Childhood depression is a serious issue that affects many children and teens. According to the National Institute of Mental Health (NIMH), an estimated 4.1 million adolescents in the United States had at least one major depressive episode in 2020 (NIMH, 2021). Depression can have a serious impact on a child’s life, affecting their mood, behavior, and ability to function.
Recognizing the signs and symptoms of childhood depression is important for parents and caregivers so that they can seek help for their child when needed. In fact, research suggests that early recognition and treatment of depression can lead to better outcomes for children and teens (Weisz et al., 2017).
In this article, we’ll explore the signs and symptoms of childhood depression, the youngest age a child can get clinical depression, how depression is different in teens versus adults, risk factors for depression, when to seek professional help, and how to help a depressed child or teenager.
Personal Statement:
We are not doctors or experts on depression or even mental health, but we feel that the severity of this issue demands that we use our voice to spread whatever awareness we can. Our hope is that by the end of this article, you’ll have a better understanding of childhood depression, know what to keep an eye out for as your kids age, and what you can do to help your child if they are struggling.
Understanding Childhood Depression
Depression is a mental health condition characterized by persistent feelings of sadness, hopelessness, and a loss of interest in activities that were once enjoyed (American Psychiatric Association [APA], 2013). While most people experience feelings of sadness or irritability at some point in their lives, depression is different because it lasts for weeks, months, or even years and can significantly impair a person’s ability to function normally in daily life.
What many people don’t know is that children and adolescents can experience depression just like adults, but the symptoms may look different. In kids, depression may look like irritability, sadness, or physical complaints like headaches or stomach aches (APA, 2013). Teenagers can experience these symptoms too, but adolescent depression may also show more classic adult symptoms of depression like a loss of interest in previously enjoyed activities, changes in sleep patterns, and feelings of worthlessness or even guilt (APA, 2013).
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) outlines the criteria for diagnosing major depressive disorder (MDD), which is a type of depression that is more severe and longer-lasting than normal feelings of sadness (APA, 2013). According to the DSM-5, to be diagnosed with MDD, a person must have at least five symptoms present for at least two weeks, including a depressed mood or a loss of interest in activities, and “significant impairment” in daily functioning (APA, 2013).
It is important to point out that there is no age limit for depression, and children as young as preschool age can develop depression (Harrington et al., 2016). In fact, research suggests that early onset depression is associated with a more severe and persistent course of the illness (Harrington et al., 2016). We only want to highlight this because we don’t want parents to brush off their children’s symptoms as a bad attitude or ingratitude, but to take them seriously, no matter how young they may be.
Risk Factors for Childhood Depression
Depression can affect anyone, regardless of age, gender, or socioeconomic status. However, there are certain factors that can increase a child or teen’s risk for becoming depressed.
Some of the risk factors for childhood depression include a family history of depression, bipolar disorder, and possibly anxiety disorders or other mood disorders as well (SM). Other risks include the child experiencing significant stress or trauma, having a chronic illness, or having serious problems in school or social relationships (APA, 2013). Other things that can increase a child’s risk for depression include having a parent who has a substance abuse disorder or having a parent who is excessively critical or controlling (APA, 2013).
It is important to note that while these risk factors can increase a child’s risk for depression, they do not necessarily mean that a child will develop the condition. Many children who have one or more of these risk factors do not go on to develop depression or any other clinical disorder.
If a child is exhibiting symptoms of depression, it is important to seek professional help. A mental health professional can evaluate the child’s symptoms and provide a diagnosis if appropriate. In some cases, a mental health professional may recommend therapy for depression, such as cognitive-behavioral therapy (CBT) or interpersonal therapy (IPT) (APA, 2013). In other cases, an antidepressant medication may be recommended, but this decision should be made carefully and in consultation with a qualified mental health professional.
Treating Childhood Depression
If a child or teenager is diagnosed with depression, there are multiple treatment options available. The most effective way to treat depression typically involves a combination of therapy and medication.
CBT:
Cognitive-behavioral therapy (CBT) is a type of therapy that is commonly used to treat depression in children and adolescents. CBT is a short-term, goal-oriented therapy that focuses on teaching children and adolescents how to change negative thought patterns and behaviors that may be contributing to their depression (APA, 2013).
DBT:
Dialectical Behavior Therapy (DBT) is therapy that has been found in recent research studies to reduce the likelihood of suicide attempts by adolescents. (NIMH, 2018) DBT is a type of talk therapy developed in 1970 based on CBT, but specifically created for people who struggle to regulate their emotions and may have suicidal ideations. (CC, 2022)
IPT:
Interpersonal therapy (IPT) is another type of therapy that may be used to treat childhood depression. IPT focuses on improving relationships with family members and peers and can be particularly effective for teen depression for teenagers who are experiencing difficulties in their social relationships (APA, 2013).
