6 Things to Know About Childhood Depression

Kids get sad often. They cry, cling and act out when they're unhappy. It's perfectly normal for kids to experience emotional ups and downs, and some kids even go through phases (a few days here and there) where they seem more worried than usual or less happy than you might expect. Growing up is hard work, and no child is happy every moment of every day.

Childhood depression, on the other hand, is a serious mental health condition that is often overlooked because childhood is largely characterized by emotional shifts and evolving friendships. We expect kids to experience some conflict with friends and other struggles as they learn and grow. On the other hand, parents are not conditioned to look for signs of a major depressive episode in young children. But with the American Academy of Pediatrics endorsing a universal depression screening for adolescents ages 12 and up, it's time to raise awareness about childhood depression.

According to data compiled by the Child Mind Institute,14 percent of children are diagnosed with depression or bipolar disorder and 22 percent of American youth will have a diagnosable mental illness with "serious impairment" before age 18.

One challenge with diagnosing depression in children is that the symptoms vary. Prepubescent children don't necessarily exhibit the same symptoms as adolescents and adults. They cry easily and often. They don't sleep alone at night. They act out and have low frustration tolerance. They're constantly irritable. In isolation, any of these symptoms is indicative of a perfectly average day for a child. So spotting childhood depression is difficult, but here are some things to keep in mind:

Look for patterns of behavior.

When kids experience a few symptoms for a short period of time, it may just be the result of normal mood changes. But be direct with your child in your observations. Start a conversation with a statement and an open-ended question: "I noticed you seem sad lately. Can you tell me what you're thinking about?"

If you notice a pattern of symptoms that occur more often than not for more than two weeks and the symptoms interfere with normal daily living and family and school life, that's a red flag. In this case, reach out for help. Your child's pediatrician is a great starting point to rule out any potential medical causes and to get a complete physical. From there, you can get referrals for licensed mental health practitioners who specialize in treating young children.

[Read: What Parents Should Know About Teen Depression.]

Know the symptoms.

Many people think of excessive sadness when they consider depression, and this is characteristic of adult depression. For kids, the symptoms are slightly different and tend to change. A pattern of excessive sadness or irritability should certainly be taken into consideration, but it's important to consider a constellation of symptoms instead of focusing on mood alone. Irritability tends to look like a behavior problem at times. For this reason, it's often overlooked.

Children with depression may exhibit some of these symptoms:

-- Sleep disturbance (difficulty falling or staying asleep)

-- Changes in eating habits

-- Depressed or irritable mood

-- Frequent crying or sadness

-- Refusing to go to school

-- Changes in grades or behavior at school

-- Frequent anger outbursts

-- Mood swings

-- Feeling worthless

-- Social isolation

-- Feeling restless

-- Loss of energy

-- Psychosomatic complaints like frequent headaches or stomachaches or generally not feeling well

-- Low self-esteem

-- Thoughts of suicide or suicide plans

There is a suicide risk with depression.

It might be difficult to believe that kids consider suicide, but when children verbalize feeling like their lives are not worth living or they want to harm themselves, parents need to seek immediate assistance.

There is an elevated risk of suicide with depression. It's important for parents to pay close attention to statements children make about self-harm and to talk openly about these feelings. There is no evidence that asking children about self-harm plants the idea in their heads. Asking your child, "Are you thinking about or have you ever thought about harming yourself?" is an important conversation starter, and it shows your child that you understand how low he feels.

When a child states that life is not worth living, he should die to make it easier for everyone else or he's considering suicide, the child needs to be evaluated immediately. Do not make the assumption that your child is being "dramatic" or "seeking attention." These are red flags that your child is at risk for suicide.

[Read: Why We Need to Talk More Openly About Suicide.]

Depression runs in families.

Children whose parents have depression are at greater risk for depression. While depression affects both genders and all ages, girls are more likely to develop depression in adolescence. If you have a family history of depression, it's important be aware of the symptoms of childhood depression.

Childhood depression is treatable.

While a diagnosis of childhood depression might feel overwhelming, it's very treatable. The sooner the treatment begins, the sooner your child will begin to recover and develop positive coping strategies. Cognitive behavioral therapy, as well as other types of talk therapy, family therapy and play therapy, which involves the use of toys and play to help children work through their emotions and develop adaptive coping skills, are all forms of professional counseling that will help your child work through depression.

Home treatment also plays an integral role in helping your child. Daily exercise, healthy eating and a consistent sleep routine that includes an early and regular bedtime are important components of treating depression at home.

The stigma of depression continues to affect families.

Due to the stigma associated with depression and suicide, many parents hesitate to discuss childhood depression with family, friends or educators. Depression is an illness, and a team approach to treatment helps kids recover. This includes putting supports and accommodations into place in school.

Talking about your child's depression with close friends, extended family and your child's educators might be difficult at first, but it will open the door to creating a stronger support network for you and your child.

[See: 10 Concerns Parents Have About Their Kids' Health.]

If you suspect your child is suffering from depression, seek a consultation from your child's doctor or a licensed mental health professional right away. If you suspect that your child is at risk for suicide, call 911 or contact the National Suicide Prevention Lifeline (1-800-273-8255) immediately.

Katie Hurley, LCSW is a child and adolescent psychotherapist in Los Angeles. She is the author of "The Happy Kid Handbook: How to Raise Joyful Children in a Stressful World" and the forthcoming "No More Mean Girls: The Secret to Raising Strong, Confident, and Compassionate Girls." She is the founder of Girls Can!