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How Do I Know If My Child is Depressed?

by Caraline McDonnell

When you think about someone who is struggling with their mental health, you may picture them as being sad, feeling down, being withdrawn, and lacking motivation. Depression is a large problem across the lifespan. Approximately 16% of children and teens in the United States have expressed struggles with depressive symptoms. This actually might be an underestimate of the overwhelming impact of depression; many believe rates have risen due to increased isolation during the pandemic and teen social interactions occurring more and more online and via social media.  

What Does Depression Look Like for Kids and Teens?

Depression is most often diagnosed in the teenage years, but younger kids may also present with depressive symptoms. In younger childhood, boys and girls are at equal risk for depression, but following puberty, females are more frequently diagnosed.

It can often be difficult to identify depression in our kids and teens, especially if we don’t know what signs to look out for. Teenagers sometimes have a reputation of being moody and irritable, which can be or seem normal, as long as their moods aren’t impacting their ability to function and engage meaningfully in day-to-day life. Kids and teenagers with depression will struggle with feelings of sadness and hopelessness, and it can impede their ability to enjoy socializing with peers or doing activities that they previously loved.

There are two main kinds of depression that kids and adolescents can be diagnosed with:

  • Major Depressive Disorder is diagnosed when a child or teen is depressed most of the time for at least 2 weeks
  • Persistent Depressive Disorder (also known as dysthymia) is diagnosed when the symptoms of depression are less severe, but they last for a year or more

Both diagnoses are dependent on the presence of depressive symptoms.

Here are some emotional symptoms to keep an eye out for:

Feelings of sadness, hopelessness, worthlessness, frustration, or anger.
They may make statements like, “The world is against me”, “No one cares about me”, and “I can’t do anything right”

Irritability or annoyed mood
This may look arguing over little things, like chores and plans, or being easily annoyed at those around them.  

Loss of interest in usual activities
They may refuse to participate in sports or clubs that they previously enjoyed or may state that everything is “boring” or that they don’t like their activities anymore.

Loss of interest in, or conflict with, family and friends
This could include not making plans with friends outside of school, withdrawing to their bedroom while at home, and high tensions between family members.

Low self-esteem
They may have a negative self-image, which can be identified through critical thoughts and statements about their appearance and abilities. This may include a fixation on past failures and excessive self-criticism. Statements may include things like; “I can’t do anything right”, “I am so stupid”, and “I hate myself”, among others.

Difficulty making decisions, concentrating, and remembering things
Some kids/teens may describe this as feeling “sluggish” and unable to think as clearly as they used to.

Lack of belief in a positive future
Including statements like; “Nothing will ever get better for me”, and “I have nothing to look forward to”.

Frequent thoughts of death and dying.
They may express; “I wish I was never born”, “I just want to die”, and “Everyone would be better off without me”.

Additionally, here are some behavioral symptoms to monitor:
  • Loss of energy and feeling consistently tired
  • Insomnia or sleeping too much
  • Changes in appetite and weight
  • Use of alcohol or drugs
  • Agitation or restlessness
  • Slowed thinking, speaking, or moving
  • Often complaining about headaches or stomachaches without a medical explanation
  • Self-harm (for older kids this could look like cutting or burning, and for younger kids this could be head-banging or skin-picking, etc.)
  • Planning for suicide or attempting suicide

It can be difficult for family and friends to identify whether your child’s moods are a normal part of the ups and downs that adolescence brings, or signs of a depressive disorder. If you suspect that your child may be battling depression, keep an eye out for the listed symptoms, and evaluate if their symptoms are interfering with your child’s ability to enjoy and succeed in their day to day lives.

If their depressive symptoms are stopping them from engaging with the world around them, and their ability to function at school or at home, it may be time to consider talking to your pediatrician or a mental health professional.

What Causes Depression in Youth?

Despite caregivers’ best efforts to provide supportive and safe environments for kids and teens to grow up in, some will become depressed. Research has not been able to identify exactly what causes depression for kids and teens, but it is known that a variety of influences may be involved.

  • Depression can be a result of differences in brain chemistry from those who do not have depression. Neurotransmitters are chemicals that take information from one part of your brain to another. When these chemicals are impaired, or different, they are unable to do their job properly which can lead to depression.
  • Changes in the balance of hormones in the body have also been linked to depression. This can help explain why girls are more often diagnosed with depression following puberty, and why diagnoses increase overall in the teenage years.
  • Depression can also be an inherited trait. If depression is common in your family, it may be more likely for your child to develop depression.
  • Learned patterns of negative thinking can also be linked to depression. As your child moves through life, if they are taught, whether explicitly or through life experience, that they are helpless to create change and improve their lives, they may be at higher risk for depression. The learned negative thoughts block their ability to feel capable of overcoming the challenges they face.
  • Depression has also been linked to anxiety, with symptoms often occurring together. If your child struggles with anxiety, they may be at risk of developing depressive symptoms as well.
  • Experiences of trauma in childhood, like physical, emotional, sexual abuse or neglect, can increase the risk of depression for children and teens.

If left untreated, depression in children and adolescents may lead to an increased risk of substance abuse, poor engagement in academic work, stilted social functioning, and a risk of self-harm and suicidal behaviors. Treating depression as close to the onset as possible will help to support your child’s mental health in the moment, and for years to come.

Want to learn more?

References
Mullen S. Major depressive disorder in children and adolescents. Ment Health Clin. 2018 Nov   1;8(6):275-283. doi: 10.9740/mhc.2018.11.275. PMID: 30397569; PMCID: PMC6213890.
“Depression at Different Ages.” Child Mind Institute, 21 Apr. 2023, childmind.org/article/depression-at-different-ages/#:~:text=Depression%20can%20affect%20people%20of,however%2C%20irritability%20can%20replace%20sadness.
“Depression in Teens.” Mental Health America, www.mhanational.org/depression-teens-0#:~:text=Recent%20surveys%20indicate%20that%20as,calls%20for%20prompt%2C%20appropriate%20treatment. Accessed 14 Sept. 2023.
“Teen Depression.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 12 Aug. 2022, www.mayoclinic.org/diseases-conditions/teen-depression/symptoms-causes/syc-20350985.
“Prevalence Data 2023.” Mental Health America, www.mhanational.org/issues/2023/mental-health-america-prevalence-data#youth-one-major-depressive-episode. Accessed 14 Sept. 2023.