Depression is a serious mental health concern that affects children, adolescents, and adults. It impacts how people think, feel, carry out tasks, and function in everyday life. Children as young as three years old can experience depression. Sometimes depression is misdiagnosed or overlooked in children because it can present differently in children than in adults.
What Does Depression Look Like In Children?
When you think of depression, you typically think of sadness or depressed mood, tearfulness, hopelessness, loss of interest in fun or pleasurable activities, and excessive sleeping. However, depression can also include feelings of guilt or worthlessness, difficulty falling asleep or staying asleep, weight loss or weight gain, difficulty thinking or making decisions, low energy or fatigue, and recurring thoughts of death or suicide. In children, depression can also look like:
- Irritability or crankiness
- Anger/angry outbursts
- Acting out
- Complaining of boredom
- Frequent stomach aches or headaches that have no medical cause
- Frequent crying or whining
- Inability to concentrate
- Poor school performance
- Feeling like nothing matters, not caring about anything, or “not caring anymore”
- Low self-esteem
- Feeling unloved or worrying about if people love them
- Sensitivity to rejection or failure
- Hyperactivity or restlessness
- Bed-wetting or increased accidents
- Change in appetite
- Failure to make expected weight gains
- Withdrawal or social isolation
- Separation anxiety or clinginess
Factors Involved In Childhood Depression
There are several factors involved in children developing depression, including family history, environment, and experiencing medical conditions.
Family history. Children with a parent or close relative who has been diagnosed with depression are more likely to experience depression.
Environment. Stressful life events or changes at home or school, like moving, changing schools, parent divorce/separation, or even change in family composition, such as becoming part of a blended family can lead to depressive symptoms in children.
Medical and biochemical factors. Being diagnosed with a chronic medical condition, such as Crohn’s disease, type 1 diabetes, or Celiac disease, can trigger feelings of hopelessness and other depressive symptoms. Biochemical imbalances in the brain can also play a role in the onset of depressive symptoms.
What Can Parents And Caregivers Do To Help?
Maintain a daily routine. Establish and maintain a consistent routine, especially for eating and sleeping. A consistent routine can help your child feel safe and in control at times when things can seem chaotic or hopeless.
Talk to your child. Help them to label their feelings. You can also model how to express and label feelings by talking about how you feel in various situations and letting your child see how you handle your feelings. If your child is older, listen to them, validate their feelings, normalize what they are going through, and offer hope. Avoid dismissing their feelings or what they are telling you, and refrain from pointing out why they should not be feeling the way they feel. Also, ask questions about how they are feeling and if they are experiencing suicidal or homicidal thoughts. Be direct. Don’t just ask if they are thinking about hurting themselves. Ask if they are thinking about killing themselves, if they have a plan, and access to something to carry it out. Call 911 or take your child to the nearest emergency room if they are experiencing suicidal thoughts.
Tell your child you love them. A lot of children who are experiencing depression question whether their parents or siblings love them or feel unlovable. Showering your child with hugs, verbal expressions of love, and one-on-one time (for example, date night every Tuesday with your child at Chick-Fil-A) can provide positive messages to counter your child’s negative thinking or feelings and further develop the parent-child relationship. Nurturing the parent-child relationship can create an atmosphere in which your child can feel heard.
Be patient. Taking care of a depressed child can be hard on a parent or caregiver. You want to fix it and you may get overwhelmed. The best thing you can do is give yourself and your child some grace as you get through it and take care of yourself.
Track changes in behavior. You are your child’s best advocate and the person most likely to know that something has changed. Keeping track of specific behavior and mood/emotional changes as well as themes of death or dying during play is helpful if you need to seek professional support for your child.
Provide healthy lifestyle choices. Incorporate daily exercise (e.g., going for walks, riding a bicycle, yoga, sports, etc.) and healthy eating into your child’s routine. Check out https://www.choosemyplate.gov/ for tips on ensuring your child receives nutritious, adequately portioned meals and healthy snacks.
Treating Childhood Depression
There are two primary forms of treatment for depression in children: psychotherapy and medication. Psychotherapy and medication can be used together or separately to treat depression. Psychotherapy can often be as effective when used alone as when used in conjunction with medication.
Psychotherapy. Sometimes children are able to overcome depression by talking to or interacting with a mental health professional, such as a clinical social worker, professional counselor, or psychologist, who is trained in treating pediatric mental health concerns. Play therapy, behavior therapy, art therapy, and parent-child interaction therapy are shown to be effective forms of treatment for depression in children as they work well for younger children as well as those who are nonverbal. Cognitive behavioral therapy also works well for older children. Regardless of which method is chosen, the best treatment involves parents in the treatment process, either through family therapy, parent education, or parent training.
Medication. You may decide that your child may benefit from taking medication to manage his or her emotional and behavioral concerns. Your child’s pediatrician or therapist can help you find a psychiatrist or nurse practitioner who specializes in pediatric/child and adolescent mental health to evaluate your child for whether medication is appropriate. Medication can help when biochemical factors influence depression or when it is necessary to stabilize the child’s mood.
Signs That Your Child May Need Immediate Professional Support
Depression is a serious mental health concern that if left untreated can lead to completed suicide, repeated episodes of depression, or prolonged, severe depression in the future. Please seek immediate professional support if:
You notice a pattern of symptoms or behaviors most of the day, almost everyday, over a two week period, or
Your child expresses that he or she is having suicidal thoughts, wants to die, or has attempted suicide (Call 911 or your local mobile crisis team or take your child to the nearest emergency room)
If you think your child may be experiencing depression, please:
Reach out to us at Milestones Counseling and Consulting Services at 443-574-4295.
- Contact your child’s pediatrician to rule out medical causes and connect to resources
- Talk to your child’s school counselor about receiving additional support in school
- Call the National Suicide Prevention Hotline at 1-800-273-8255
- Text hello to 741741 (The Crisis Textline)