How to Tell If Your Child Shows Symptoms of Depression

If your child feels sad but doesn't know why, it could be a sign of childhood depression. Kids often don't have the resources to identify their own emotions or figure out what might be causing them.

"Depression can often look different in kids than adults. While adults often look sad or down, feel helpless or worthless, and lack energy, children may not even complain that they are upset or know that something is wrong," says Erica Miller, PhD, a children's therapist at Connected Minds NYC. 

Even though they may not be able to put what they are feeling into words, there are signs and symptoms that parents can watch for. Sad mood, social withdrawal, irritability, and periods of loneliness are just a few signs that your child might be dealing with depression.

Depression May Look Different In Kids

Symptoms of depression in children tend to be a bit different than those in adults. That is why your child might be sad but not know why or be able to explain how they are feeling.

Low mood and loss of pleasure are often the two primary symptoms in adults with depression. Kids are more likely to experience primary symptoms such as irritability and physical complaints.

Other symptoms of childhood depression include difficulty focusing and making decisions, extreme shyness, clinging to a parent, feeling hopeless, unexplained physical complaints, sleeping problems, appetite changes, and thoughts or actions of self-harm.

"Depression does not always bring with it self-harming behaviors or suicidal ideation, but these are flags to pay attention to and never fear in asking your child about it," says Abbey Sangmeister, MSEd, LPC, ACS, a therapist and parental burnout coach. "It is better to be straightforward and ask than for these conversations to go unaddressed and your child to be suffering silently."

Symptoms of Depression in Children

If you suspect that your child might be depressed, keep an eye out for the following signs.

Sadness

Children may become sad about many things such as lost relationships, school work, failures, missing out on something, moving, or loss of a friend, pet, or loved one.

Kids express and explain sadness differently than adults do. This is especially true for very young kids who lack the emotional resources to label and explain what they are feeling.

Because your child might be unable to explain why they are sad, it might take some detective work to figure out the underlying cause. If your child has been struggling with problems in school, with friends, stress, or other disappointments, their sadness may be a temporary mood that will pass with time and support.

Try to identify what your child is sad about and provide support. If symptoms of sadness improve or disappear after just a few days, they are probably unrelated to depression.

Depressed children may have a general sense of sadness about their life and their future, or they may not be able to identify what they are sad about. They may cry a lot or tear up frequently for no obvious reason. Feelings of sadness that last longer than two weeks are a reason to talk to your child's pediatrician.

Withdrawal From Friends and Family

Most children will change friends at some point and spend varying amounts of time with their parents. As children go through puberty, they naturally pull away from their families and start identifying more with peers. This is an important developmental step that should not be confused with social withdrawal.

When social withdrawal is associated with depression, it can contribute to a child's negative social experiences, which can reinforce depressive symptoms (such as worthlessness or feeling like no one likes or understands them).

Losing Interest in Activities

Your child may naturally lose interest in things they once loved, like a favorite toy or TV show, or suddenly declare that they no longer want to engage in a favorite activity. This is different from a child with depression.

A depressed child has a hard time finding joy or excitement in anything. Your child may be indifferent to almost everything. Kids who are depressed often seem like they are just going through the motions without any joy or pleasure in what they are doing.

Feeling Misunderstood

Every child will feel misunderstood at some point in time. A depressed child may feel that there is no one who can understand their feelings or that it is pointless to even try to talk about them. Your child may fear trying new things, speaking out, or sharing ideas out of fear of rejection, misinterpretation, or ridicule.

Academic Decline

Children may have academic highs and lows over time. Remember that during times of transition to middle school or high school, course work may become more challenging.

A depressed child may have a significant decline in grades. Missing school, trouble paying attention, or simply failing to do work are all reasons for such declines in grades. This may be more apparent in a child who had been a high academic achiever in the past.

Lack of Energy

Everyone gets tired, especially after busy days, hard work, late nights, illnesses, and exercise, but a depressed child may seem to always lack energy and motivation.

Guilt

Feelings of excessive and unrelenting guilt are common in children with depressive disorders, such as major depressive disorder, depressive episodes in bipolar disorder, and dysthymia. A child with depression may blame themselves for anything that goes wrong, even if it is out of their control.

