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What is depression?

Depression is a mental health condition that can cause children and teenagers to feel very sad and hopeless. Kids with depression have trouble enjoying things they used to love. They may also seem listless and easily annoyed.  

Depression can have a lot of negative effects on a child’s life, like missing school and not wanting to be around friends. It’s normal for children to feel sad when bad things happen, but a child with depression doesn’t feel better if things change. Kids with depression might think about or attempt suicide. 

The most prevalent depressive disorders include: 

  • Major depressive disorder: Severe symptoms that last between two weeks and several months 
  • Persistent depressive disorder (also called dysthymia): Less severe symptoms that last for a year or more 

Depression usually begins during the teenage years, but younger kids can also be diagnosed. Girls are diagnosed withmajor depressive disorder

major depressive disorder

A mood disorder characterized by periods or “episodes” of profound sadness, crying and feelings of hopelessness and helplessness. There is a high risk for suicidal thoughts and behaviors during a depressive episode. While episodes can last months or years, there are usually extended periods of relative normal mood (euthymia). This is also known as “clinical depression.”

twice as often as boys.  

What are the symptoms of depression?

The biggest sign of depression is a change in mood. A depressed child will feel sad for no reason and lose interest in things they normally enjoy. These changes will last at least two weeks. Other symptoms include:  

  • Being easily annoyed 
  • Feeling hopeless 
  • Lacking energy or seeming lazy 
  • Trouble concentrating 
  • Trouble making decisions 
  • Struggling in school 
  • Low self-esteem or saying negative things about themselves 
  • Having trouble talking to friends 
  • Eating too little or too much 
  • Gaining or losing a lot of weight 
  • Being tired all the time 
  • Trouble sleeping 
  • Thinking about or attempting suicide 

Some children with depression no longer look forward to things they used to enjoy, but they can enjoy them in the moment. This can confuse parents, making them think their child doesn’t want to cooperate when they are actually depressed.  

Until recently, kids who had been through a major loss (like the death of a loved one) could not be diagnosed with depression. Now, experts acknowledge that such losses can trigger depression, especially if the child has been depressed before.  

How is depression diagnosed?

Depression is diagnosed by a mental health or medical professional. To make thediagnosis,

diagnosis
A specific set of signs and symptoms that together define a disorder. For psychiatric disorders, the criteria are based on standards established in the Diagnostic and Statistical Manual (DSM).
they will speak to the child, family members and other adults in the child’s life.  

To be diagnosed with major depressive disorder, a child must be depressed most of the time for at least two weeks. They will also have several of the symptoms listed above. Their symptoms must be very different from their usual way of being.  

To be diagnosed with persistent depressive disorder, a child must be depressed or annoyed most of the time for at least one year. They must also have at least two of these symptoms getting in the way of their daily life: 

  • Eating too little or too much 
  • Lacking energy  
  • Trouble sleeping 
  • Trouble concentrating 
  • Trouble making decisions 
  • Low self-esteem 

A clinician will also see if the child’s symptoms could have a different cause, such assubstance abuse,

substance abuse
Unhealthy use of substances including alcohol, marijuana and other drugs.
another psychiatric disorder, or a medical cause like diabetes or hypothyroidism. 

How is depression treated?

The best treatment for depression is a combination of therapy and medication. 

Therapy 

Two types of therapy are commonly used to treat children with depression: 

  • Cognitivebehavioral therapy
    behavioral therapy
    A form of treatment that focuses directly on reducing or managing problematic behaviors without particular attention to thoughts, events or circumstances that prompted the behaviors.
    (CBT): CBT teaches children how their thoughts shape their feelings and behaviors. The therapist will also encourage them to return to activities they liked in the past. This is calledbehavioral activation.
    behavioral activation
    Form of behavioral therapy used to treat depression that encourages kids to participate in activities they've lost interest in, with the goal of jumpstarting renergizing and positive thoughts.
     
  • Interpersonal therapy (IPT): In IPT, the child talks with a therapist about their relationships with friends and family. They learn how these relationships can cause good or bad feelings for the child. 

Medication 

There are severalantidepressant

antidepressant

A class of medications originally designed to treat depression and other mood disorders. There are many kinds of antidepressants, from the newer SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Selective Norepinephrine Reuptake Inhibitors), as well as the older and less frequently prescribed tricyclics and MAOIs. Some antidepressants are also useful for treating anxiety disorders.

medications that children can take. These include selective serotoninreuptake inhibitors
reuptake inhibitors
Medications that increase the supply of neurotransmitters in the brain by blocking their re-absorption and rapid destruction.
(SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants (TCAs). These medications can have side effects, but they are safe for children to use with proper care from their doctor. A child who is taking one of these medications should see their doctor regularly, especially if their dosage has recently changed.  

Research has found that taking antidepressants can increase suicidal thoughts in very rare cases. That’s why they have FDA warning labels. However, this is not common and there is no evidence that antidepressants cause actual suicide attempts. 

Risk for other disorders

Children with depression are at higher risk for other mental health conditions includinganxiety disorders

anxiety disorders
A group of psychiatric disorders characterized by feelings of significant and impairing anxiety that is either out of proportion to the threat or with no discernible cause.
and substance abuse.  

They are also more likely to attempt suicide. If you think your child or teenager is suicidal, you can call the National Suicide Prevention Lifeline by dialing 988 or 1-800-273-8255, or 911 if there is an emergency. Don’t wait — the risk of suicide in children and teenagers is very real. 

This guide was last reviewed or updated on October 31, 2024.