Childhood depression is different than a moody kid who sometimes seems down or upset. Children, like adults, have times when they feel “blue” or sad. Emotional fluctuations are normal.

But if those feelings and behaviors last longer than two weeks, they may be a sign of an affective disorder like depression.

Depression isn't an adult-only illness. Children and adolescents can and do develop depression. Children may go undiagnosed and untreated because parents and caregivers may struggle to recognize the signs of the disorder.

Depression affects about 3 percent of U.S. children. The persistent sadness and symptoms can interfere with daily life, interrupting school and social activities.

Childhood depression is a serious mental health issue, but it is treatable. Read on to learn more about the signs, symptoms, causes, and risks associated with childhood depression.

Children with depression often experience many of the same depression symptoms as adolescents and adults do. However, children may have a hard time expressing themselves and these feelings because of their limited emotional vocabulary.

SYMPTOMS OF CHILDHOOD DEPRESSION

Children with depression may not experience all of these symptoms. Some may be more prominent than others.

Warning signs of depression are emotions or changes that parents and caregivers can see for themselves.

Children may not be sure how to express their feelings to you, or they may be unwilling to. These warning signs can occur in children with depression:

  • irritability or anger
  • changes in behavior and temperament
  • increased or decreased appetite
  • increased or decreased sleep
  • emotional or vocal outbursts
  • frequent expression of physical illness, such as headaches or stomachaches
  • reduced concentration
  • defiance
  • decline in performance at school
  • expressing negative thinking (self-critical comments or complaining)
  • talking about death or dying

Suicide risk

Childhood depression can cause thoughts of suicide, even suicidal behavior. In fact, suicide is the third leading cause of death for children ages 5 to 14.

If your child has been diagnosed with depression or you suspect they may be depressed, it’s important to watch them for warning signs and help them find help.

Warning Signs of Suicide Risk
  • multiple symptoms of depression
  • social isolation
  • increased problematic behavior
  • talking of suicide, death, or dying
  • talking about hopelessness or feeling helpless
  • frequent accidents
  • substance use
  • interest in weapons

Childhood depression may be the result of a combination of factors. These risk factors alone may not account for the mood disorder, but they might play a role.

These risk factors increase a child’s chances for developing depression:

  • Physical health. Children with chronic or severe medical conditions are more likely to be depressed. This includes obesity.
  • Stressful events. Changes at home, at school, or with friends can increase a child’s risk for depressive symptoms.
  • Environment. A chaotic or stressful home life can put a child at greater risk for a mood disorder like depression.
  • Family history. Children who have family members with mood disorders or depression may be more likely to develop depression at a young age.
  • Biochemical imbalances. Uneven levels of certain hormones and chemicals may impact how the brain works. This can increase the risk for depression.

Childhood depression is a serious condition, but it is treatable. However, if it's not treated, children may experience consequences for many years to come.

These complications include:

  • suicidal thoughts or behaviors
  • worsening symptoms
  • increased risk of developing depression that's worse or prolonged later
  • severe depressive episodes
  • other mood disorders

Treatment for children with depression involves therapy and prescription medication. Some children may benefit from one of these — others may use a combination.

These are not lifelong treatments. Your child’s doctor will prescribe a treatment plan, and they'll decide when it’s appropriate for your child to stop using it.

The treatment plan for childhood depression often depends on the severity of symptoms. The good news is that the right care can help your child find relief from their symptoms.

Therapy

If a child is diagnosed with depression, the first line of treatment is often psychotherapy. This type of therapy can address the emotional and life factors that increase a child’s risk for depression, such as environment and stressful events.

Cognitive behavior therapy (CBT) is commonly used to treat depression. This type of therapy involves talking through emotions and experiences, analyzing areas for changes, and finding proactive ways to make those changes.

For young children, traditional talk therapy may not be as effective because of their limited vocabulary. Play therapy, which uses toys and entertainment, can help children learn to reinforce their feelings and experiences. Art therapy, which uses painting, drawing, and other artistic techniques, is a type of expressive therapy that may help children cope with symptoms of depression, too.

Medication

As of 2015, the U.S. Food and Drug Administration (FDA) has five antidepressant medications for the treatment of MDD in children. These recommendations vary by age, so the doctor will consider your child’s age when choosing the best medication treatment.

According to the U.S. Department of Health and Human Services (HHS), the following medications may be used in the treatment of children with MDD:

  • Zoloft® (sertraline)
  • Lexapro® (escitalopram)
  • Luvox® (fluvoxamine)
  • Anafranil® (clomipramine)
  • Prozac® (fluoxetine)

A rare side effect of these medications in children may be an increased risk of suicide. Parents and caregivers of children who are taking this medication are encouraged to closely monitor their child for changes and seek immediate help from a doctor if they become concerned.

Children taking any of these medicines should not stop taking them without permission from the doctor. Quitting the medicine can lead to significant side effects.

Treating childhood depression starts with finding the right provider and the right type of treatment.

These steps can help.

1. Talk with your child. While it may be difficult, try to have a conversation with your child about what they’re feeling and experiencing. Some children will open up. This will help you understand what’s happening.

2. Take notes. If your child will not talk with you, keep a diary of observable changes and signs. This can help a doctor see behavior trends.

3. Talk to the pediatrician. Your child’s doctor will first want to rule out physical issues that could account for the symptoms. This may require a series of blood tests and a physical exam.

4. Find a specialist. If your child’s pediatrician believes the issue is a mood disorder like depression, they may recommend you to a specialist, such as a psychologist or psychiatrist. These doctors are trained to recognize and treat childhood depression.

questions for your child's therapist

When you meet with your child’s specialist, these questions may help you begin a conversation.

  • What’s normal and what’s not? You can review the signs you’ve seen to understand if these may be problematic or normal.
  • How will you diagnose my child? Ask about the process and what is needed from you and your child.
  • What are the possible treatments? This will give you an understanding of the doctor’s approach to treatment. For example, you may decide you want to use a doctor that tries therapy before medication.
  • What’s my role? As a parent, it’s normal to worry about your child’s physical and emotional health. Ask the doctor what they need from you in this process. Some parents will go through individual therapy to help them learn how to interact with their children in a different manner.