Depression in children: Signs to be vary of

In this article we’ll learn more about depression that too especially in children, the symptoms, its types, depression in children statistics, treatment and signs to be vary of.

A condition that is more severe than normal sadness and can interfere with a child’s ability to function is known as depression. Depression is known to affect about 2% of preschool and school-age children. Suicide is the third leading cause of death in young people 10-24 years of age. Not only that it is the leading cause of disability in the United States in people over 5 years of age.

Depression in children is not because of one specific cause but rather a number of biological, psychological, and environmental risk factors that are part of its development.

Prevention of childhood depression is to reduce risk factors and support protective factors using approaches that are apt for the child’s developmental level.It is advisable for family members and friends to seek mental health assessment and treatment for the depressed child.

Childhood Depression Symptoms:
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. Depressive disorders are characterized by pervasive mood changes that affect all aspects of an individual’s daily functioning.
Some other symptoms are:

  1. helplessness,
  2. guilt,
  3. feelings of worthlessness,
  4. hopelessness,
  5. loss of energy,
  6. loss of appetite,
  7. lack of interest in daily activities,
  8. irritability,
  9. sleep problems,
  10. self-loathing,
  11. Suicidal thoughts.

What is childhood depression?

Clinically noted depression is severe enough to interfere with a person’s ability to function. It is common for all ages, affecting more than 16% of children in the United States at some time in their lives and thought to be increasing in children and adolescents, both in US and elsewhere.
Other statistics show that this to occurs at a rate of about 2% prior to the teenage years and at approximately 5%-8% when both adolescents and children younger than adolescence are considered. It is a leading cause of health impairment and even death. About 3,000 adolescents and young adults die by suicide each year in the United States, making it the third leading cause of death in people 10-24 years of age.

What are the types of depression in children?

Children may suffer from the episodes of moderate to severe depression associated with major depressive disorder, or more chronic, mild to moderate low mood of dysthymia.

Depression is also a part of other mood disorders like bipolar disorder, as a result of psychosis (for example, having symptoms of delusions/hallucinations), as part of a medical condition like hypothyroidism, or the result of exposure to certain medications such as cold medications or drug abuse, like cocaine withdrawal.

What are causes and risk factors for depression in children?

Depressive disorders in children is not because of one specific cause. Rather, people with these conditions tend to have a number of biological, psychological, and environmental contributors to its development.
Psychological contributors to depression are as follows:

  1. low self-esteem,
  2. negative social skills,
  3. negative body image,
  4. being excessively self-critical

What are the warning signs of depression in children?

Some of the warning signs to be aware of are, clinical/major depression is more than sadness that lasts for a day or two. The symptoms last weeks, months, or sometimes years if not treated. The one suffering from depression are unable to perform daily activities like getting out of bed , performing well at school, or playing with peers.

General symptoms of a major depressive episode (regardless of age) are:

Having a depressed mood or irritability or difficulty experiencing pleasure for at least two weeks and having at least five of the following signs and symptoms:

  1. Feeling sad or irritable or seeming that way as observed by others (for examples, tearfulness or otherwise looking persistently sad, or angry)
  2. Significant appetite changes, with or without significant weight loss, failing to gain weight appropriately or gaining excessive weight
  3. Change in sleep pattern: trouble sleeping or sleeping too much
  4. Physical agitation or retardation (for example, restlessness or feeling slowed down)
  5. Fatigue(tired) or loss of energy
  6. Difficulty concentrating
  7. Feeling worthless, excessively guilty, or tend to self-blame
  8. Thoughts of death or suicide

Children with depression also experience the general symptoms but may exhibit other symptoms as well, including:

  1. impaired performance of schoolwork,
  2. persistent boredom,
  3. quickness to anger,
  4. frequent physical complaints, like headaches and stomachaches,
  5. more risk-taking behaviors and/or showing less concern for their own safety.
  6. (unsafe play, like climbing excessively high or running in the street.)

Parents of infants and children with depression often report noticing the following behavior changes in the child:

  1. Crying more often or more easily
  2. Increased sensitivity to criticism or other negative experiences
  3. More irritable mood than usual or compared to others their age and gender, leading to vocal or physical outbursts, destructive, angry or other acting out behaviors
  4. Eating patterns, sleeping patterns, or significant increase or decrease in weight change, or the child fails to achieve appropriate gain weight for their age
  5. Unexplained physical complaints (for examples, headaches or abdominal pain)
  6. Social withdrawal, in that the youth spends more time alone, away from friends and family
  7. Developing more “clinginess” and more dependent on certain relationships (This is not as common as social withdrawal.)
  8. Overly pessimistic, hopeless, helpless, excessively guilty or feeling worthless
  9. Expressing thoughts about hurting themself or engaging in self-injury (like cutting or burning him or herself), reckless or other potentially harmful behavior
  10. Young children may act younger than their age or than they had before (regress).

What is the treatment for depression in children?

Treatment options may include treating any medical condition that causes or worsens depression. For example, a person who has low levels of thyroid hormone might receive hormone replacement with levothyroxine (Synthroid). Other aspects of treatment may include supportive therapy, like lifestyle and behavioral changes, psychotherapy, complementary treatments, and possibly medication for moderate to severe depression. If symptoms are severe then it is treated with medication, symptoms tend to improve faster and for a longer period when medication is combined with psychotherapy. Most mental health professionals will continue treatment of major depression for six months to a year to prevent a recurrence of symptoms.
Treatment for children for this have a significantly positive effect on the child’s functioning with peers, family members, and at school. Without treatment, symptoms much longer, may not improve, or may worsen. With treatment, the chances of recovery are significantly improved.


