Children can feel sad, irritable, or just be in a bad mood like an adult. They have bad days and situational sadness just like we do, only sometimes they aren’t armed with the same experienced coping mechanisms as adults. The concern is when feeling down, sad or in a bad mood becomes a recurring theme in your child’s life.
If your son or daughter has been experiencing chronic sadness, irritability or their bad mood is starting to limit their ability to function normally, it could be a sign that your child is dealing with depression.
What Is Depression?
Depression is essentially a type of mood disorder that is characterized by persistently depressed mood or loss of interest in activities to a degree that it causes significant impairment in the individual’s daily life. Depending on the root cause it can last for weeks, months, or even longer.
Many people who are struggling to deal with depression often get caught up in negative thinking, which includes an excessive focus on problems and faults to the point of being extremely self-critical. This can also include things like negative self-talk and excessively complaining about seemingly minor disappointments.
Depression can also interfere with other aspects of the individual’s life. This includes things like general energy level, as well as concentration ability, and sleep. Many people with depression will also develop noticeable changes in appetite. This might include significantly eating less or eating more.
What Does Depression Look Like In A Child?
Children who are struggling to deal with depression often lose interest in their schoolwork and show disinterest in activities that they previously enjoyed. They often seem tired and tend to give up easily when challenged by learning a new skill. Some children will also start to withdraw from friends and family.
Some children experiencing significant depression symptoms feel worthless, unworthy of being loved, or rejected. This can make seemingly simple everyday problems seem more difficult than they truly are for them. In some children, severe depression can manifest as self-harmful behavior and in the extreme can result in suicide attempts.
How To Recognize Depression In Children?
It can be understandably challenging for parents and other adults in a child’s life to know when a child is depressed or simply having a string of bad days. Things like chronic irritability or angry moods that might seem like a bad attitude that persist are certainly red flags, but may not be clear indicators of depression on their own. It’s when these behaviors are coupled with other negative emotional patterns like chronic periods of low energy, disinterest, negative self-talk, or changes in appetite that might mean the child is dealing with unresolved depression.
If this pattern persists for more than 7 to 10 days, or your child is displaying self-harmful behavior, you should strongly consider seeing a doctor.
How Is Childhood Depression Diagnosed?
Doctors and trained mental health professionals will typically start the diagnostic process with obtaining a detailed history. This typically includes collecting a recent medical history focused on their behavior, mood, and emotional displays.
Screening for Depression: Patient Health Questionnaire-9
There are many tools available to screen for depression. One common one is the Patient Health Questionnaire-9 or PHQ-9. This is often used by pediatricians during routine exams of young and older teens, but may also be used at the time of a visit for the evaluation of depression. The tool asks teens to evaluate the severity of nine key areas of depression, then calculates a score. The higher the score, the greater the likelihood of depression. The screen asks about:
- Little interest or pleasure in doing things
- Feeling down, depressed or hopeless
- Trouble falling or staying asleep, or sleeping too much
- Feeling tired or having little energy
- Poor appetite or overeating
- Feeling bad about yourself
- Trouble concentrating on things
- Being fidgety or moving so slowly that others have noticed
- Having thoughts of hurting yourself, or that you are better off dead
At some point, the doctor or psychologist might refer your child to a specialist or will start a clinical diagnostic process to clarify the type or types of depression that your child is experiencing. This includes the following designations.
This is defined as an intense episode of depression that has developed recently and has lasted for two weeks or more. It might be associated with situational depression from a significant event in their life that affects their emotions.
Also known as “Dysthymia” this is a milder form of depression that generally develops gradually, and has persisted for two years or longer.
Adjustment Disorder With A Depressed Mood – It’s also worth bearing in mind that depression can develop following an upsetting event such as a death in the family or experiencing a natural disaster. The lingering after-effects of adjusting to their “New Normal” can affect brain chemistry. Left under-addressed, this can lead to depression.
Seasonal Affective Disorder
Also known as “Seasonal Depression” this is a type of depression that is associated with decreased exposure to sunlight. Seasonal Affective Disorder is more common in winter and can influence children as well as adults.
Previously referred to as “Manic Depression” as well as “Bipolar Depression” is a condition that causes swinging episodes of major depression that might then be countered by uncontrolled mania or high-energy periods.
Disruptive Mood Dysregulation Disorder
This is a pattern of frequent and intense temper tantrums or outbursts of aggressive behavior. It’s usually accompanied by a frequent mood of irritability and persists in children over the age of 6 years of age.
What To Do If Your Child Is Showing Signs Of Depression
There are a few things you can do to help assess the need to get a professional diagnosis or help your child with suspected depression.
Try Talking With Your Child
It’s not uncommon for children of all ages to ignore, hide, or even deny how they feel. In general, the younger they are, the harder it is for them to comprehend and vocalize what they are feeling. It’s important to let them know that you are always willing to talk and that you won’t judge them for how they are thinking and feeling. Especially if there are underlying situational factors that are influencing their feelings.
Schedule Family Bonding Time
This goes beyond forcing family game night on your child. Especially if they are a teenager. Try to choose or offer something they are interested in. Sometimes the simple act of interacting on something they want to do, like go for a drive or shopping, will open up their doors to talking to you or increasing their willingness to speak to a mental health professional.
How is Depression Treated?
When it is time to get professional help for the treatment of depression, there are lots of places to turn. As with most medical conditions, the treatment of depression needs to be individualized to the patient. Pediatricians, Adolescent Specialists, Internists, Psychologists, Social Workers, and Psychiatrists are all equipped to treat depression. Treatment usually includes counseling, therapy, medication, or a combination of all three. Studies have shown that counseling/therapy and medication do fairly well in the long run on their own, though the improvement in symptoms tends to be faster and more lasting when therapeutic modalities are combined. Your practitioner will be able to discuss this with you and individualize the treatment for your child.
Some cases of depression in children will improve over time. Though left untreated most forms of juvenile depression will worsen or deepen in nature. Fortunately, there are a lot of tools available today to families who have children trying to deal with depression and other mood disorders. Letting your child know you are there for them, and reaching out to mental health professionals when needed, will go a long way toward helping them get the help they need.