Depression in Children

It’s natural for children, like adults, to experience emotional ups and downs. For some children, feeling “blue” for an extended period can be a sign of depression. If your child’s mental health interferes with social activities, interests, schoolwork or family life, it’s time to get help.

What is depression?

Depression is a mood disorder that can cause someone to feel sad, irritable or hopeless. It may affect your sleep, appetite or relationships with others. Depression can also cause you to lose interest in hobbies or activities you once enjoyed. In severe cases, depression can lead to thoughts of suicide.

Depression is typically diagnosed if symptoms last two weeks or longer. It should only get evaluated, diagnosed and treated by a healthcare provider. Although depression is a serious medical condition, it’s usually treatable.

Does depression affect children?

Depression can affect people of any age, including children. Although children naturally have mood swings as they grow and develop, depression is different. The disorder can affect how children interact with friends and family. It may prevent them from enjoying school, sports, hobbies or other normal childhood activities.

In children, depression and anxiety often go hand in hand. Anxiety is a medical condition that causes feelings of fear, panic or worry about everyday situations. Sometimes, depression or anxiety in children gets chalked up to “growing pains.” But if you have any concerns about behavioral or mental health, talk to a healthcare provider.

How common is childhood depression and anxiety?

Depression and anxiety are among the most common mental health disorders in children. About 7% of children ages 3 to 17 have anxiety; about 3% deal with depression.

Both depression and anxiety tend to be higher in older children and teenagers between the ages of 12 and 17. An estimated 3.2 million adolescents aged 12 to 17 in the United States had at least one major depressive episode. This number represented 13.3% of the U.S. population aged 12 to 17. An estimated 31.9% of adolescents have had an anxiety disorder.

SYMPTOMS AND CAUSES

What causes depression and anxiety in children?

Childhood depression may be the result of a combination of factors. These risk factors alone may not account for the mood disorder, but they might play a role.

These risk factors increase a child’s chances for developing depression:

• Physical health. Children with chronic or severe medical conditions are more likely to be depressed. This includes obesity.
• Stressful events. Changes at home, at school, or with friends can increase a child’s risk for depressive symptoms.
• Environment. A chaotic or stressful home life can put a child at greater risk for a mood disorder like depression.
• Family history. Children who have family members with mood disorders or depression may be more likely to develop depression at a young age.
• Biochemical imbalances. Uneven levels of certain hormones and chemicals may impact how the brain works. This can increase the risk for depression.

Parents should look out for the following signs of depression in children:

• Behavioral problems at school.
• Changes in eating or sleeping habits.
• Feelings of sadness or hopelessness.
• Lack of interest in fun activities.
• Low energy levels or general tiredness.
• Mood changes, such as irritability.

What are the signs of anxiety in children?

Signs of anxiety in children may include:

• Anxiety about the future.
• Fear of being away from a parent.
• Physical symptoms of panic, such as sweating or dizziness.
• Refusal to go to school or take part in social activities.
• Worry that a parent or loved one may die.

Suicide risk

Childhood depression can cause thoughts of suicide, even suicidal behavior. In fact, suicide is the third leading causeTrusted Source of death for children ages 5 to 14.

If your child has been diagnosed with depression or you suspect they may be depressed, it’s important to watch them for warning signs and help them find help.

WARNING SIGNS OF SUICIDE RISK

• multiple symptoms of depression
• social isolation
• increased problematic behavior
• talking of suicide, death, or dying
• talking about hopelessness or feeling helpless
• frequent accidents
• substance use
• interest in weapons

DIAGNOSIS AND TESTS

How are childhood depression and anxiety diagnosed?

If you think your child is showing signs of depression or anxiety, talk to a healthcare provider. Start with your child’s pediatrician. Your pediatrician may refer you to a mental health professional for a more detailed evaluation.

A healthcare provider will likely start by ruling out conditions that may be causing your child’s mood issues. Illnesses known to cause symptoms of depression include:

• Anemia.
• Concussion.
• Diabetes.
• Epilepsy.
• Hypothyroidism or hyperthyroidism.
• Mononucleosis.
• Vitamin D deficiency.

There are no tests to diagnose depression. A mental health evaluation should include interviews with you (the parents) and your child. Information from teachers, friends and classmates can also shed light on your child’s mood and behavior changes.

MANAGEMENT AND TREATMENT

How are depression and anxiety in children treated?

Treatment options for children with depression are like those for adults. Your child’s healthcare provider may recommend:

• Psychotherapy (counseling).
• Medication.
• Combination of the two.

How does psychotherapy work?

Cognitive-behavioral therapy (CBT) is a form of psychotherapy that can treat anxiety or depression in children. CBT helps children learn to think more positively and control negative behaviors. It can also help children manage anxiety by getting to the root of their fears and worries. Therapy gives children tools to cope with anxiety and depression in healthier ways.

How do antidepressants work?

The most common antidepressant medications for children are selective serotonin reuptake inhibitors (SSRIs). These medications increase the level of serotonin in the brain. Serotonin is a chemical that can help increase feelings of happiness and well-being.

Use extra caution with antidepressants in children. Some children show no improvement with the medications, or may even feel more depressed. If a healthcare provider recommends antidepressants, watch your child’s condition closely. Never allow your child to stop taking antidepressants suddenly. Doing so can cause serious side effects or make depression worse.

PREVENTION

Can I prevent my child from developing depression or anxiety?

Depression can result from certain situations in life or may have a biological cause. As a parent, you can’t always control the stressors in your child’s life. But you can help improve your child’s mental health by ensuring they get:

• Daily exercise.
• Safe, supportive environment at home and school.
• Plenty of sleep.
• Well-balanced meals.

OUTLOOK / PROGNOSIS

Will my child’s depression or anxiety go away?

Every child is different. Some children may outgrow depression or anxiety. Others may need to manage these conditions for the rest of their lives. You can help your child now by making sure they get a proper diagnosis and the right treatment.

QUESTIONS FOR YOUR CHILD’S THERAPIST

When you meet with your child’s specialist, these questions may help you begin a conversation.

• What’s normal and what’s not? You can review the signs you’ve seen to understand if these may be problematic or normal.
• How will you diagnose my child? Ask about the process and what is needed from you and your child.
• What are the possible treatments? This will give you an understanding of the doctor’s approach to treatment. For example, you may decide you want to use a doctor that tries therapy before medication.
• What’s my role? As a parent, it’s normal to worry about your child’s physical and emotional health. Ask the doctor what they need from you in this process. Some parents will go through individual therapy to help them learn how to interact with their children in a different manner.