The typical presentation of depression can vary from unwanted feelings of sadness, loneliness, or chronic irritability to more serious presentations leading to impaired academic functioning, social withdrawal, feelings of hopelessness, and in some cases suicide. Depression can affect a child or teen’s ability to enjoy themselves and if left untreated may be associated with academic decline, family conflict, and poor choices regarding sexual behaviors and drugs.

It has been more common for some children and teens to engage in self-harm or cutting behaviors. These dangerous behaviors which are commonly associated with Major Depressive Disorder or Bipolar Disorder can range from superficial scratches to dangerous attempts to harm oneself.

***All of these behaviors, as well as a child or teen’s own statements about wishing to harm themselves or unhappiness with their life situation should be taken seriously and professionals should be contacted. If you fear your child is in immediate danger of seriously harming themselves or attempting suicide, please take them to the nearest emergency room or call 911.

 

Signs and symptoms of depression in children and teens may include:

• Depressed, sad, or irritable mood (irritable mood instead of sad mood especially common in boys)

• Low frustration tolerance, argumentativeness, and difficulty in getting along with others

• Social and family withdrawal

• Frequent complaints of boredom

• Decline in academic achievement

• Lowered self-esteem

• Change or decline in motivation

• Non-caring attitude or sense of hopelessness about the future

• Feelings of helplessness

• Somatic symptoms such as tiredness or fatigue

• Anxiety

• Drug use, self-harm, or other dangerous behaviors

 

Children and teens are often embarrassed to admit that they may be struggling with feelings of sadness, frustration, or hopelessness. Many do not recognize it as depression and many adults write off symptoms due to hormonal changes co-occurring. Boys may not even exhibit some of the traditional symptoms of depression such as sad mood, rather they may show symptoms of depression in the form of isolation, decreased school performance, withdrawal into TV, video/computer games, and chronic irritability or agitation. In fact, irritability, frequent complaints of boredom, and low frustration tolerance are sometimes the only visible forms of depression parents, teachers, and friends may observe. This presentation of depression is common among children and teens, as there may be some defensiveness and feelings of shame/disappointment.

 

Depression is no one’s fault. The causes of depression are varied. While genetically some children and teens may be more vulnerable to depression and life stressors, depression can affect anyone. It is important not to make children or teens feel guilty or blame them for the way they feel. A warm, open, and nonjudgmental approach on the part of the parents can help children to be more comfortable communicating their feelings. It can be extremely frustrating for parents supporting a child who may be experiencing symptoms of depression, as they may be more prone to power struggles, argumentative behaviors, and less likely to cooperate with school.

 

Therapy
Therapy can help children and teens with depression. Therapy can also be a helpful addition to medication in assisting children in learning strategies to cope more effectively and build skills to become more resistant to symptoms of depression in the future. A therapist working with the child or teen can also help parents learn how to best support their children, as well as serve as a facilitator of communication to reduce conflict and arguments.

 

Therapeutic Goals for Children and Teens with Depression include:

• Stabilize and improve mood through learning how to identify thoughts and behaviors that lead to depressed and sad feelings and strategies to change thoughts and actions

• Reduce withdrawal and increase activity through behavioral planning

• Improve motivation and increase goal directed behavior by reassessing priorities and behavioral scheduling

• Gain insight into behaviors that decrease self-esteem and unhappiness and schedule pro-social and healthy behaviors

• Reduce irritability and improve family and social relations

• Improve ability to cope with stressors and effectively deal with adversity