Depression in Kids: How to Recognize Symptoms and Get Treatment
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Many people associate depression with adulthood, but an estimated 3.2 percent of children aged 3-17 years suffer from the condition, according to the Centers for Disease Control and Prevention (CDC). "We think it's easy to be a kid, but life for a child can be challenging and painful," says Rachelle Theise, Psy.D., a clinical assistant professor and child psychologist at The NYU Child Study Center. So how do you know if your child is depressed or just a little blue? Use our guide to help diagnose, assess, and treat depression in kids.
Risk Factors for Childhood Depression
Any child can experience depression, but some kids may be at higher risk. For example, the condition tends to pop up more in those who feel "different" because of their looks or interests, as well as those suffering from a learning disorder or academic failure. Childhood depression is also more prevalent in kids experiencing serious health issues, extended hospital stays, or family problems such as divorce, domestic violence, or substance abuse.
Genetics also plays a major role. "Children who have first-degree biological relatives with depression are two to four times more likely to be at risk for depression than children without depressed first-degree biological relatives," says Jephtha Tausig-Edwards, Ph.D., a clinical psychologist and clinical instructor at Mt. Sinai Medical Center in New York City.
Depression usually doesn't have one direct cause; rather, it results from a combination of different factors. "Looking for a 'smoking gun' or assigning blame is not helpful and can be counterproductive in the treatment process," says Dr. Tausig-Edwards. "Very often, children become depressed because of stressful life events, such as a severe illness or passing of a beloved relative, peer, or pet, especially if several of these occur within a relatively short time frame."
Children can also become depressed if they don't feel successful academically or socially at school, or if there are conflicts in the home (regular fighting between parents, an impending divorce, etc). "Not all children will react to these events by becoming depressed, but it's important to look for the signs and symptoms of depression in children if they do develop," Dr. Tausig-Edwards says. "Depression is treatable and in most cases, individuals experience relief within three months to one year of when their symptoms started."
Signs of Depression in Kids
"It's important to know the signs of depression in children so parents can accurately understand their kid's distress," Dr. Theise says. Because there's no real depression test for kids, parents must simply rely on their instincts. Any changes in mood or behavior (more sleeping, different eating habits, difficulty concentrating), increased sadness, or irritability—especially when it lasts most of the day over the course of a week or two—could mean something is off. You might also notice your child withdrawing from or seeming disinterested in things they once enjoyed, like playing tennis or hanging out with the neighborhood kids.
Some older children may write stories or poems or draw pictures that will provide insight into their moods. "If your child is expressing her feelings, that is therapeutic and should be encouraged," says Stacey Brown, a licensed mental health counselor in Fort Myers, Florida, and a professor of Human Services at Edison State College. "But if the parent is concerned about what is written or drawn, seek professional advice."
Parents should also watch out for these symptoms of depression in kids, compiled from the Anxiety & Depression Association of America and the American Academy Child & Adolescent Psychiatry.
Difficulty sleeping or restlessness
Difficulty concentrating
Low energy
Frequent complaints of physical illnesses such as headaches and stomachaches
Persistent boredom
Withdrawal/ decreased interest in friends and favorite activities
Change in grades, getting into trouble at school, or refusing to go to school
Change in eating habits or sleep patterns
Anger, irritability, sadness, crying, or mood swings
Feelings of worthlessness, low self-esteem
Talk of death or suicide
Efforts to run away from home
How to Handle Depression in Kids
If you're concerned that your child may be depressed, approach them gently. Find a time when you can talk without distractions—that means no electronics or siblings around, and not the two minutes before they're racing off to school or going to bed. Stick to open-ended and non-accusatory questions like, "I noticed you haven't been as interested in tennis lately. What's going on with that?" or "How do you feel when you're at school?" Your child might respond, "I just don't like tennis anymore. I want to try soccer." But if they say something like, "I don't know why I don't like tennis now. I'm feeling blah," reassure them that you're always available to talk.
You can also ask if they'd like to speak with a "feelings doctor" and tell them that you can find a good one (not all kids will want to talk about their emotions). Keep an eye on how they're doing, and continue to say, "I want to hear about your feelings. How can I help?"
Even so, "if the child's behavior or moods are restricting life or [affecting] family activities, if he's not able to demonstrate the usual happiness or joy, withdraws from friendships, has trouble sleeping, or says he'd like to talk to someone, it's time to seek help," Brown says.
Getting Help for Childhood Depression
If you're worried about childhood depression, seek help from your pediatrician, a psychiatrist, or a psychologist specializing in children's mental health. There are two main forms of treatment for depression in children: psychotherapy and pharmacology. Some experts may recommend a combination of both treatment methods.
Psychotherapy: Also known as talk therapy, psychotherapy relies on a psychologist (or psychiatrist or social worker) to help your child work through negative feelings. One common example is cognitive behavioral therapy (CBT).
Pharmacology: Doctors will treat your child's symptoms with antidepressant medication. Like all meds, antidepressants can have side effects, so parents should be vigilant in asking questions about the benefits and potential risks if this method is recommended by your child's doctor.
