Depression in Children and Adolescents: Types and Signs

Introduction

Depression is not the same thing as sadness or grief. When children experience a difficult event, such as the loss of a pet or family member or the divorce of their parents, they may feel deeply sad and not be able to feel happy even when doing the things they usually enjoy. It is normal for grief to last for a while and then lessen, over time.

However, depression is a disorder of mood that causes sadness and/or other 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.

What are common types of depression?

Two common types of depression are major depressive disorder and persistent depressive disorder.

Major depressive disorder. A doctor or another licensed mental health professional diagnoses major depressive disorder when at least 5 symptoms of depression last for more than 2 weeks, on most days. (See What are common signs of depression?) Although major depressive disorder can be mild, moderate, or severe, all children 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 1 year. A child with persistent depressive disorder may also have an episode of major depression at the same time.

How common is depression in children and adolescents?

Depression is one of the most common disorders in the United States.

• Children. More children are being diagnosed with depression than in the past. This includes young children. 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.

• Adolescents. 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.

What are common signs of depression?

Children and adolescents often don't know how to describe what they are feeling, or they may not want to talk about their feelings. Here are some common signs of depression in children and adolescents.

• Seems more irritable or angry

• Lacks motivation to do things that are usually enjoyable

• Has trouble focusing or making choices

• Uses words such as "sad" or "bored"

• Spends more time alone and less time with friends

• Makes less eye contact than usual

• Talks less than usual

• Is spending more time using media

• Cries more often

• Has trouble falling or staying asleep

• Sleeps more than usual

• Eats more or less than usual

• Has lost or gained a noticeable amount of weight

• Has less energy than usual

• Is failing or struggling at school

• Is feeling worthless or guilty

Additional signs of depression common in adolescents include

• Not feeling hopeful about the future

• Lacking interest in personal grooming or appearance

• Persistent irritability or anger

• Substance use

The 2 most common signs of depression in children and adolescents are irritability and not feeling pleasure in activities they used to find to be fun.

What can I do if my child seems depressed?

If you suspect your child or teen may be depressed, it's important to openly talk with your child about what your child is feeling. 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 2 weeks, talk with your child's doctor.

Getting Help

Your child's doctor has specific questionnaires and techniques for age-appropriate ways of talking with children and adolescents about feelings of sadness. Your child's doctor can help determine whether your child feels depressed. If your child has depression, the doctor may provide treatment or refer your family to a mental health specialist for treatment.

Coping Strategies

Although treatment of depression works, it takes time. Some children and adolescents get discouraged when they don't feel better right away. There are things you can do at home to help you, your family, and your child while you are waiting for an appointment or while the treatment is starting to work.

• Educate yourself, other caregivers, and 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.

• Help your child relax with physical, creative, nurturing, and meaningful activities.

• Focus on your child's strengths, rather than areas that need improving, and provide verbal encouragement.

• Talk with and listen to your child with love and support. Encourage your child to share their feelings by listening without judgment.

• Help your child look at problems in a different, more positive way.

• Break down problems or tasks into smaller steps so your child can be successful.

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

Remember

Contact your child's doctor if you have any questions and visit www.HealthyChildren.org for more parenting information.