Depression in children and teenagers

Photo of a teenage boy looking upset (PantherMedia / Andrey Shadrin) Children and teenagers feel sad, down or distressed from time to time. But if these feelings last longer and are stronger than usual, they might have depression. It is then especially important for them to have people who they can trust and open up to, to talk about how they are feeling.

Children and teenagers often have a lot of difficult issues to cope with, like trouble with parents, bad grades at school, losing friends, feeling unhappy with themselves or their bodies, and being lovesick for the first time. Problems and tough situations can get you down. That's completely normal. But depression is more than just being in a bad mood or having a bad day. It can become a serious illness.

Depression often has more than one cause. It usually comes from a combination of biological processes in the body, mental factors and events in a person's life. Although these factors can’t always be influenced, young people can learn how to cope better with the challenges in their life. This can also prevent depression.

What are the signs of depression in children and teenagers?

Children and teenagers who are depressed have some of the typical symptoms that adults have, such as deep sadness and a lack of motivation to do anything. But they often have different symptoms too. These depend on their age:

  • Pre-school children probably don't get depressed very often, and it can be hard to tell if they are. Pre-schoolers who are depressed cry a lot, aren't interested in playing and are very anxious. Many try too hard to be well-behaved and obedient. In some children it can set back their development.
  • School-aged children who are depressed often lose interest in their hobbies and can be hostile to others. They quickly lose their temper, easily get upset about little things and have low self-esteem.
  • With teenagers it can be hard to tell the difference between "normal” mood swings and when they are actually depressed. Even healthy young people are sometimes defiant, aggressive, indifferent, have low self-esteem or retreat into themselves. As well as feeling down all the time, things like changes in weight, drug and alcohol abuse, extreme tiredness and suicidal thoughts (thinking about killing yourself) can be signs of depression in teenagers.

What causes depression in young people?

About 5 out of 100 children and teenagers have symptoms that could be signs of depression. Depression is often caused by problems in the family, loss (of a parent, for instance), difficulties at school and not having any friends. Young people also have a higher risk of depression if they

  • have relatives with depression or other serious mental illnesses,
  • have had depression or an anxiety disorder in the past,
  • have previously been exposed to violence or abuse, or
  • have a very negative view of themselves or their bodies.

Physical illnesses and the side effects of some medications can increase the likelihood of depression too.

How can depression be prevented?

Ideally, parents and other adults will help children develop a stable personality and cope with challenges. People with close, stable relationships are also less likely to get depression.

If a child becomes depressed, it is important that their friends and family realize this early on. Signs of depression may include no longer enjoying anything or wanting to do anything, and becoming very withdrawn.

As children grow older, they develop more strategies to deal with problems and difficult situations on their own. They learn these strategies through their own experiences as well as through their family and friends. But sometimes that isn’t enough. Professional help is then available.

Some places offer various programs and courses to help children or teenagers manage stress and deal with problems. These usually involve group sessions where they learn things like how to cope with stress and solve conflicts, and what they can do if they feel unhappy.

If a child or teenager is suffering from paralyzing sadness or even feels like they no longer want to live, it's important that they tell someone how they are feeling. Those who don’t dare tell their friends or parents can contact a doctor or psychotherapy practice. There are also doctors who have specialized in the treatment of mental health problems in children and teenagers. And they can use telephone helplines too.

How is depression treated in children and teenagers?

In milder cases of depression, one option is to wait and see whether the symptoms get better without treatment. But it's important to perhaps be there for the child more than usual in the meantime. This involves trying to better understand their needs and take them seriously. They might need more understanding and patience than other children, as well as more opportunities to boost their self-esteem. If necessary, they can also make use of professional psychological advice. Family support centers can help here.

Like depression in adults, depression in children and teenagers can be treated with antidepressants or psychological treatment such as cognitive behavioral therapy (CBT). The treatment is managed by pediatricians and psychotherapists or psychiatrists. Medication should be used with caution because it can have side effects. For instance, there's some evidence that certain kinds of antidepressants may increase the likelihood of teenagers thinking about killing themselves (committing suicide).

What else do young people do to cope with problems?

Many children and teenagers do sports or attend classes – for instance at a sports club – that combine physical, mental health and often social elements too. This can improve their self-confidence. If a child or teenager doesn’t enjoy sports at school, it could be worth looking for sports activities and classes elsewhere, so he or she feels under less pressure to perform and can just enjoy the activity.

Quite a few young people keep a diary in which they try to make sense of their thoughts, worries and feelings and cope with them better. Some find comfort in a pet. Talking to other people and feeling close to them is particularly important for your emotional wellbeing, though.

Young people who have depression can make use of telephone helplines as well as support centers for families, children and teenagers. Many schools have social workers, psychologists or counselors to talk to. Teenagers often look for information on the internet too, and chat with others in social networks and forums.

Learning how to cope with difficult feelings and situations is an important part of growing up. But it's never easy to deal with depression or an anxiety disorder. Even if a young person has already had depression in the past and got through it, the fear of getting depression again could be distressing. It is then important to know what you can do about it yourself and also where to find help if you need it.