Mind on Health: Early signs of childhood and adolescent depression, and what to do

All children and adolescents feel sad or down at times. However, when such feelings persist and are accompanied by other symptoms — such as loss of interest or pleasure in previously enjoyable activities, irritability, fatigue, changes in sleep or appetite, or trouble concentrating — it may be a good idea to see a mental health professional.

Depression is relatively rare in young children, but rates increase dramatically in adolescence and into adulthood. Approximately 20 percent of the population experiences depression at some time in their lives.

Changes in mood or behavior

Knowing the signs of depression can help parents know when to seek help. Many parents start to notice that their child is spending more time alone in his or her bedroom or just does not seem like the same happy kid anymore. In children and adolescents, depression is often characterized by an irritable mood, and some parents notice that their child is crankier or more easily annoyed than before. Others may exhibit a lack of energy and trouble concentrating. Some parents notice a drop in their child’s grades, and teens may complain of difficulties with motivation or attention. Depression presents differently for each teen, so if you are concerned about changes in your child’s mood, see a mental health professional for an evaluation as soon as possible.

One of the most concerning symptoms of depression is the presence of suicidal thoughts and actions. Do not be afraid to talk with your child about suicide. Find a time when you are likely to have your child’s full attention, acknowledge that it is a tough topic to discuss and ask what your child’s thoughts are about suicide. For additional resources and guidance on how to have such a conversation, visit the Society for the Prevention of Teen Suicide website at sptsusa.org, or call the National Suicide Prevention Lifeline at 1-800-273-TALK. If you have immediate concerns about your child’s safety, go to the nearest hospital emergency department or call 911.

Depression is caused by a range of biological and psychological factors, and specific causes likely vary from person to person. Children with a family history of depression are at higher risk of developing the disorder themselves, and research suggests that children with depression show differences in how their brains function compared to children without the disorder. Young people with depression are also likely to have more negative thoughts and attitudes about themselves, relationships and the future. The development of depression is often preceded by stressful life events, such as bullying, loss of a relationship or academic pressures. Youth who are vulnerable to depression are also likely to have recurrences throughout life, and learning skills to cope with the disorder is key.

Treatment and recovery

The good news is that several effective treatments exist for depression in children and adolescents. They include cognitive behavioral therapy (CBT), which is based on the idea that our thoughts and behaviors contribute to feelings, and teaches skills for managing depressed mood. For example, teens may learn how to recognize negative thought patterns, develop more balanced thinking and increase positive and rewarding behaviors. In addition, some adolescents may benefit from interpersonal therapy (IPT), which focuses on addressing issues in relationships that may be contributing to depressed mood. CBT and IPT are relatively short-term types of therapy — typically lasting a few months — that may involve weekly sessions and practice implementing skills between sessions. In addition to therapy, some medications, particularly selective serotonin reuptake inhibitors (SSRI), have been shown to be effective for treating depression in children. Those with more severe depression may benefit from the combination of therapy and medication.

If your child is showing signs of depression, do not delay seeking the advice of a mental health professional. Intervening early could help to improve your child’s mood and prevent some of the negative effects of depression. If you are not sure where to go, contact your health insurance provider for a list of mental health providers — psychologists, social workers, counselors or psychiatrists — that are covered by your insurance. There are also many online tools to search for providers in your area, or your child’s pediatrician may be able to help you find mental health services.

If you think your child may benefit from therapy, ask providers ahead of time what type of therapy they offer to evaluate whether it might be a good fit for your child’s needs. Noticing signs of depression in your child can be alarming, but there is hope. Knowing the signs to look for and getting effective treatment can help your child recover and become that happy kid again.


Autumn Kujawa, Ph.D., is a clinical psychology postdoctoral fellow at Penn State Health Milton S. Hershey Medical Center.


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