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Depression in Children and Adolescents

What is depression?

Everyone occasionally feels sad or has a “down” day. These feelings are usually temporary and pass within a couple of days. But when you have depression, it interferes with daily life and causes pain for both you and those who care about you. Depression is a common but serious illness.

Many people with a depressive illness never seek treatment, but most of them, even those with the most severe depression, can get better with treatment. Medications, psychotherapies and other methods can effectively treat people with depression. The following guide comes from information provided by the National Institute of Mental Health and the nonprofit organization Mental Health America.

How do children and teens experience depression?

A child with depression may:

  • Pretend to be sick
  • Refuse to go to school
  • Cling to a parent
  • Worry that a parent may die

Older children may:

  • Sulk
  • Get into trouble at school
  • Be negative and irritable
  • Feel misunderstood

Because these signs may be viewed as normal mood swings for children going through developmental stages, it may be difficult to accurately diagnose a young person with depression.

Before puberty, boys and girls are equally likely to develop depression. By age 15, however, girls are twice as likely as boys to have had a major depressive episode.

Depression during the teen years comes at a time when boys and girls are already going through significant physical and developmental changes: forming an identity apart from their parents; grappling with gender issues and emerging sexuality; and making independent decisions for the first time in their lives. Depression in adolescence frequently occurs at the same time as other disorders, such as anxiety, eating disorders or substance abuse. It can also lead to increased risk for suicide.

Childhood depression can persist, occur again and continue into adulthood, especially if left untreated.

Recognizing Adolescent Depression

One in five teens may suffer from clinical depression. It is a serious problem that calls for prompt, appropriate treatment. Depression can take several forms, including bipolar disorder, which is a condition that alternates between periods of euphoria and depression.

Depression can be difficult to diagnose in teens because adults may expect teens to act moody. Also, adolescents do not always understand or express their feelings very well. They may not be aware of the symptoms of depression and may not seek help.

These symptoms may indicate depression, particularly when they last for more than two weeks:

  • Poor performance in school
  • Withdrawal from friends and activities
  • Sadness and hopelessness
  • Lack of enthusiasm, energy or motivation
  • Anger and rage
  • Overreaction to criticism
  • Feelings of being unable to satisfy ideals
  • Poor self-esteem or guilt
  • Indecision, lack of concentration or forgetfulness
  • Restlessness and agitation
  • Changes in eating or sleeping patterns
  • Substance abuse
  • Problems with authority
  • Suicidal thoughts or actions

Teens may experiment with drugs or alcohol or become sexually promiscuous to avoid feelings of depression. Teens also may express their depression through hostile, aggressive, risk-taking behavior. But such behaviors only lead to new problems, deeper levels of depression and destroyed relationships with friends, family, law enforcement or school officials.

Treating Adolescent Depression

It is extremely important that depressed teens receive prompt, professional treatment.

Depression is serious and, if left untreated, can worsen to the point of becoming life-threatening. If depressed teens refuse treatment, it may be necessary for family members or other concerned adults to seek professional advice.

Therapy can help teens understand why they are depressed and learn how to cope with stressful situations. Depending on the situation, treatment may consist of individual, group or family counseling. Medications that can be prescribed by a psychiatrist may be necessary to help teens feel better.

Some of the most common and effective ways to treat depression in adolescents are:

  • Psychotherapy, which provides teens an opportunity to explore events and feelings that are painful or troubling to them. Psychotherapy also teaches them coping skills.
  • Cognitive-behavioral therapy, which helps teens change negative patterns of thinking and behaving.
  • Interpersonal therapy, which focuses on how to develop healthier relationships at home and at school.
  • Medication, which relieves some symptoms of depression and is often prescribed along with therapy.

When depressed adolescents recognize the need for help, they have taken a major step toward recovery. However, remember that few adolescents seek help on their own. They may need encouragement from their friends and support from concerned adults to seek help and follow treatment recommendations.

Learn about facing the danger of teen suicide.

For more information about mental health and children, go to the websites for the National Institute of Mental Health and Mental Health America.