a child has depression, their sadness can last for more than two weeks, and they may also experience lingering irritability or hopelessness. It can impact their sleep, appetite, and relationships, and prevent them from enjoying activities they once liked, such as school, sports, or hobbies. In severe cases, depression can lead to thoughts of suicide.
Depression in children can manifest differently than in adults. It’s important to note that simply being moody or unpredictable should not be diagnosed as depression; a diagnosis requires a range of symptoms that significantly impair day-to-day functioning. Types of depressive disorders mentioned include:
Major Depressive Disorder (clinical depression), characterized by persistent sadness, hopelessness, or anger, along with sleep disturbances and loss of interest in enjoyable activities.
Dysthymia is another form, denoting milder feelings of depression that last for a longer period. Children with dysthymia might be seen by peers as “moaners” and by teachers as complaining excessively. Dysthymia is milder than major depressive disorder, but symptoms last longer, sometimes for years.
Seasonal Affective Disorder (SAD) involves symptoms similar to major depressive disorder, but they occur with the seasons.
Premenstrual Dysphoric Disorder (PMDD) can affect children after their first period, causing depressive symptoms and/or anxiety about a week before each period.
Disruptive Mood Dysregulation Disorder is diagnosed in children aged 6 or older who have frequent angry outbursts or temper tantrums inappropriate for their age.
How Common is Depression in Children?
Estimates suggest that about 3.2 percent of American children and adolescents have diagnosed depression. Around 3% of children and teens aged 3 to 17 have depression, and it is more common in teens than younger children. About 1 in 5 teens have been diagnosed with major depression, although the actual number is likely higher as this only counts official diagnoses. Rates of depression might be even higher in children and teens with certain chronic illnesses like diabetes, epilepsy, chronic pain, and asthma.
What are the Signs and Symptoms?
Symptoms of depression in children often include sadness or a low mood that does not go away, being irritable or grumpy all the time, not being interested in things they used to enjoy, and feeling tired and exhausted a lot of the time.
Children and young people with depression may also experience a range of other symptoms, including:
- Trouble sleeping or sleeping more than usual
- Difficulty concentrating
- Interacting less with friends and family or social isolation
- Being indecisive
- Low confidence or negative self-talk/low self-esteem
- Eating less than usual or overeating
- Big changes in weight, either loss or gain
- Seeming unable to relax or being more lethargic than usual
- Talking about feeling guilty or worthless
- Feeling empty or unable to feel emotions (numb)
- Feelings of worthlessness, restlessness, or low self-esteem
- Feeling hopeless or empty
- Loss of interest or pleasure in usual activities
- Loss of interest in, or conflict with, family and friends
- Fixation on past failures or exaggerated self-blame or self-criticism
- Extreme sensitivity to rejection or failure, and the need for excessive reassurance
- Trouble thinking, concentrating, making decisions and remembering things
- Ongoing sense that life and the future are grim and bleak
- Frequent thoughts of death, dying or suicide
- Actually self-harming, such as cutting skin or taking an overdose
- Problems at school and problem behavior, including a drop in academic performance or refusal to attend school
- Physical symptoms like headaches and stomach aches or other aches and pains
- Risk-taking behaviors
- Older children who are depressed may misuse drugs or alcohol or abuse alcohol or drugs
- Some children also have problems with anxiety as well as depression.
- Acting out behaviors, ranging from oppositional defiance to disruptiveness, angry outbursts, disruptive or risky behavior, or other acting-out behaviors
- Preoccupation with song lyrics, books, poetry, or art that suggest that life is meaningless (in adolescents)
- Less attention to personal hygiene or appearance (in adolescents)
- Less frequently, some children and teens may show more extreme symptoms, such as paranoid delusions or auditory hallucinations.
A significant difference between children/adolescents and adults is that children and adolescents may express depression more through irritability than with a low mood. Symptoms can also look different from one child to the next, and it’s important to focus on what is normal for a particular child. If children are visibly unhappy or uncharacteristically irritable for at least 2 to 4 weeks, with these feelings lingering or worsening, they may be depress.
