Depression in Children

Overview

What is depression?

Depression is a mood disorder that can cause someone to feel sad, irritable or hopeless. It may affect your sleep, appetite or relationships with others. Depression can also cause you to lose interest in hobbies or activities you once enjoyed. In severe cases, depression can lead to thoughts of suicide.

Depression is typically diagnosed if symptoms last two weeks or longer. It should only get evaluated, diagnosed and treated by a healthcare provider. Although depression is a serious medical condition, it’s usually treatable.

Does depression affect children?

Depression can affect people of any age, including children. Although children naturally have mood swings as they grow and develop, depression is different. The disorder can affect how children interact with friends and family. It may prevent them from enjoying school, sports, hobbies or other normal childhood activities.

In children, depression and anxiety often go hand in hand. Anxiety is a medical condition that causes feelings of fear, panic or worry about everyday situations. Sometimes, depression or anxiety in children gets chalked up to “growing pains.” But if you have any concerns about behavioral or mental health, talk to a healthcare provider.

How common is childhood depression and anxiety?

Depression and anxiety are among the most common mental health disorders in children. About 7% of children ages 3 to 17 have anxiety; about 3% deal with depression.

Both depression and anxiety tend to be higher in older children and teenagers between the ages of 12 and 17. An estimated 3.2 million adolescents aged 12 to 17 in the United States had at least one major depressive episode. This number represented 13.3% of the U.S. population aged 12 to 17. An estimated 31.9% of adolescents have had an anxiety disorder.

Symptoms and Causes

What causes depression and anxiety in children?

Depression and anxiety in children can have many causes, including:

  • Alcohol or drug use.
  • Environment (including family problems).
  • Family history (others in the family have depression).
  • Physical illness.
  • Stressful life events.

What are the signs of depression in children?

Parents should look out for the following signs of depression in children:

  • Behavioral problems at school.
  • Changes in eating or sleeping habits.
  • Feelings of sadness or hopelessness.
  • Lack of interest in fun activities.
  • Low energy levels or general tiredness.
  • Mood changes, such as irritability.

What are the signs of anxiety in children?

Signs of anxiety in children may include:

  • Anxiety about the future.
  • Fear of being away from a parent.
  • Physical symptoms of panic, such as sweating or dizziness.
  • Refusal to go to school or take part in social activities.
  • Worry that a parent or loved one may die.

Should I worry that my child will commit suicide?

National surveys from the government show the overall risk. In 2019, for example, nearly 9% of high school students attempted suicide at least once over the course of a year. Thinking about suicide also continued to rise from previous years . Although less common, young children do attempt suicide as well.

Watch your child closely for the warning signs of suicidal behavior, including:

  • Focus on death and dying.
  • Giving away possessions.
  • Increased risk-taking.
  • Self-destructive behavior or self-harm.
  • Social isolation.
  • Talk of suicide or hopelessness.

Diagnosis and Tests

How are childhood depression and anxiety diagnosed?

If you think your child is showing signs of depression or anxiety, talk to a healthcare provider. Start with your child’s pediatrician. Your pediatrician may refer you to a mental health professional for a more detailed evaluation.

A healthcare provider will likely start by ruling out conditions that may be causing your child’s mood issues. Illnesses known to cause symptoms of depression include:

There are no tests to diagnose depression. A mental health evaluation should include interviews with you (the parents) and your child. Information from teachers, friends and classmates can also shed light on your child’s mood and behavior changes.

Management and Treatment

How are depression and anxiety in children treated?

Treatment options for children with depression are like those for adults. Your child’s healthcare provider may recommend:

How does psychotherapy work?

Cognitive-behavioral therapy (CBT) is a form of psychotherapy that can treat anxiety or depression in children. CBT helps children learn to think more positively and control negative behaviors. It can also help children manage anxiety by getting to the root of their fears and worries. Therapy gives children tools to cope with anxiety and depression in healthier ways.

How do antidepressants work?

The most common antidepressant medications for children are selective serotonin reuptake inhibitors (SSRIs). These medications increase the level of serotonin in the brain. Serotonin is a chemical that can help increase feelings of happiness and well-being.

Use extra caution with antidepressants in children. Some children show no improvement with the medications, or may even feel more depressed. If a healthcare provider recommends antidepressants, watch your child’s condition closely. Never allow your child to stop taking antidepressants suddenly. Doing so can cause serious side effects or make depression worse.

Prevention

Can I prevent my child from developing depression or anxiety?

Depression can result from certain situations in life or may have a biological cause. As a parent, you can’t always control the stressors in your child’s life. But you can help improve your child’s mental health by ensuring they get:

  • Daily exercise.
  • Safe, supportive environment at home and school.
  • Plenty of sleep.
  • Well-balanced meals.

Outlook / Prognosis

Will my child’s depression or anxiety go away?

Every child is different. Some children may outgrow depression or anxiety. Others may need to manage these conditions for the rest of their lives. You can help your child now by making sure they get a proper diagnosis and the right treatment.

Living With

When should I call the doctor?

Call a healthcare provider if your child has any signs of depression or anxiety. If your child is showing signs of suicide, get help right away. You can call the National Suicide Prevention Lifeline at 800.273.8255. This hotline connects you to a national network of local crisis centers for free and confidential emotional support. The centers support people in suicidal crisis or emotional distress 24 hours a day, 7 days a week. In an emergency, call 911.

A note from Cleveland Clinic

While it may be difficult to watch your child dealing with depression or anxiety, help is available. The right treatment can ensure your child continues to grow and thrive throughout their development. In addition to medical help, you can support your child by making sure they have a healthy environment at home, at school and in the community. Always let your child know they can communicate openly and honestly about their feelings.

Last reviewed by a Cleveland Clinic medical professional on 11/17/2020.

References

  • American Foundation for Suicide Prevention. Teens and suicide: What parents should know. (https://afsp.org/teens-and-suicide-what-parents-should-know) Accessed 11/9/2021.
  • Block, MH, Dwyer, JB. Antidepressants for Pediatric Patients. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6738970/) Current Psychiatry. September 2019;18:26-42. Accessed 11/9/2021.
  • Anxiety and Depression Association of America. Childhood Depression. (https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/childhood-depression) Accessed 11/9/2021.
  • Centers for Disease Control and Prevention. Depression and Anxiety in Children. (https://www.cdc.gov/childrensmentalhealth/depression.html) Accessed 11/9/2021.
  • Centers for Disease Control and Prevention. Data and Statistics on Children’s Mental Health. (https://www.cdc.gov/childrensmentalhealth/data.html) Accessed 11/9/2021.
  • Kirchner, JT, Son, SE. Depression in Children and Adolescents. (https://www.aafp.org/afp/2000/1115/p2297.html) American Family Physician. November 2000;62:2297-2308. Accessed 11/9/2021.
  • National Institute of Mental Health. Depression Basics. (https://www.nimh.nih.gov/health/publications/depression/index.shtml) Accessed 11/9/2021.

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