Childhood is a time of ups and downs, but sometimes the lows can signal something more serious. Depression is a complex mental health disorder that can affect children and teens, not just adults. In fact, an estimated 4.4% of children aged 3-17 years (approximately 2.7 million) have diagnosed depression.[1] As a parent, it's important to be aware of the warning signs that your child may be struggling with depression so you can get them the support they need. Here are 10 key symptoms to watch for.
Understanding the DSM-5 Diagnostic Criteria for Depression in Children
When mental health professionals assess a child for depression, they often turn to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The DSM-5 provides standard criteria for diagnosing depression and other mental health conditions. To be diagnosed with depression, a child must meet specific symptomatic criteria.
According to the DSM-5, a child must experience at least five of the following symptoms during the same two-week period, with at least one of the symptoms being either depressed mood or loss of interest or pleasure:[2]
- Persistent feelings of sadness or low mood that last for most of the day, occurring nearly every day.
- Significantly reduced interest or enjoyment in almost all daily activities, experienced for the majority of the day, nearly every day.
- Noticeable changes in weight (loss or gain) when not actively trying to change weight, or daily fluctuations in appetite (either increased or decreased).
- Disrupted sleep patterns, either difficulty falling or staying asleep (insomnia) or sleeping excessively (hypersomnia), occurring nearly every day.
- Observable restlessness (psychomotor agitation) or slowed movements and reactions (psychomotor retardation), present nearly every day.
- Consistently feeling tired, fatigued, or lacking energy, experienced nearly every day.
- Persistent thoughts of worthlessness or excessive and inappropriate guilt, occurring nearly every day.
- Reduced capacity for thinking, focusing, or making decisions, experienced nearly every day.
- Frequently thinking about death, having recurring thoughts of suicide without a specific plan, or attempting suicide or having a detailed plan for taking one's life.
If your child meets the diagnostic criteria for depression, a mental health professional can work with you and your child to develop an individualized treatment. If you suspect your child is depressed, schedule an evaluation with a mental health provider experienced in treating children and adolescents.
Common Depression Risk Factors
It's also important to be aware of factors that may increase your child's vulnerability to depression. While the precise causes of childhood depression are complex, research has identified several key risk factors:
- Family history of depression, bipolar disorder, or other mental health conditions
- Exposure to trauma, abuse, neglect, or violence
- Major life changes such as divorce, moving, or losing a loved one
- Chronic illness, disability, or serious medical conditions
- Learning or developmental disorders
- Substance abuse or misuse
Children who are bullied, struggle socially, or identify as LGBTQ are also at higher risk.[3] Remember, depression isn't caused by personal weakness or poor parenting. By understanding your child's unique risk factors, you can be more attuned to early warning signs and take steps to foster resilience.
Treatment Options for Children with Depression
If your child is diagnosed with depression, know that effective treatments are available. The earlier treatment begins, the better the outcome tends to be. The two main evidence-based treatments for childhood depression are psychotherapy and medication.
Psychotherapy, also known as talk therapy, can help children:
- Explore and express their feelings
- Identify and change negative thought patterns
- Develop coping skills and problem-solving strategies
- Improve communication and relationships
Three types of psychotherapy are particularly effective for treating childhood depression:
- Cognitive Behavioral Therapy (CBT): Helps children identify and change unhelpful thoughts and behaviors that contribute to depression.
- Interpersonal Therapy (IPT): Focuses on improving children's relationships and communication skills to reduce depressive symptoms.
- Psychodynamic Therapy: Explores how past experiences and unconscious thoughts and feelings may be contributing to current symptoms. This approach helps children gain insight, resolve internal conflicts, and develop healthier coping mechanisms.
For some children, especially those with severe symptoms, medication may be necessary in addition to therapy. The most commonly prescribed antidepressants for children are selective serotonin reuptake inhibitors (SSRIs). These medications can help balance brain chemistry and alleviate depressive symptoms. However, antidepressants must be closely monitored in children and teens, as they can increase the risk of suicidal thoughts in a small percentage of youth.[4]
The best treatment plan will depend on your child's age, symptoms, and unique needs. A skilled mental health provider can work with you and your child to determine the most appropriate interventions. Throughout treatment, your love, support, and involvement will be invaluable to your child's healing.
In addition to professional treatment, you can support your child's mental health by:
- Encouraging open and non-judgmental communication
- Helping your child maintain routines and engage in enjoyable activities
- Promoting a healthy lifestyle with regular exercise, balanced nutrition, and quality sleep
- Monitoring your child's symptoms and working closely with treatment providers
Remember, recovery from depression is possible with the right care. By combining professional help, family support, and self-care strategies, your child can overcome depression and build lifelong resilience.
The Bottom Line
If you notice several of these warning signs in your child for more than two weeks, don't ignore them. With proper diagnosis and a combination of therapy, medication if needed, and support, most children can overcome depression.[5] You play an important role in identifying the problem and connecting your child with help. Remember, depression is a real illness - not a personal weakness or parenting failure. With your love and the right treatment, your child can thrive again.
Common Questions
How common is depression in children?
According to the CDC, approximately 4.4% of children aged 3-17 years (about 2.7 million) have diagnosed depression.[1]
Can depression in children be prevented?
While there's no surefire way to prevent depression, there are steps you can take to reduce your child's risk. These include fostering strong, supportive relationships, encouraging healthy habits, and teaching coping skills.
How do I talk to my child about depression?
When talking to your child about depression, create a safe, non-judgmental space. Use age-appropriate language, listen actively, and validate their feelings. Emphasize that depression is treatable and that you're there to support them.
How long does treatment for childhood depression typically last?
Treatment length can vary. Most children show significant improvement within 3-6 months of starting therapy and/or medication. However, some may need longer-term support.
Can untreated depression in children lead to other problems?
Yes, untreated depression can have serious consequences. Children with depression are at higher risk for substance abuse, academic difficulties, social isolation, self-harm, and suicide. Early intervention is crucial.
How can I support my child during depression treatment?
You play a vital role in your child's recovery. Attend therapy sessions if invited, help your child practice coping skills at home, and celebrate their progress. Maintain open communication with your child and their treatment team.
Sources:
https://www.psychiatry.org/patients-families/depression/what-is-depression
Steger, Michael F, and Todd B Kashdan. “Depression and Everyday Social Activity, Belonging, and Well-Being.” Journal of counseling psychology vol. 56,2 (2009): 289-300. doi:10.1037/a0015416 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2860146/
