In the United States, depression is the most common mental health disorder. Each year it affects 17 million people of all age groups, races, and economic backgrounds. As many as 1 in every 33 children may have depression; in teens, that number may be as high as 1 in 8. If you suspect that your child is depressed, you'll want to learn more about what depression is, what causes it, and what you can do if your child is depressed.
What Is Depression?
Depression isn't just bad moods and occasional melancholy. It's not just feeling down or sad, either. These feelings are normal in children, especially during the teen years. Even when major disappointments and setbacks make people feel sad and angry, the negative feelings usually lessen with time. But when a depressive state, or mood, lingers for a long time — weeks, months, or even longer — and limits a child's ability to function normally, it can be diagnosed as depression.
Types of depression include: major depression, dysthymia, adjustment disorder with depressed mood, seasonal affective disorder, and bipolar disorder or manic depression. All of these can affect children.
Major depression is a serious condition characterized by a persistent sad mood, feelings of worthlessness or guilt, and the inability to feel pleasure or happiness. Major depression typically interferes with day-to-day functioning like eating and sleeping. A child with major depression feels depressed almost every day.
Dysthymia may be diagnosed if the sadness is not as severe but continues for a year or longer. Children with dysthymia often feel “down in the dumps.” They can have low self-esteem, feel hopeless, and even have problems sleeping and eating. Unlike major depression, dysthymia does not severely interfere with day-to-day functioning but the “down mood” is a pervasive part of the child’s world. Perhaps as many as 1% to 3% of children have dysthymia.
Bipolar disorder is another type of mood disturbance and is characterized by episodes of low-energy depression (sadness and hopelessness) and high-energy mania (irritability and explosive temper). Bipolar disorder may affect as many as 1% to 2% of children. More than 2 million adults have bipolar disorder, and it typically develops in the late teen years and early adulthood. Research on bipolar disorders in children is only in its infancy. Researchers believe that kids and teens with bipolar disorder can experience a number of problems, including attention deficit disorders, oppositional behavior disorders, anxiety, and irritability in addition to changes in mood from depression to mania.
What Causes Depression?
Depression usually isn't caused by one event or thing; it's typically the result of one or more factors, and its causes vary from child to child. Depression can be caused by lowered levels of neurotransmitters (chemicals that carry signals through the nervous system) in the brain, which limits a person's ability to feel good. Depression can run in families, so a child who has a close relative with depression may be more likely to experience it.
Significant life events such as the death of a loved one, a divorce, a move to a new area, and even a breakup with a girlfriend or boyfriend can bring on symptoms of depression. Stress also can be a factor, and because the teen years can be a time of emotional and social turmoil, things that are difficult for anyone to handle can be devastating to a teen.
Also, chronic illness can contribute to depression, as can the side effects of certain medicines or infections.
Diagnosing Depression
Depressed kids have described themselves as feeling hopeless about everything or feeling that nothing is worth the effort. They honestly believe that they are “no good,” that their world is a difficult place, and that they're helpless to do anything about it.
But for an accurate diagnosis of major depression to be made, a more detailed clinical evaluation must be done. A medical or mental health professional (such as a psychologist or psychiatrist) must be sure that your child has had five or more of the following symptoms for more than 2 weeks:
- a feeling of being down in the dumps or really sad for no reason
- a lack of energy, feeling unable to do the simplest task
- an inability to enjoy the things that used to bring pleasure
- a lack of desire to be with friends or family members
- feelings of irritability, anger, or anxiety
- an inability to concentrate
- a marked weight gain or loss (or failure to gain weight as expected), and little or too much interest in eating
- a significant change in sleep habits, such as trouble falling asleep or getting up
- feelings of guilt or worthlessness
- aches and pains even though nothing is physically wrong
- a lack of caring about what happens in the future
- frequent thoughts about death or suicide
A child who has dysthymia must experience two or more of the following symptoms almost all the time for at least 1 year:
- feelings of hopelessness
- low self-esteem
- sleeping too much or being unable to sleep
- extreme fatigue
- difficulty concentrating
- lack of appetite or overeating
Depressed kids and teens are more likely to use alcohol and drugs than those who aren't depressed. Because these substances can momentarily allow a child to forget about the depression, they seem like perfect fixes. But they don't fix anything; in fact, they can make the depressed child feel even worse.
