Depression in young children isn't common, and it's not always easy to spot. But if your little one isn't acting like her usual self, is having sleep or appetite changes, or complains that she doesn't feel well when she's not sick, she could be dealing with a mood problem.
Here are some of the common symptoms of depression in children to look for and what you can do to help your little one feel better.
What is depression in children?
Depression is a serious medical illness characterized by persistent feelings of sadness or hopelessness. Older children and adolescents are more likely to become depressed than younger children, but kids of any age can potentially be affected — even toddlers.
Around 3.2 percent of U.S. children ages 3 to 17 have been diagnosed with depression, according to the Centers for Disease Control and Prevention (CDC). But among those ages 3 to 5 in particular, the rate is less than 1 percent.
All kids get moody from time to time. But the effects of depression go much further. Children who are depressed may start to interact differently with their family or friends, show signs of behavior problems, or lose interest in the things they normally enjoy.
They can experience physical side effects too, like having a harder time getting enough sleep or eating less, which can affect how they grow and develop.
Signs of depression in children
Depression can be hard to recognize in children, who aren't always able (or willing) to verbalize exactly how they're feeling. Instead, changes in behavior and physical symptoms often provide the best clues.
Younger children who are depressed may:
- Seem sad or withdrawn.
- Be more grouchy or irritable.
- Cry more often or throw more frequent tantrums.
- Stop wanting to socialize with friends. They may suddenly tell you they’re no longer friends with someone they’ve been close to for a long time.
- Poor school or day care performance and/or refusal to go to school or day care (they may complain of stomach aches as the cause, for example).
- Seem to care less about things they normally enjoy and have less fun playing.
- Have sleep problems like trouble falling asleep, waking up very early, or refusing to get out of bed in the morning.
- Eat less or more than usual.
- Move slowly or act sluggish or lethargic.
- Pace around or have trouble staying still.
- Say self-critical things (if they're older), like "I can't do anything right," or "I always mess up."
Unusual behavior that lasts for a day or two likely isn't cause for concern — everyone has bad days sometimes. But if your child's behavior seems off for two weeks or longer, it's possible that depression could be the culprit.
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Physical symptoms of depression in children
Behavioral changes are a big part of depression in children, but they're not the only ones. Kids who are depressed might complain that their bodies don't feel good or show other physical signs that something isn't right. For instance, your child may:
- Tell you often that her stomach or head hurts, even if she isn't sick.
- Complain about feeling tired or not having a lot of energy.
- Over time, lose weight or not grow as expected, due to eating less.
- Over time, gain weight due to eating too much.
Causes of depression in children
There's no one single factor that causes depression, and you can't always predict whether a child might become depressed. However, certain things can make kids more prone to depression. Risk factors for depression include:
- Stressful or traumatic life events or major life changes, like losing a loved one or having a divorce or serious illness in the family.
- Having another mental health or behavioral condition like anxiety, attention problems or learning problems.
- Having a family history of depression, especially immediate family members like parents or siblings, though extended family history of depression can factor in too.
- Living in an abusive or highly stressful environment, like a home with alcohol or drug use.
How to treat depression in children
There are ways to manage your child's depression and help her feel better. Together, you and your child's pediatrician can discuss treatment approaches including:
Cognitive behavioral therapy (CBT)
A type of talk therapy, cognitive behavioral therapy is one of the most commonly used tools for addressing depression in children. In CBT, a child meets with a therapist to talk about what she's thinking and feeling and learn how to cope with anxious or depressing thoughts by thinking more positively. Parents are often involved in CBT sessions.
Medication
Antidepressants can be an effective option for treating depression in children and teenagers. But the medications also come with serious possible side effects. If you're considering antidepressants for your child, it's important to first weigh the benefits and risks with your child's pediatrician and therapist.
At-home support
You can't always change the way your child feels. But simply being there for her and providing her with a healthy, safe environment can go a long way towards supporting her mental health. At home, you can:
- Encourage healthy habits. Wholesome meals, regular active play and outdoor time, and a solid sleep schedule and routine can all help your child feel her best.
- Spend time together. Play games together, snuggle up and read books, chase each other on the playground, or just head outside for a walk. Being with you makes your child feel loved and supported, and fun activities can lighten the mood in the moment too.
- Talk about feelings. Mention when your child seems like she's having big or hard feelings. Let her know that her feelings are okay and that you're there to listen and help however you can.
When to call the doctor
Call your child's pediatrician if your child's behavior, eating, or sleep seems off for more than a few days, she's complaining about physical symptoms but doesn't seem sick, or she shows any possible signs or symptoms of depression that go on for more than two weeks. If you sense a problem, it’s good to get help. Although it’s extremely unlikely that a toddler’s depression will lead to self-harm, the CDC has recorded cases of death by suicide for children as young as 5. If your child is showing signs of suicidal thoughts or behavior, call the National Suicide Prevention Lifeline at 800-273-8255.
It's important for your child's symptoms to be evaluated by her practitioner. Sometimes mood changes can be caused by an underlying health condition including anemia, diabetes, epilepsy, concussion, over- or underactive thyroid, mononucleosis, or even a vitamin D deficiency. Together, you and her care team can determine the root cause and decide on the best treatment option.
Helping your child deal with depression can be challenging. Taking action sooner rather than later to get her the treatment she needs is the first step towards helping her feel better — and showing her that you're there to support her no matter what.
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