Medication:
In some cases, an antidepressant medication may also be prescribed to treat severe depression. Antidepressants work by altering the levels of certain neurotransmitters in the brain, which can help to improve mood and reduce symptoms of depression (Mayo Clinic, 2021). However, it is important to note that antidepressant medications can have some serious side effects and should only be used under the close supervision of a qualified mental health professional.
If a child or teenager is taking an antidepressant, it’s important to watch for warning signs of suicidal thoughts or behaviors, as some antidepressants can increase the risk of suicidal ideation in children and adolescents (Mayo Clinic, 2021).
Ultimately, the best treatment will depend on the specific child and their unique symptoms and circumstances. It is important to work closely with a mental health professional to develop a treatment plan that is tailored to the child’s needs.
Warning Signs for Teen Suicide
Startling Truth:
The horrific fact is that suicide was the second highest cause of death in the US in 2020 for children 10-14 and the third highest for teens 15+. (CDC, 2022)
Depression is a serious condition that can significantly impact a teen’s life. In some cases, depression may lead to suicidal thoughts or behaviors. It is important for parents and caregivers to be aware of the warning signs of teen suicide and to seek professional help if they are concerned about a child’s well-being.
Signs:
Some of the warning signs of teen suicide include talking about wanting to die or to kill oneself, expressing feelings of hopelessness, worthlessness or low self esteem, not wanting to spend as much time doing social activities or with friends, and engaging in risky behaviors (National Institute of Mental Health, 2020). Other warning signs may include changes in eating or sleeping patterns, increased use of drugs or alcohol, and giving away prized possessions (National Institute of Mental Health, 2020).
If a parent or caregiver is concerned that a teen may be at risk for suicide, they should seek professional help immediately. This may involve contacting a mental health professional, a crisis hotline, or taking the teen to an emergency room for screening and potential medical treatment.
Prevention:
Suicide is preventable, and there are resources available to help parents and caregivers support a teen who may be struggling with depression or suicidal thoughts. Encouraging open communication, offering support, and seeking professional help and medical treatment are all important parts of helping a child or teen who may be at risk for suicide.
References:
National Institute of Mental Health. (2021). Major depression. https://www.nimh.nih.gov/health/statistics/major-depression.shtml
Weisz, J. R., Kuppens, S., Ng, M. Y., Eckshtain, D., Ugueto, A. M., Vaughn-Coaxum, R., … & Weersing, V. R. (2017). What five decades of research tells us about the effects of youth psychological therapy: A multilevel meta-analysis and implications for science and practice. American Psychologist, 72(2), 79-117. doi: 10.1037/a0040360
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, 5th edition. Harrington, R., Luntamo, T., & Rutter, M. (2016). Early-onset depressive disorders: magnitude and correlates of burden in the young. Journal of Child Psychology and Psychiatry, 57(3), 251-259. doi: 10.1111/jcpp.12454
Mayo Clinic. (2021). Antidepressants for children and teens. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20047502
National Institute of Mental Health. (2020). Suicide in children and teens. https://www.nimh.nih.gov/health/topics/suicide-prevention/index.shtml#part_154986.
Ivie, E., Moses, L., Pettitt, A., & Allen, N. (2020) A meta-analysis of the association between adolescent social media use and depressive symptoms. Journal of Affective Disorders, 275, 165-174. DOI:10.1016/j.jad.2020.06.014
Primack, B. A., Shensa, A., Sidani, J. E., Whaite, E. O., Lin, L. Y., Rosen, D., … & Miller, E. (2020). Social media use and perceived social isolation among young adults in the US. American Journal of Preventive Medicine, 58(1), 46-54. DOI: 10.1016/j.amepre.2017.01.010
American Academy of Child and Adolescent Psychiatry. (2020). Depression in children and teens.
https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/The-Depressed-Child-004.aspx
Mayo Clinic. (2021). Antidepressants for children and teens. https://www.mayoclinic.org/diseases-conditions/teen-depression/in-depth/antidepressants/art-20047502
National Institute of Mental Health. (2020). Depression in children and adolescents. https://www.nimh.nih.gov/health/topics/depression/index.shtml
10 Leading Causes of Death in the US in 2020: https://wisqars.cdc.gov/data/lcd/home
DBT can reduce the likelihood of suicide attempts in adolescents. https://pubmed.ncbi.nlm.nih.gov/29926087/
Stanford Medicine. Major Depression and genetics https://med.stanford.edu/depressiongenetics/mddandgenes.html
Genetics of Depression: A Review (Biol Psychiatry 2005)
Dialectical Behavior Therapy (DBT)
https://my.clevelandclinic.org/health/treatments/22838-dialectical-behavior-therapy-dbt