Guilt can also contribute to feelings of sadness, worthlessness, and hopelessness. If your child's guilt seems to be worsening, lasts longer than two weeks, and is present with other signs of depression, seek out your doctor or mental health professional.

Worthlessness

Children with depressive disorders may feel worthless frequently or for long periods of time, especially following a negative event. Children who experience feelings of worthlessness typically think they are weak, inadequate, or flawed.

Children who feel worthless may believe that they are inherently bad and that everything they do is wrong. They may not put any effort into their schoolwork, engage in unstable relationships, or not even try to connect with others because they believe that their efforts will fail or cause additional problems.

Impulsivity and Aggression

For some depressed children and adolescents, their emotions may cause them to feel angry toward the people or things that they believe are the sources of their pain. This can lead to impulsive and aggressive reactions.

Impulsive behaviors are quick reactions to events (usually negative) without regard for consequences. Impulsive behaviors often, but do not always, lead to aggressive actions. Aggressive behaviors may be directed inward in the form of self-injury, or at someone or something else through angry outbursts, harassment, property damage, or violence.

What Causes Depression in Kids

Childhood depression is a complex condition that has many causes. A number of different factors can contribute to the onset of depression in kids. Depression affects many children.

Some of the risk factors that can contribute to childhood depression include:

• Brain chemistry: Imbalances in certain neurotransmitters such as serotonin, dopamine, and norepinephrine can play a role in causing depression.
• Environment: A chaotic or unstable home life can be a risk factor for depression, as can experiencing social isolation or bullying at school.
• Family history: Having close family members and relatives with depression increases the risk of experiencing childhood depression. One 30-year study found that those with the highest risk of depression were those with two previous generations of family members with depression.
• Physical health: Health conditions, particularly chronic illnesses such as type 1 diabetes, can increase the risk of experiencing childhood depression.
• Stress: Life events such as moving and divorce can play a role in causing childhood depression.

How to Help Your Child

If you think that your child may be depressed, consult with your pediatrician, who can evaluate the symptoms, rule out an underlying medical illness, and recommend the appropriate treatment.

Here are a few things that you can do to help your child cope with feelings of depression.

Monitor Your Child's Moods

Watch for symptoms such as sadness, irritability, loss of pleasure, change of appetite, change of sleep habits, tiredness, feelings of worthlessness, and thoughts of death. Talk to a health professional if your child shows such signs.

Provide Reassurance

Let your child know that depression is nothing to be ashamed of. Depression is an illness just like the flu and getting the right treatment can help kids get better.

Encourage Your Child to Talk

Give your child the right to have these feelings. Children can quickly get the idea that it's not OK to feel depressed and start to hide their feelings rather than deal with them in a healthy way.

How do you go about starting the conversation? "I suggest going for a walk, coffee shop, playing a game, or going for a drive in the car. Children are more inclined to open up when doing something. This also takes some of the stress and pressure off the conversation for both of you," Sangmeister suggests.

She also recommends asking open-ended questions about how your child is feeling, such as, "How are you sleeping?" or "Is there anything you have on your mind? I've noticed you've been (sad/anxious/quiet) lately.

It's important to give your child plenty of space to respond. Remain attentive, but don't try to fill the silence with your own comments.

Teach Your Child to Ask for Help

Kids need to know that there will be help available when they need it. Give them a list of people they may talk to such as yourself, a teacher, or a counselor.

Sangmeister also suggests that talking to a therapist yourself is a great way to model help-seeking behavior for your child. "Set the example for your child that there is no judgment in getting additional support and normalize having a space to process your own thoughts and feelings with a professional," she explains.

Never Minimize Feelings

It may seem small to you, but what counts is how it feels to your child. Listen and be a source of support.

"Initiate an open and non-judgmental conversation with your child to show you are concerned and provide them a space to share their feelings. Actively listen, validate them, and do not dismiss what they are feeling," says Daniel Rinaldi, MA, a therapist and life coach.

Watch Your Own Behavior

Be aware of the impact your own responses to life are having on your child. Your child learns coping skills by watching you.