Most people think of depression as an adult condition—or one found in preteen or teenaged children. However, depression can develop in younger children too and so it’s important for parents, caregivers, teachers and other adults to recognize the symptoms. In many cases, depression in children often presents itself differently than depression in adults. For example, where a depressed adult may have easily recognizable symptoms such as sadness, depressed children may simply appear to be irritable or angry. Because childhood depression can have a serious impact on a child’s life, it’s important to be on the lookout for warning signs.

What is depression?

Depression is a mental illness where someone has ongoing feelings of sadness, irritability, loss of interest in normal activities, feelings of hopelessness and worthlessness, and sometimes, thoughts of suicide. When someone is depressed, it can affect the way they feel, think and act. Other side effects of depression can make someone have changes in normal sleeping habits and have trouble concentrating. Typically, depression is diagnosed when symptoms last for two weeks or longer and prevent someone from being able to function normally.

For caregivers and parents, it’s important to remember that childhood depression is more than a case of “having the blues” or a passing bad mood. Often, childhood depression is not treated because parents and caregivers think a child may only be experiencing the normal emotional and psychological changes that occur during growth. That’s why it’s important to know the symptoms of childhood depression that can include one or any combination of the following:

• Irritability, anger, or being “on edge”
• Persistent feelings of sadness, hopelessness
• Withdrawal from previously enjoyed activities as well as from friends and family
• Increased sensitivity to rejection or criticism
• Changes in appetite (either increased or decreased)
• Changes in sleep (sleeplessness or too much sleep)
• Crying or temper tantrums
• Difficulty concentrating and focusing
• Fatigue (tiredness) and low energy
• Physical complaints (such as stomach aches, headaches) that do not respond to treatment
• Reduced ability to function during activities at home or with friends, in school, extracurricular activities, and in other hobbies or interests
• Feelings of worthlessness or guilt
• Thoughts or talk of death or suicide

What causes childhood depression?

Just like in adults, depression in children can be caused by a combination of factors that include stressful life events such as divorce or death of a family member. But there may be other factors causing childhood depression that can include:

• Physical illness (such as diabetes or epilepsy)
• Family history (such as a parent who suffers from depression)
• Brain chemistry (such as imbalances in neurotransmitters and hormones)
• Environmental factors (including a stressful or unstable home environment or bullying at school)

Remember that not all depressed children will have all of these symptoms. In fact, some children will exhibit some at different times and in different settings. If you suspect your child has symptoms of depression, keep in mind that the child might insist that they're fine or they may deny that they're experiencing any problems. Also keep in mind that younger children also lack the language skills to talk about their moods and may not be able to describe how they're feeling or what they're experiencing. Older children that may have a better understanding of what depression means may feel embarrassed or they may worry that they're different.

Diagnosing Childhood Depression

If you suspect your child is depressed, it’s a good idea to seek out a pediatrician or general physician to talk about your concerns. You can also keep a diary to track the changes in mood or behavior that you're seeing in your child and share those observations with the doctor.

A pediatrician typically diagnoses depression if a child has exhibited five or more symptoms for at least two weeks. The pediatrician can also rule out potential physical health issues that may be contributing to depression symptoms. A mental health evaluation may involve your doctor speaking to your child without you present. While there is no specific test to diagnose depression, a doctor may use psychological assessments to further evaluate the type and severity of the symptoms your child is experiencing. If needed, your child may be referred to a mental health professional. 

Treatment options for childhood depression can involve medications, psychotherapy (or talk therapy), lifestyle changes, or a combination of treatment plans—depending on the nature and severity of your child's depression. Remember that parents and caregivers can't always prevent depression in children. However, they can be proactive in improving a child's mental health, regardless of whether there is a diagnosed mental health issue.

For more information on childhood depression, visit the Anxiety and Depression Association of America at https://adaa.org/.