Kids and Depression: Why It's Real and How to Ease Their Pain

Get Answers to Overcome a Serious Childhood Mental Health Illness

Childhood is often synonymous with being carefree, but for children living with depression each day can be increasingly difficult. While becoming more common, depression in children and adolescents is frequently overlooked and easily missed - leading to serious mental health issues, including an increased risk of suicide.

Fortunately, timely recognition and treatment can be life-changing for children and adolescents struggling with depression, according to Howard A. Beazel, Psy.D., Genesis Behavioral Health. "It certainly can be harder to diagnose depression in children," he states.

To help understand the reality of childhood depression, Dr. Beazel offers answers and hope for the serious, but treatable, illness.

    Depression affects the way one feels, thinks and acts. A mental illness marked by persistent feelings of sadness, loss of interest in activities, feelings of hopelessness and worthlessness, depression can also lead to thoughts of suicide.

    Yes, but children don't always get the classic symptoms of sadness, decrease in mood and lack of energy most people think of when they think of depression, explains Dr. Beazel.

    In fact, children may frequently show more irritability and become more overactive and/or complain more of somatic or physical symptoms,” he says. “While adults can tell you they feel depressed, children often don’t.”

    Although it's normal for children to experience the normal “blues” and everyday emotions as they develop, ongoing symptoms that interfere with social activities, interests, schoolwork, and family life may signal a child has depression. Studies report the mental health of teens and young adults in the U.S. has considerably declined, with rates of depression among kids ages 14 to 17 increased by more than 60% between 2009 and 2017.

    Just like every child is different, so are the symptoms that may show they are depressed. Although some children may continue to function with depression, others suffer a noticeable change in behavior. Some children may also begin using drugs or alcohol, especially if they are over age 12.

    Signs a child may be depressed include:

    • Increased sensitivity to rejection
    • Changes in appetite — either increased or decreased
    • Changes in sleep — lack of or excessive sleep
    • Vocal outbursts or crying
    • Difficulty concentrating
    • Fatigue and low energy
    • Physical complaints (including stomachaches, headaches) that can’t be treated
    • Reduced ability to function during events and activities at home or with friends, in school, extracurricular activities, and in other hobbies or interests
    • Feelings of worthlessness or guilt
    • Impaired thinking or concentration

    While there are no specific tests — medical or psychological — that can clearly diagnose depression in children, there are tools including questionnaires for both the child and parents that can be helpful. Therapy sessions combined with questionnaires can often uncover other concerns that may contribute to depression, such as attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD).

    “Because children often won’t tell you or anyone else how they’re feeling, we almost always try to talk with their parents to help diagnose depression,” says Dr. Beazel. “What the parents see, such as appetite or sleep changes, changes in level of activity or ability, or change in mood is paramount for us to best evaluate a child.”

    Thoughts of killing oneself can accompany depression — even in children, according to Dr. Beazel. “Although relatively rare in children under 12, young children do attempt suicide.”

    Suicidal thoughts, also known as suicidal ideation, may not always be obvious to others, even the child’s parents. In fact, teen and adolescent suicides have continued to rise dramatically in recent years. According to a recent study in the Journal of Abnormal Psychology, among young people, rates of suicidal thoughts, plans and attempts increased significantly — and in some cases doubled — between 2008 and 2017.

    Signs of suicidal thoughts may be apparent in the child’s social behaviors, what they watch on television, the websites they visit, and through journal entries or on their homework. “In the majority of cases where a child is admitted for inpatient treatment of depression, they have made some comment or gesture that makes people concerned they may hurt themselves,” states Dr. Beazel.

    While depression is significantly more common in boys under age 10, girls have a greater incidence of depression by age 16. During adolescence, young women are almost twice as likely to be depressed as young men — and these women continue to have a higher likelihood of depression in their adult years.

    “It appears adolescent females tend to have depression complaints more frequently, with some theorizing that this difference may be related to hormonal changes,” says Dr. Beazel. “There are also often more social demands and expectations on females in terms of behavior and conforming, which can contribute to additional stresses for females.”

    Treatment options for children with depression are similar to those used for adults, including psychotherapy (counseling) and medication. Your child’s doctor may suggest either medications or psychotherapy first, but research has shown the best treatment for those with a true depressive disorder is the combination of medication and therapy, according to Dr. Beazel.

    “Some people may have concerns about using medications due to possible side-effects and these concerns should be discussed with the medical provider, but again, research indicates the best outcome for seriously depressed individuals tends to be from using therapy/counseling and antidepressant medication together,” he states.

    Oftentimes medications tend to have a more rapid effect, and psychotherapeutic efforts may enable the patient to recognize and cope with problems more effectively. “One major concern is many kids who’ve been depressed, are facing depression or have been diagnosed with depression are at a greater risk of being diagnosed with depression again later,” Dr. Beazel explains.

    Clearly if a seriously depressed youth is considered to be at risk for hurting themselves, medical intervention may be critical, and inpatient treatment is usually undertaken, explains Dr. Beazel.

    “Youth that are hospitalized for depression and/or suicidal concerns generally receive both psychotropic medication as well as various forms of psychotherapeutic interventions, such as group therapies,” he states. “Psychotherapy can teach kids to recognize and cope with problems and situations that may have been difficult before — as well as responding more effectively to new challenges.”