According to nationally representative surveys reported by the U.S. Preventive Services Task Force, about eight percent of adolescents reported having major depression in the past year. Among children and adolescents ages 8 to 15 years, two percent of males and four percent of females reported major depression in the past year.
Depression can have devastating effects on children, including functional impairments in their performance at school or work and can impact interactions with friends and family, according to the CDC. And major depressive disorder in children and adolescents is "strongly associated" with recurrent depression in adulthood and other mental disorders, along with increased risk for suicidal ideation and suicide attempts.
"We think it's easy to be a kid, but life for a child can be challenging and painful," Rachelle Theise, a child psychologist and clinical assistant professor at The NYU Child Study Center, told Parents. "It's important to know the signs of depression so parents can accurately understand their kid's distress."
While it's important to note that kids can experience a few symptoms of depression without actually being depressed, it's also vital to understand that some symptoms of depression aren't at all what you would expect. "Some children may not talk about helpless and hopeless thoughts, and they may not appear sad," the CDC Children's Mental Health division warned. "Depression might also cause a child to make trouble or act unmotivated, so others might not notice that the child is depressed or may incorrectly label the child as a trouble-maker or lazy."
To help distinguish childhood depression from an ordinary bout of the blues, consider these tips from the CDC, Theise and other pediatric and psychology experts:
Look for behavioral clues
In general, a child suffering from depression may feel sad or uninterested in things they used to enjoy, or feel helpless or hopeless in situations where they could do something to address the situations, according to the CDC. Specific behaviors that may indicate childhood depression include:
- Feeling sad, hopeless or irritable a lot of the time
- Not wanting to do (or enjoy doing) fun things
- Changes in eating patterns, including eating a lot more or a lot less than usual
- Changes in sleep patterns, particularly sleeping a lot more or a lot less than normal
- Changes in energy, including being tired and sluggish or tense and restless a lot of the time
- Having a hard time paying attention
- Feeling worthless, useless or guilty
- Self-injury and self-destructive behavior
The Anxiety & Depression Association of America and the American Academy of Child & Adolescent Psychiatry offer additional warning signs:
- Frequent complaints of physical illnesses such as headaches and stomachaches
- Persistent boredom or withdrawal/decreased interest in friends and favorite activities
- Changes in grades, getting into trouble at school or refusing to go to school
- Talk of death or suicide
- Efforts to run away from home
Note the staying power
Moodiness may come and go, but depression has a constancy that distinguishes it from the normal travails of growing up. "If the child maintains these symptoms in different settings over time - if he's sad at school, sad at home, sad at Disney World, sad at restaurants, sad at friends' house - then it's a problem," Stacey Brown, a licensed mental health counselor and professor of human services at Edison State College, told Parents. Parents should also pay close attention to the time frame of the symptoms. Parents should worry if symptoms last for more than two weeks, Theise said.
Know the risks
If your kid feels "different" because of their looks or interests, or suffers from a learning disorder or academic failure, they might be more at risk for depression. Other kids at higher risk include those who face serious health issues or extended hospital stays or family problems such as divorce, domestic violence or substance abuse. Genetics may also play 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," Jephtha Tausig-Edwards, a clinical psychologist and clinical instructor at Mt. Sinai Medical Center in New York City, told Parents.
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Follow your instincts
This advice applies especially to parents worried about so-called helicopter parenting. "Parents need to trust their instincts. If they think something is wrong, it probably is," Brown said.
Distinguish between creative expression and calls for help
Some older children write stories or poems or draw pictures that will provide insight into their moods, according to Parents. "If your child is expressing her feelings, that is therapeutic and should be encouraged," Brown said. "But if the parent is concerned about what is written or drawn, seek professional advice."
What to do
If you believe your child is depressed, the next step is to give your kid the chance to talk about the situation in a way that makes him or her feel supported and loved.
"Try giving the child time to talk and hang out with other supportive adults in his life, such as older siblings, aunts or uncles or other family friends who you have trusted with your child's emotional state," Parents advised.
Next, take your child to a pediatrician to rule out any medical conditions that may be appearing as depression, Theise suggested.
But "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 or withdraws from friendships or has trouble sleeping, or if the child says he'd like to talk to someone, it's time to seek help," Brown added.
Treatments for depression in children include psychotherapy, which is talk therapy with a psychologist, psychiatrist or social worker, and pharmacology.
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If it does come to this point, don't feel bad that you didn't arrive sooner, David Fassler, a clinical professor of psychiatry at the University of Vermont, told Parenting. Childhood depression can be easy to miss. "Depression is no more the result of 'bad parenting' than is diabetes or cancer," he added. "All are real illnesses that require careful evaluation and appropriate treatment. The good news is that we can help most children and adolescents."