Psychotherapy (“talk therapy”) is a mental health counseling working with a trained therapist to figure out ways to solve problems and cope with depression. It can be a powerfully effective intervention, even resulting in positive biochemical changes in the brain. For babies, music therapy and infant massage are useful interventions.

Two major kinds of psychotherapy are used commonly treat childhood depression: interpersonal psychotherapy and cognitive behavioral therapy. In general, these forms of treatment take weeks to months to complete and has a goal of alleviating depressive symptoms.

  1. Intensive psychotherapy may be needed for a longer period of time when treating very severe depression or for depression that is accompanied by other psychiatric symptoms
  2. Interpersonal psychotherapy: This type of psychotherapy seeks to alleviate depressive symptoms by helping child with depression and develops more effective skills for coping with their emotions and relationships. IPT uses two strategies to achieve those goals:


Educating the child, their parents, and other family members about the nature of depression: The therapist will reassure the child and his or her loved ones that depression is a common illness and that most people tend to improve with treatment.

3.Defining problems:

Defining problems (such as abnormal grief or interpersonal conflicts): The therapist helps the child set realistic goals for solving problems and work with him or her and the child’s family using different treatment techniques to reach these goals.

  • Cognitive-behavioral therapy (CBT): This helps to decrease depression and the likelihood it will come back by helping the child change his or her way of thinking about certain issues.
  • In CBT, the therapist uses three techniques to achieve these goals.

1. Didactic component: This phase helps to establish positive expectations for treatment and promote the child’s participation in treatment.
2. Cognitive component: This promotes identifying the thoughts and assumptions that play a role in the child’s behaviors, especially those that may predispose the sufferer to being depressed.
3. Behavioral component: This uses behavior-modification methods to teach the child more effective ways of dealing with problems.


The most commonly used group of antidepressant medications prescribed for children is the selective serotonin reuptake inhibitors (SSRIs). SSRI medications influence the levels of serotonin in the brain.
For many prescribing professionals, these medications are the first choice because of the significant degree of effectiveness and safety of this group of medicines. Examples of these medications are listed here with the generic name first and the brand name in parentheses:

  1. Fluoxetine (Prozac)
  2. Sertraline (Zoloft)
  3. Paroxetine (Paxil)
  4. Fluvoxamine (Luvox)

Prozac and Lexapro are approved by the Food and Drug Administration (FDA) to treat childhood depression and only in those 8 years of age and older for Prozac, 12 years old and older for Lexapro. Any other medications used to treat this condition in children or using an antidepressant in younger children is therefore considered to be being used “off label.”
Other antidepressant medications work differently than the commonly used SSRIs. Physicians may prescribe the following medications when SSRIs have not worked:

  1. bupropion (Wellbutrin)
  2. venlafaxine (Effexor)
  3. duloxetine (Cymbalta)
“Side effects of antidepressant medications vary significantly from drug to drug and from person to person.”

Common side effects can include dry mouth, upset stomach, nausea, tremor, insomnia, blurred vision, constipation, and dizziness.
In rare cases, some people of all ages become more depressed when on the medication, even having suicidal or homicidal thoughts, and/or attempting or completing suicide or homicide. Children and teenagers are particularly vulnerable to this rare possibility. This risk shows the possibly serious outcomes that can result from untreated depression.

5.Alternative treatments

People use a number of nonprescription herbal supplements like St. John’s wort and dietary supplements like vitamin C and B complex vitamins as remedies for depression. There is little known about the safety, effectiveness, or appropriate doses of these remedies, despite their being taken by thousands of people around the world. While some of the best-known alternative remedies continue to be studied to see how well they work, there remains little evidence that herbal supplements effectively treat moderate to severe clinical depression. Medical professionals are hesitant to recommend herbs or dietary supplements to treat depression, particularly in children, because the FDA doesn’t allow : to ensure their purity, quality, and effectiveness.

What are complications of depression in children?

Depression during childhood puts sufferers at risk for developing a number of other mental health issues. Children with depression are also have poor academic performance and engage in alcohol and other drug abuse. As adults, people who had depression during childhood and adolescence are at risk for having trouble maintaining employment, as well as family and other social disruptions during adulthood.

What is the prognosis for depression in children?

Depression can be chronic,85% of people who have one episode of the disorder will have another one within 15 years of the first episode. Depressed individuals exposed to trauma are less likely to respond to treatment with antidepressant medication than those who have not experienced trauma. Early treatment of childhood depression improves the prognosis, improving access to care (including encouraging parents and other family members to seek mental health treatment for their child) promotes a better prognosis.

Is it possible to prevent depression in children?

For children, from infancy through the teenage years, strong, healthy parent-child attachment can help protect the child from developing depression. Parental behaviors plays a major role right from forming healthy attachment with their kids, consistent love and care, attentive responsiveness, age-appropriate steps toward the child’s gradual independence & using an appropriate approach for the child’s developmental level. Protective factors for adolescent depression include involving supportive adults, strong family and peer relationships, healthy coping skills, and emotional regulation.


Children of a depressed parent are more happy when the child is able to focus on age-appropriate tasks in their lives and on their relationships, as well as being able to understand their parents’ condition. For depressed parents, their children seem to be less likely to develop the disorder when the parent is able to demonstrate a commitment to parenting and to relationships. Depression is not something that a person, especially a child can come out of easily. To come out of they need constant love , support & trust worthy people around them. Be aware of these signs and if anyone around you is going through this help them come out of it. Do know depression can destroy a life if left untreated. So, let us be aware and make others aware.

Subin Joshua
Author: Hi there, my name is Subin Joshua, and I am a Medical student. I grew up in a family of teachers and know that being a social worker is my calling. My passion for helping others has been evident in my involvement in helping the poor and needy for the last three years. Through those experiences, I have learned to interact with a diverse group of people, which has increased my ability to relate to others.