Experts do not know exactly what causes depression in children and adolescents, but they believe genetics and environmental factors play a role. Often, it is caused by a mixture of things.
Things that increase the risk of depression in children include:
- Family difficulties
- Bullying
- Physical, emotional or sexual abuse or exposure to other traumatic experiences or adversity including child abuse
- A family history of depression or other mental health problems, such as bipolar disorder or alcohol use problems
- Loss, stress
- Co-occurring mental health conditions such as ADHD, anxiety, a personality disorder, anorexia or bulimia, or conduct issues
- A history of depression or anxiety disorders
- Substance use or abusing alcohol, nicotine or other drugs
- Problems with peers
- Lack of self-confidence and inability to keep up at school
- Discord within the family or if other members of the family are depressed
- Exposure to drug and alcohol use
- Other life events such as moving away from home, experiencing bereavement, or suffering other illnesses may bring instability and render a child more vulnerable.
- Difficult events such as parents separating, a bereavement, or problems with school or other children can trigger depression.
- Having a tendency to get depression combined with difficult life events.
- Physical illness or injury.
- Being female.
- Puberty.
- Low birth weight, brain injury, or chronic illness (like diabetes).
- Loss of a loved one or a romantic relationship.
- Certain personality traits, such as low self-esteem or being overly dependent, self-critical or pessimistic.
- Being gay, lesbian, bisexual or transgender in an unsupportive environment.
- Early childhood trauma, such as physical or emotional abuse or loss of a parent, may cause brain changes increasing risk.
- Learned patterns of negative thinking, such as feeling helpless instead of capable of finding solutions.
- Issues that negatively impact self-esteem, like obesity, peer problems, long-term bullying, or academic problems.
- Having been the victim or witness of violence.
- Having a family member who died by suicide.
- Having a family with major communication and relationship problems.
- Having experienced recent stressful life events, such as parental divorce or parental military service.
The more risk factors present in home and school life, the more likely a child could become depressed. Some children are much more vulnerable to stresses and untoward life events, particularly with biological and environmental risk factors.
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How is it Diagnosed?
Since there are no reliable laboratory tests for depression, mental health evaluations are essential. If you think your child is showing signs of depression, the first step is to talk to a healthcare provider, such as your child’s pediatrician. They may refer you to a mental health professional for a more detailed evaluation.
Their healthcare provider may first rule out conditions with similar symptoms, such as anemia, chronic pain, concussion, diabetes, epilepsy, hypothyroidism or hyperthyroidism, mononucleosis, or vitamin D deficiency.
If a physical issue is ruled out, the pediatrician may refer you to a mental health professional like a therapist, child psychologist, or psychiatrist. To diagnose depression, the provider will talk with both you and your child, asking about their behavior, mood, symptoms, and when they occur. They may also ask parents to complete surveys and may want to speak with the child’s teacher or other caregivers for more information. A diagnosis is typically made if feelings of sadness and hopelessness, along with a lack of interest in daily activities, are present with other symptoms for two or more consecutive weeks.
It is difficult to diagnose depression in young children as they may not be able to describe their feelings. Teachers should not be afraid to ask questions like “Are you unhappy, what is making you unhappy, do you cry, do you feel bad about yourself in any way?”.
How is it Treated?
Depression in children is usually treatable. Treatment strategies are individualized and vary depending on the child’s age. The two main ways to treat depression in children are talk therapy and medication. Both can work alone, but they seem to work better together.
Psychotherapy, most often in the form of cognitive behavioral therapy (CBT), is a common approach. CBT helps children learn to think more positively, manage anxiety and negative behaviors, and develop coping skills and relaxation techniques. Often, parents participate in the psychotherapy. In mild cases, therapy can be as effective as medication.
For children whose depression does not respond to psychotherapy or for moderate to severe cases, medication can be an option. The goal with medication, especially for younger children, is to use the fewest medications at the lowest effective dose.
