Depression in Children & Adolescents

What is depression?

Depression is a state of persistent sadness that is often accompanied by a loss of interest in activities that were formerly enjoyed. For children with depression, it can disrupt every part of their life, including their schoolwork and their relationships with family and friends. If childhood depression is left untreated, the feelings of unending sadness can become overwhelming and potentially lead to thoughts of self-harm.

What causes depression in a child or adolescent?

There isn’t one definitive cause of depression at any age. It is likely caused by a combination of factors that may include environment, genetics & family history, physical health and stressful life events.

Symptoms of depression in children and adolescents

It is important to know that everyone occasionally feels down or “blue” and, as long as these feelings eventually pass, they are not a sign of clinical depression. In children and adolescents, however, depression often goes undiagnosed and untreated because parents or caregivers assume that their child is simply going through the normal emotional and psychological changes that come with growing up. It is, therefore, important to watch for the signs and symptoms that may indicate your child’s moodiness is more than just a phase. These include:

  • Changes in appetite and sleep habits
  • Obvious and continuous demeanor of sadness, worthlessness or guilt
  • Low energy and extreme fatigue
  • Difficulty concentrating
  • Irritability, anger or vocal outbursts such as crying
  • Social withdrawal
  • Self-destructive behavior
  • Thoughts of self-harm or death

How is depression diagnosed in a child or adolescent?

If one or more of the signs and symptoms of childhood depression listed above persist, it is important to schedule an appointment with your child’s pediatrician. The initial visit will include:

  • A physical exam to determine if an underlying physical health problem may be a factor
  • Lab tests including a complete blood count and a thyroid functioning test
  • A preliminary psychological evaluation. Most pediatricians are aware of the signs and symptoms of depression and will have a focused conversation with your child about their thoughts, feelings and behaviors

If your child’s doctor suspects your child is depressed or at risk for depression, he or she may refer you to a child psychologist or psychiatrist for additional evaluation and treatment recommendations.

How is childhood depression treated?

  • Medications. Your child’s doctor, nurse practitioner or clinical nurse specialist may prescribe antidepressant medication, often beginning with one that has been approved by the FDA for use in children and adolescents. Parents should carefully monitor their child’s use of these medications. To work properly, antidepressants need to be taken consistently at the prescribed dose and often for several weeks before their effectiveness can be evaluated. Talk to your child’s prescriber about the potential side effects of the medication and weigh the risks and benefits before beginning treatment.
  • Cognitive therapy. A type of psychotherapy, cognitive therapy can help a child or adolescent learn how to better manage their feelings and emotions
  • Family therapy. Family dynamics often play a part in mood disorders in children and adolescents. Therapist-led sessions with the entire family can provide the opportunity for open discussion and problem-solving.
  • Inpatient care. Hospitalization may be recommended for severely depressed and/or suicidal children.
  • Intensive outpatient care or partial hospitalization. Treatment approaches for children and adolescents not responding to traditional outpatient care or those who have completed an inpatient course of treatment and are ready to step down to intermediate level care in an outpatient setting.