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Depression in Children and Teens

It's normal for children and teens to feel down sometimes. When kids experience a difficult event such as the loss of a loved one, for example, they may feel grief or deep sadness. For a while, they may not be able to feel happy even when doing the things they usually enjoy. It is normal for grief to lessen over time, though.

Depression is not the same as sadness or grief.

Depression is a mood disorder that causes sadness and related symptoms to be more intense or last longer than usual after a difficult event. Depression can also occur without a triggering event. Children may have depression if their symptoms, which may include sadness, occur every day for more than 2 weeks.

Children and teens may not always know how to describe what they are feeling, or may try to avoid talking about it. Older children and teens may try to hide their feelings because they don't want to bother others, for example. However, there are some common signs that of depression you may notice. Any of these signs can occur in children who are not depressed, but when seen together, nearly every day, they are red flags for depression.

The two most common signs of depression in children & teens

  • Seems more sad and irritable than usual, in a low mood for most of the day

  • No longer enjoys activities that used to make them happy

Other common signs & symptoms of depression

Kids & teens of all ages:

  • Spending more time alone and less time with friends

  • Trouble falling or staying asleep, or sleeps more than usual

  • More trouble focusing or making choices

  • Struggling or failing at school

  • A marked change in weight or eating, either up or down

  • Talks less and makes less eye contact than usual

  • Spending more time using media

  • Has less energy or motivation than usual for even simple tasks

  • Cries more often or mentions feeling sad, worthless or guilty about things

Among teens & adolescents:

  • Not caring or feeling hopeful about the future

  • Lacking interest in personal grooming or appearance

  • Engaging in substance use

How common is depression in young people?

Depression is one of the most common disorders in the United States, and rates among children and teens have been rising in recent years. As many as 1 in 5 adolescents has depression at some point during their teen years. Every year, about 1 out of 11 adolescents has an episode of major depression.

Experts estimate that between 2% and 3% of children aged 3 to 11 years have depression. Although it is not common, children as young as 3 years have been diagnosed with depression. Depression in a young child is very concerning and can lead to more serious consequences.

Are there different types of depression?

Major depressive disorder

A doctor or another licensed mental health professional diagnoses major depressive disorder when at least five symptoms of depression last for more than 2 weeks, on most days. Although major depressive disorder can be mild, moderate or severe, all kids with major depressive disorder tend to have difficulty managing everyday life.

Persistent depressive disorder

This type of depression is less severe, and children who have it may be able to manage their activities. However, they are not at their best and often feel down. Usually, a doctor diagnoses persistent depressive disorder when symptoms last for more than a year. A child with persistent depressive disorder may also have an episode of major depression at the same time.

What can I do if my child seems depressed?

Talking with your child

It is important to openly talk with your child about what your child is feeling. Encourage them to share their feelings by listening without judgment. Often children or adolescents do not bring up the topic of their feelings but may respond honestly if you ask directly. Regardless of what your child says, if you notice signs of depression for more than two weeks, talk with your child's doctor.

Getting help

Your child's doctor can help determine whether your child is depressed. They have specific questionnaires and techniques for age-appropriate ways of talking with children and adolescents about feelings of sadness. In fact, many screen patients for depression every year from ages 12 through 21, with suicide now a leading cause of death among adolescents. If your child has depression, the doctor may provide treatment or refer your family to a mental health specialist for treatment.

Supporting your child

Although treatment of depression works, it may take a few weeks. Your child may get discouraged when they don't feel better right away. Make sure they follow the treatment plan, attending therapy and taking any medicines prescribed as directed. In the meantime, there are things you can do at home to support them:

  • Educate yourself, other caregivers & other family members. A child who feels depressed is not making up symptoms. What might look like laziness or irritability is a symptom of depression.

  • Let your child know that feelings of hopelessness are a symptom of depression and are not an accurate picture of reality.

  • Focus on your child's strengths, rather than areas that need improving, and provide verbal encouragement. Help your child look at problems in a different, more positive way.

  • Help your child relax and with physical, creative, nurturing and meaningful activities. Encourage them to get a healthy amount of exercise, sleep and nutritious foods, which can help boost mood.

  • While socializing is helpful, limit "social" screen time. Communicating by text or social media isn’t a substitute for face-to-face time with friends or family in person; it can actually make your child feel more cut off from others.

Safety planning & suicide prevention

It can be very scary to even think about your child hurting themself. But if they feel depressed, take extra steps to help make your home a safe place. Remove guns and other weapons, alcohol, medicines and harmful household chemicals. If you can’t remove these items, store them safely (for example, in a lockbox). Other steps:

Identifying warning signs/triggers. Your child should write down the thoughts or situations that generally lead to having thoughts of suicide. They can also list things that they can do, when they are feeling depressed or thinking about suicide, to help them feel better.

Make a list of people, and their phone numbers, who can help when your child is under stress or experiencing the warning signs in step 1. This can include family and friends and their therapist or doctor. Also, add the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) and the Crisis Text Line (text HOME to 741741 to connect with a trained counselor). You can ask your child or teen’s doctor for a safety plan you can fill out.

Remember

Don't hesitate to talk with your child's pediatrician if you have any questions or concerns about their mental health.

More information

Last Updated
9/12/2022
Source
Adapted from Depression in Children and Adolescents: Types and Signs (American Academy of Pediatrics Copyright © 2021)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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