The most common antidepressant medications are selective serotonin re-uptake inhibitors (SSRIs). SSRIs increase serotonin levels in the brain, which can help increase feelings of happiness and well-being. Common SSRIs prescribed for childhood depression include Fluoxetine (Prozac®), Paroxetine (Paxil®, Pexeva®), and Sertraline (Zoloft®). SSRIs are FDA-approved for use by adolescents and teens and often bring improvement.
Medications can have side effects, including allergic reactions, bloody poop, fast or irregular heartbeat, fainting, dizziness, chest pain, shortness of breath, high fever, sudden vision changes, eye pain, and critically, thoughts of suicide or worsening mood. Other side effects that may not require immediate medical attention but should be monitored include appetite changes, difficulty sleeping or drowsiness, dry mouth, headache, shaking (tremors), and upset stomach, nausea or diarrhea. It is crucial to pay attention when a child starts an antidepressant or when the dose changes, as some children may not improve or may even feel more depressed.
Antidepressants can take about four to six weeks to start working, and finding the right medication and dose may take time. Never allow a child to stop taking antidepressants suddenly, as this can cause serious side effects or worsen depression. Psychiatrists recommend staying on medication for at least nine months after the first depressive episode.
While counseling can offer more immediate benefits, it takes time to build trust with a therapist and change patterns in thinking and behavior. Combining medication with therapy is often preferred because therapy helps the child learn about triggers and develop coping skills while the medication takes effect.
Children can recover. Continued vigilance is required because depression can recur and become chronic. The younger someone is diagnosed with depression, the higher the risks of recurrence and more depressed episodes in adulthood.
What are the Potential Complications?
Depression is associated with serious complications. If left untreated, depression symptoms are unlikely to get better on their own and may worsen or lead to other problems.
Potential complications include:
- Poor school performance or academic problems
- Impaired social relationships or family conflicts and relationship difficulties
- Recurrence of depressive episodes or depressive disorder as they grow up
- Increased risk for anxiety and substance use disorders
- Alcohol and drug misuse
- Higher risk for suicide
- In the worst-case scenario, the end result may be suicide. Suicide is often associated with depression and is a leading cause of death for children and teens.
Can it be Prevented?
You cannot prevent depression in your child, as it can have biological causes or develop due to life situations, and you cannot control genetics or all stressors. However, parents can help improve a child’s mental health by ensuring they get:
- Daily exercise
- A safe, supportive environment at home and school
- Plenty of sleep or a regular sleep routine
- Well-balanced meals or a balanced diet
Encouraging teenagers to take steps to control stress, increase resilience, boost self-esteem, practice self-care (including healthy sleep and responsible electronics use), reach out for friendship and social support, and seek treatment early can also help. Maintaining ongoing treatment, if recommended, even after symptoms improve, can help prevent relapse.
What Should Parents Do?
If you think your child may be depressed, it’s important to talk to them. Try to find out what is troubling them and how they are feeling. Take whatever is causing the problem seriously, even if it doesn’t seem significant to you, as it could be a major issue for your child.
If your child does not want to talk, let them know you are concerned and are there for them. Encourage them to talk to someone else they trust, like another family member, a friend, or someone at school. It can also be helpful to talk to others who know your child, including their other parent, or contact their school to see if staff have concerns.
The most important things parents and caregivers can do are listen to them and support them. When you notice mood changes, ask questions about how they feel physically and about themselves. What they do not say may also be important. If your child’s symptoms worsen after a conversation, consider a different approach next time.
Keeping track of your child’s sleep, eating habits, energy level, activities, medication side effects, interactions with you, participation in hobbies, and interaction with peers can be helpful. Recording these details in a journal can assist you and their healthcare provider in identifying trends and meaningful changes.
If you think your child is depressed or you are concerned about their general wellbeing, make an appointment for them to see a GP. Parents and teachers are often the first to identify symptoms. If symptoms persist or worsen, they should be referred to a GP or school nurse.
