Depression in children and teenagers

Photo of a teenage boy looking upset

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 . 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 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 .

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 in teenagers.

What causes depression in young people?

About 5 out of 100 children and teenagers have symptoms that could be signs of . 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 if they

  • have relatives with or other serious mental illnesses,
  • have had 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 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 .

If a child becomes depressed, it is important that their friends and family realize this early on. Signs of 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 , 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 in adults, 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 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 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 or an anxiety disorder. Even if a young person has already had in the past and got through it, the fear of getting 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.

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Robert Koch-Institut (RKI), Statistisches Bundesamt (Destatis). Depressive Erkrankungen. Berlin: RKI; 2010. (Gesundheitsberichterstattung des Bundes; Heft 51).

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IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on June 18, 2020

Next planned update: 2023


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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