Recognizing Depression in Your Child
If you think your child has symptoms of depression, talk with your child and your child’s doctor. Many parents dismiss their child’s concerns, thinking they’ll go away, or avoid acting on their concerns because they fear they’re responsible for their child’s depression. But it’s important to get past those concerns and get your child the help needed to feel better. You're not responsible for your child's depression — even if something you did (such as a divorce) triggered it. It's nobody's fault.
Let your child know that you're there whenever he or she needs you and wherever you may be. Say this over and over again — your child may need to hear it a lot because he or she feels unworthy of love and attention. Remember, kids who are depressed see the world through “dark lenses” because their experiences are colored by their depression. They might act like they don’t want help or might not even know what they are really experiencing. It's important to let your child know that you understand what he or she might be going through and that you're going to seek an expert opinion to find a way to make life easier.
If You Suspect a Problem
The good news is that professionals can help your child. Depression can be successfully treated in more than 80% of the people who have it. But if it goes untreated, depression can be deadly — it is the number-one cause of suicide.
Depression can be treated with psychotherapy, medicine, or a combination of therapy and medicine. A psychiatrist can prescribe medicine, and although it may take a few tries to find the right drug for your child, most people who follow their prescribed regimen eventually begin to feel better. Psychotherapy focuses on the causes of the depression and works to help change negative thoughts and find ways to allow your child to feel better. Feeling is healing, and talking about feelings can be a powerful antidote for depression. A good therapist will communicate this to your child.
Getting Help for Your Child
Your first consultation should be with your child's doctor, who probably will perform a complete examination to rule out physical illness. If depression is suspected, the doctor may refer you to a psychiatrist (a medical doctor who can make a diagnosis, offer treatment, and prescribe medicine), psychologist (a health professional who can diagnose and treat depression but is unable to write prescriptions), or licensed clinical social worker (a person who has a degree in social work and is qualified to treat childhood depression).
When it comes to managing your child's depression, all of these health professionals can help. The important thing is that your child feels comfortable with the person. If it's not a good fit, find another.
Your child's teacher, guidance counselor, or school psychologist also may be able to help. These professionals have the welfare of your child at heart and all information you and your child reveal to them during therapy is kept confidential.
Treating Depression
Don't put off your child's treatment. Early detection and diagnosis are key in treating kids with depression.
A child or adolescent psychiatrist or psychologist can perform a complete evaluation and start a treatment plan that may include counseling, medicine, or both. The counselor may prescribe some sort of group counseling where the family works with the child in therapy sessions.
Depending on your child's age and maturity, it may be beneficial for him or her to participate in treatment decisions.
What Can I Do to Help?
Most parents think that it's their job to ensure the happiness of their child. When your child's depressed, you may feel guilty because you can't cheer him or her up. You also may think that your child is suffering because of something you did or didn't do. This isn't true. If you're struggling with guilt, frustration, or anger, you may want to consider counseling for yourself. In the long run, this can only help both you and your child.
Other ways to help:
- Make sure your child takes any prescribed medicines and encourage healthy eating too, as this may help improve your child’s mood and outlook.
- Make sure your child stays active. Physical activity has been shown to help alleviate the symptoms of depression. Incorporate physical activities, such as bike rides or walks, into your family's routine.
- Say that you're there, that you love and care about your child and want to hear what he or she has to say, even if it isn't pleasant. Although these things may be difficult for your child to believe, it's important for you to say them. Eventually, they'll be acknowledged.
- Accept the situation and never tell your child to "snap out of it." Remind yourself that it isn't laziness causing your child's inability to get out of bed, complete chores, or do homework. He or she simply doesn't have the desire or the energy.
- Keep up treatment for your child and watch for warning signs. Make sure the prescribed treatment is followed, whether it’s medication, therapy, or both. Call the doctor if you see signs that your child may be thinking about suicide because untreated depression is the top cause of suicide. If your child talks about suicide, to you or anyone else, or shows warning signs such as giving belongings away and being preoccupied with death, call your child's doctor or mental health professional immediately.
Depression can be frightening and frustrating for your child, you, and your entire family. With the proper treatment and your help, though, your child can start to feel better and go on to enjoy the teen and adult years.
Reviewed by: David V. Sheslow, PhD
Date reviewed: April 2006