Where to Get Help?
If you think your child is depressed, start by talking to their pediatrician. If necessary, the GP can refer your child to local children and young people’s mental health services (CYPMHS) for specialist help. CYPMHS is a term for services that work with children and young people with mental health difficulties. You may also be able to refer your child without seeing a GP in some cases.
Resources for immediate help with suicidal thoughts in the U.S. include calling 911 or your local emergency number. You can also call or text the 988 Suicide & Crisis Lifeline at 988, available 24/7.
The Lifeline offers free and confidential emotional support. The Spanish language line is 1-888-628-9454. Another crisis service for teens is TXT 4 HELP: Text “safe” and your location to 4HELP (44357). Reach out to a mental health professional, doctor, school nurse, parent, friend, spiritual leader, teacher, or someone else you trust. If a loved one is in danger or has attempted suicide, ensure someone stays with them, call emergency services immediately, or take them to the nearest hospital emergency room if safe to do so. Never ignore comments or concerns about suicide.
Remember, depression in childhood is common, and it’s nobody’s fault. Letting your child’s healthcare provider know about changes in mood or other symptoms that last for more than a few weeks is crucial. Treatment can help, whether it’s needed temporarily or ongoing.
FAQ
Can children and young people experience depression?
Yes, children and young people can experience depression, just like adults. It is important to recognize the signs and seek help early. Even very young children can get depressed. While sadness is a normal part of growing up, depression involves a persistent sense of sadness that needs to be worried about.
- What is depression in children and young people? Depression is a serious mental health problem or a mood disorder that causes a persistent feeling of sadness and loss of interest in activities. It’s more than just feeling sad or “blue” for a short time. Depression in children involves persistent feelings of sadness that interfere with their ability to function in daily life, relationships, and activities. It affects how a child or teenager thinks, feels, and behaves. Unlike normal sadness or grieving, most bouts of depression last for weeks, months, or even years.
- How is depression in children different from adults? Symptoms may be different between teens and adults. The biggest difference is that children and adolescents may express their sadness or depression more with irritability than low mood. Acting out behaviors, ranging from oppositional defiance to disruptiveness, and anger are also symptoms that may suggest depression in children. Younger children who complain persistently of aches and pains or other nonspecific physical discomfort may also be depressed.
- What are the common signs and symptoms of depression in children and young people? Symptoms can vary from one child to the next and may look different than in adults. It’s important to focus on what’s normal for a particular child when considering symptoms. Common signs include: Sadness, or a low mood that does not go away. This may include crying spells for no apparent reason.
- Being irritable or grumpy all the time, or an annoyed mood. This is often a bigger difference in children/teens than low mood.
- Feeling tired and exhausted a lot of the time, or low energy levels.
Changes in sleep: having trouble sleeping, sleeping more than usual, difficulty falling or staying asleep, or wanting to sleep much more than is usual.
**Changes in appetite/weight:** eating less than usual or overeating, big changes in weight, decreased appetite and weight loss, or increased cravings for food and weight gain. Not reaching developmental weight milestones can be a sign.
**Difficulty concentrating** or being unable to concentrate.
**Interacting less with friends and family**, social withdrawal, or isolation. They may not want to spend time with family and friends and isolate themselves.
**Feeling worthless or guilty**, negative self-talk, low self-esteem. Fixation on past failures or exaggerated self-blame or self-criticism.
**Feeling empty or unable to feel emotions (numb)**.
**Physical symptoms** like headaches and stomach aches, or persistent aches and pains.
* Being indecisive.
* Seeming unable to relax or being more lethargic than usual.
* Losing interest in their general appearance.
**Problems at school** (including changes in grades or refusing to attend), poor school performance, frequency absences, or problem behavior.
* Angry outbursts, disruptive or risky behavior, or other acting-out behaviors. Older children may misuse drugs or alcohol.
