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 don't get depressed very often, and it can be hard to tell if they are. Pre-schoolers who have depression 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 Even healthy young people are sometimes defiant, aggressive, or indifferent, and may have low self-esteem or become withdrawn. 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.

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

Their depression is often caused by problems in the family or stressful events such as the loss of a parent or a divorce. Other causes include difficulties at school or feeling very lonely. 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,
• experience serious conflict in the family, or
• have a very negative view of themselves or their bodies.

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

Ideally, parents and other adults will help children develop a stable personality and cope with challenges. But that can't always prevent mental health problems. People with close, stable relationships are also less likely to get depression.

If a child becomes depressed, it's important that their friends and family take it seriously and ask what's getting them down. Then they can work together to figure out what might help relieve the depression. If parents feel they need professional help, there are various places they can go to. Doctors specialized in children's and teenagers' health can be a big help. Mental health support centers and psychologists can also provide information on the help available.

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.

In milder cases of depression, one option is to wait and see whether the symptoms get better without treatment. But in the meantime it's important to be there for the child more than usual, and to listen and provide as much support as possible. This involves trying to better understand their needs and take them seriously. They might need a lot more sympathy and patience than normal, or more opportunities to strengthen their self-confidence. Dealing with the situation is often not easy for parents. Family support centers or therapists can help.

If additional treatment is necessary, psychotherapy and medication (antidepressants) are options. And psychoeducation and special apps can help too. Doctors, therapists, or psychiatrists specialized in child and teenage health can oversee the treatment.

In depression, negative thought patterns such as self-doubt and feelings of guilt often make the problem worse. Therapy aims to break these patterns bit by bit, so that people feel better about themselves. Their parents or other family members are often included too.

Treatment may include something called "psychoeducation." This involves learning about the symptoms of depression and ways to manage it. The information is provided by the doctor or therapist, in information material, or in courses. These courses are available for individuals or groups and are often held in hospitals. Some online programs include a psychoeducation component too.

Various medications and groups of drugs that are used to treat depression are classified as antidepressants. They can have a mood-lifting effect and increase motivation. Antidepressants are used alone or in combination with psychological treatment. Research results show that treatment using these medications doesn't have much of an effect on children and teenagers. They tend to be prescribed for severe depression.

These medications can have side effects like a dry mouth, headache, feeling faint, restlessness, and a decreased sex drive. So they should be used with caution. There's some evidence that certain kinds of antidepressants may increase the likelihood of teenagers thinking about killing themselves (committing suicide). If children or teenagers are put on antidepressants, they should be checked regularly to see what impact the medication is having on their symptoms and whether there are any side effects.

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. 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.

Sports and exercise can help reduce the symptoms of depression. They can have a positive effect on the mind and the body, and boost self-confidence. They are also a way of meeting other people and sharing positive experiences with them. If a child or teenager doesn’t enjoy sports at school, it could be worth looking for sports activities and classes elsewhere, so they feel under less pressure to perform and can just enjoy the activity.

Teenagers often look for information and on the internet and in social networks. Some young people keep a diary in which they try to make sense of their thoughts, worries and feelings and cope with them better. They can also use it to keep a record of their mood and their go-to methods for making themselves feel 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 feel very distressed can make use of telephone helplines as well as support centers for families, children and teenagers. In Germany, these include the Jugendnotmail website and the Nummer gegen Kummer helpline, both of which offer confidential advice. Lots of schools also have social workers, psychologists, or liaison teachers, who students can ask for help.

The Ich bin alles website is aimed specifically at children and teenagers and provides information on how to recognize depression, what causes it, and how it can be treated.

If the symptoms don't go away, it might be useful to talk to a doctor specialized in child and teenage health. Another option is to make an appointment for an introductory session with a psychiatrist or therapist for children and teenagers. Family support centers can help in crisis situations too.