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Identifying depression in children

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Depression is often thought of as an adult illness and not always recognized when it affects children and teens. However, the persistent symptoms of depression can interfere with children’s success at home and school. The National Institute of Mental Health (NIMH) estimates that approximately 11 percent of adolescents have a depressive disorder by age 18.

During childhood, the number of boys and girls affected by depression are almost equal. In adolescence, twice as many girls as boys are diagnosed. Well over one-half of depressed adolescents have a recurrence within seven years.

Children and teens who are at higher risk for depression include those who have attention deficit/hyperactivity disorder, conduct disorder, learning disability, anxiety disorders, and/or oppositional defiance disorder. Experiencing considerable stress or trauma, facing a significant loss, or a family history of mood disorders also increases the risk for depression.

Children and teens will often express depression differently than adults. While depressed adults may isolate themselves, appear sad and listless, and withdraw from the world, depressed children or teenagers are more likely to become irritable and extremely sensitive to criticism, hang out with a different crowd or less friends than before, and have unexplained aches and pains that have no medical cause.

Common signs of depression in children and teens are listed below; if multiple signs are present for an extended period of time, parents should consider seeking professional help.

• Difficulty with relationships
• Increased irritability, anger or hostility
• Extreme sensitivity to rejection or failure
• Low self-esteem and guilt
• Social isolation, poor communication
Fixation on online media to the point of avoiding opportunities to exercise, eat, or socialize
• Persistent boredom; low energy
• Hopelessness
• Decreased interest in activities or inability to enjoy previously favorite activities
• Frequent sadness, tearfulness, crying
• Frequent complaints of physical illnesses such as headaches and stomachaches
• Frequent absences from school or poor performance in school
• Poor concentration
• A major change in eating and/or sleeping patterns
• Talk of or efforts to run away from home
• Thoughts or expressions of suicide or self-destructive behavior

Elementary-aged children are more likely to complain of aches and pains than to say they are depressed. Episodes of depression in children last six to nine months on average, but in some children they may last for years. When children are experiencing a depressive episode they may struggle at school, have impaired relationships with their friends and family, internalize their feelings, and even have an increased risk for suicide.

Teenagers face many pressures, from puberty to questions about who they are and where they fit in. The natural transition from child to adult can also bring parental conflict as teens start to assert their independence. With all this to consider, it is not always easy to differentiate between depression and normal teenage "angst." Making things even more complicated, teens with depression do not necessarily appear sad, nor do they always withdraw from others. Depressed teens may become aggressive, abuse drugs or alcohol, perform poorly in school, demonstrate internet addiction, engage in reckless or unsafe behavior, and/or show symptoms of low self esteem. In contrast to outward appearances, on the inside they may be experiencing feelings of isolation, emptiness and hopelessness.

If you are not sure if your teenager is depressed or just “being a teenager,” consider how long the symptoms have been present, how severe they are, and how different your teen is acting from his or her usual self. While some growing pains are to be expected as teenagers grapple with the challenges of growing up, dramatic, long-lasting changes in personality, mood, or behavior are red flags of a deeper problem.

Suicide is the third-leading cause of death among teenagers aged 15 to 19. It is essential for young people with severe symptoms or those lasting several weeks to be evaluated by doctors. If your teen is having suicidal thoughts, get help right away.

You can call the National Suicide Prevention Lifeline at (800) 273-TALK (8255) to reach a trained professional or you can encourage your child to do so.

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