**Thoughts about suicide or self-harming**. Actually self-harming, for example, cutting their skin or taking an overdose.
* Less frequently, some children may show more extreme symptoms like paranoid delusions or auditory hallucinations.
How common is depression in children and teens?
About **3% of children and teens between the ages of 3 and 17 have depression**. An estimated 3.2 percent of American children and adolescents have diagnosed depression. It is **more common in teens** than children. About 1 in 5 teens have been diagnosed with major depression, and the actual number is likely much higher.
What causes depression in children and young people?
Experts don’t know exactly what causes depression, but it is thought to be the result of one or more factors. It’s often caused by a mixture of things.
Potential causes include:
**Genetics and family history:** Depression is more common if close biological relatives have the condition.
**Environmental factors**.
**Stressful life events:** Such as parents separating, a bereavement, problems with school or other children, parental divorce, parental military service, or the death of a loved one.
**Difficult life events**.
**Brain chemistry:** Abnormal or impaired neurotransmitters may change nerve system function, leading to depression.
**Hormones:** Changes in hormonal balance may be involved.
**Early childhood trauma:** Traumatic events like physical or emotional abuse or loss of a parent may cause brain changes that increase risk.
* **Learned patterns of negative thinking:** Linked to learning to feel helpless.
- What are the risk factors for depression in children and young people? Many factors can increase the risk. The more risk factors present, the more likely a child could become depressed. These include: Family history of depression or other mental health problems. Family difficulties or major communication and relationship problems. Bullying or problems with peers. Physical, emotional, or sexual abuse, or being the victim or witness of violence.
- A history of depression, anxiety disorders, ADHD, or conduct issues.
- Lack of self-confidence.
- Inability to keep up at school.
- Exposure to drug and alcohol use within the family.
- Adversity, or adverse childhood experiences.
- Other life events such as moving away from home or suffering other illnesses.
- Experiencing bereavement.
- Being female.
- Physical illness or injury, chronic physical illness (like diabetes, epilepsy, chronic pain, asthma), low birth weight, or brain injury.
- Problems with friends.
- Puberty.
- Substance use.
- Having issues that negatively impact self-esteem, such as obesity or academic problems.
- Having certain personality traits like low self-esteem, being overly dependent, self-critical, or pessimistic.
- Being gay, lesbian, bisexual, or transgender in an unsupportive environment.
How is depression in children and young people diagnosed?
If you think your child is showing signs of depression, talk to a healthcare provider, starting with your child’s pediatrician. They may refer you to a mental health professional like a therapist, child psychologist, or psychiatrist for a detailed evaluation. There are no reliable laboratory tests to diagnose depression, so mental health evaluations are essential. The provider will talk with both you and your child, asking about behavior, mood, and symptoms.
They may use surveys or talk to teachers or other caregivers for more information. They will likely first rule out other physical conditions with similar symptoms, such as anemia, chronic pain, concussion, diabetes, epilepsy, thyroid issues, mononucleosis, or Vitamin D deficiency. A diagnosis is typically made if symptoms like sadness and loss of interest, along with others, last for two or more consecutive weeks.
Are there different types of depression in children?
Yes, the sources mention several types:
**Major depressive disorder (clinical depression):** Involves persistent sadness, hopelessness, or anger, trouble sleeping (too much or too little), lack of interest, and feeling disengaged.
Premenstrual dysphoric disorder (PMDD): Can occur after a child’s first period, with depression/anxiety symptoms starting about a week before each period.
Seasonal affective disorder (SAD): Symptoms similar to major depressive disorder that come and go with the seasons, often during winter.
Disruptive mood dysregulation disorder: Diagnosed in children 6+, characterized by frequent angry outbursts or temper tantrums inappropriate for their age.
Dysthymia: Milder feelings of depression that last for a longer period, sometimes for years. Symptoms are similar to major depression but milder and chronic. Children with dysthymia may be perceived as moaners or complaining excessively. This chronic state can sometimes exacerbate into major depression.
How is depression in children and young people treated?
