Depression in Children and Teenagers

Did you know that up to 3% of children and 20% of teens experience depressive symptoms? Because childhood is full of developmental changes, it is sometimes hard to tell the difference between normal and concerning behaviors. Parents should consider seeking advice from their trusted pediatrician for the following issues, especially If they persist for longer than two weeks. 

• Irritability or sadness
• Frequent boredom or loss of interest in normal activities like sports, clubs and seeing friends
• Changes in appetite or sleep
• Isolation from family and friends (e.g., spending time alone in their room)
• Inability to focus or sudden worsening in school performance
• Thoughts about death or suicide or signs of self-harm, such as cutting
• Excessive worry or negative thoughts that are hard to control

What can I do?

Talk to your child openly and without judgement. Children and teens are often worried about being reprimanded or lectured and may even think there is something wrong with them. Ask how they are feeling and listen more than you speak. Reassure your child that their mental health is just as important as their physical health. Accept their initial silence on the subject while your child processes how to talk with you, but you should also continue to check in with them. Love and support will not only encourage your child to be open, but also can decrease the stigma around mental illness.

You can further support your child by encouraging them to get a healthy amount of physical activity and sleep and by eating nutritious foods. Limit screen time to no more than two hours a day while encouraging face-to-face social activities with family and friends.

A special word about trauma

Traumatic events are well known to cause “toxic stress” and can result in behavioral issues. Trauma includes divorce or the death of a parent, experiencing neglect, abuse or social inequities, witnessing domestic violence, or having a parent incarcerated or with mental illness and/or substance abuse. Unaddressed, these exposures lead to high rates of both mental and physical illness later in life. A child is more likely to suffer later in life from chronic issues when they’ve experienced longer periods of or more frequent exposure to trauma. Acutely, kids will act out, sleep more poorly, lose developmental skills, struggle to focus, or feel sad. Parents or parental figures can counter this stress with the following:

• Providing safe and nourishing environments 
• Modeling emotion and emotional regulation (e.g., how to calm down effectively by taking a time out or using a calming jar)
• Fostering connection in shared activities and positive experiences

When do I call the doctor?

If any of the above symptoms have lasted for two or more weeks or if there is any concern for self-harm or suicidal thoughts, you should contact your child’s pediatrician. Your child’s pediatrician can help diagnose and provide treatment options, including medications and community resources such as counseling. You can also talk to your pediatrician about whether your child needs accommodations in school such as a 504 plan or an Individualized Education Plan (IEP).

Suicide

Any concern that your child has suicidal thoughts is considered an emergency. Contact your child’s doctor immediately. There are also national hotlines you and/or your child can call: 1-800-TALK (8255) or text HOME to 741741. If your child or teen is struggling with depression, it is critically important to remove or lock up any dangerous objects such as guns or other weapons, alcohol, harmful household chemicals and medicine. If the items cannot be removed, store them in a lockbox.