Treatment is often individualized based on the child’s age and symptom severity. The best approach typically involves **psychotherapy** (talk therapy), most often in the form of **cognitive behavioral therapy (CBT)**. CBT helps children learn new, more effective strategies to regulate emotions, thoughts, and behaviors. Parents often participate in psychotherapy. For children whose depression doesn’t respond to psychotherapy, **medication can be an option**.
The most common antidepressants prescribed are selective serotonin reuptake inhibitors (SSRIs). These increase serotonin levels in the brain, which can help increase feelings of happiness and well-being. Common SSRIs mentioned are Fluoxetine (Prozac®), Paroxetine (Paxil®, Pexeva®), and Sertraline (Zoloft®). Medications are often used at the lowest effective dose, especially in younger children. Often, therapy and medication seem to work better together.
- How soon after treatment will my child feel better? Antidepressants can take some time to start working, typically about four to six weeks. It may take even longer for patterns in thinking and behavior to change through therapy. Your child’s healthcare provider may try one medication for several weeks to months, and if it doesn’t help, they may adjust the dose or try a different medication. For a first episode of depression, staying on medication for at least nine months is recommended. The therapist can help the child learn about triggers and develop coping skills while medication takes effect.
- Can depression in children and young people lead to suicide? Yes, in more severe cases, depression can lead a child or teen to consider or plan for suicide. It is a serious potential complication. Thoughts about suicide or self-harming are potential symptoms. While not all children with depression will have suicidal thoughts, it increases the risk. Any mention or indication of suicidal thoughts or self-harm should be taken very seriously and addressed immediately. Suicide is a leading cause of death for children and teens in the U.S..
- What are the potential complications of childhood depression?
Untreated depression can result in emotional, behavioral, and health problems. Complications can include: - How can parents and caregivers help a child who may be experiencing depression? Parents and caregivers play a crucial role. The most important thing is to listen to them and support them. Talk to them and try to find out what’s troubling them and how they’re feeling. Take their concerns seriously.
- If they don’t want to talk to you, let them know you’re concerned and are there for them. Encourage them to talk to someone else they trust.
- It may be helpful to talk to others who know your child, like their other parent.
- Contact their school to ask if staff have concerns.
- Seek professional help from a GP or mental health service if you suspect depression.
- Provide a safe, supportive environment at home.
- Encourage healthy habits like regular sleep, a balanced diet, and sufficient exercise.
- Track their symptoms (sleep, eating, energy, activities, interactions, participation in hobbies, peer interaction, side effects of medication) in a journal to help identify trends and changes with their provider.
- When should I seek medical help for my child? It’s important to get help early if you think your child may be depressed. If depression signs and symptoms continue or begin to interfere in your teen’s life, talk to a doctor or a mental health professional trained to work with adolescents.
- Make an appointment with a GP if you think your child is depressed or are concerned about their general wellbeing.
- Talk to a healthcare provider if your child shows signs of depression that don’t go away, if they struggle to fall asleep for more than three days, or don’t go to school for more than five days.
- If your child shows signs of suicide, get help right away. If you think your child might hurt themselves, seek immediate medical attention.
- You can call the Suicide and Crisis Lifeline at 988 in the U.S.. In an emergency, call 911.
- Never ignore comments or concerns about suicide. Always take action to get help.
Can childhood depression be prevented?
There is no guaranteed way to prevent depression. However, certain strategies can help improve a child’s mental health and resilience.
Encourage your child to:
Take steps to control stress, increase resilience, and boost self-esteem.
Practice self-care, including healthy sleep and responsible use of electronics.
Reach out for friendship and social support.
- Practice self-care, including healthy sleep and responsible use of electronics.
- Reach out for friendship and social support.
Get treatment at the earliest sign of a problem to help prevent it from worsening.
Maintain **ongoing treatment** if recommended to help prevent relapse. Ensure they get daily exercise, a safe and supportive environment, plenty of sleep, and well-balanced meals.