Depression in children and teenagers: Signs and causes

It’s estimated that between 2 and 3 percent of young children and between 6 and 8 percent of teenagers have depression significant enough to impede normal functioning. 

Signs of depression

It’s natural for children and teenagers to feel sad or anxious at times—for example, when a grandparent dies or a best friend moves away. Typically, these feelings become less intense over time and children seem like themselves again. But if your child has been feeling sad for a over a month, if their depression deepens, if they continue to struggle emotionally, or if they display one or more of the signs below, it may be time to seek help. You know your child better than anyone else. Observe your child carefully for sudden or gradual changes in their outlook and behavior.

Seek help immediately if you observe any of the following three behaviors in your child or teenager:

Inflicting, or talking about inflicting, physical harm to self or others, or posting such intentions on social media. This includes cutting, burning, or any other kinds of self-harming behavior. This also includes talking about or causing harm to others, pets, property, or possessions.

Giving away belongings. Or talking about giving away their possessions to others should something happen to them.

Preoccupation with death, particularly with asking about what happens after death.

Below are some typical signs of depression in children. If you observe one or more of these signs for over one month, seek help promptly. The existence of one symptom may not mean your child is significantly depressed, but if you observe more than one sign over time, it’s important to act promptly and contact your child’s physician to rule out underlying medical issues. Your physician can also guide you in finding a mental health professional who can assess your child and suggest appropriate next steps.

Feeling sad for prolonged periods (more than one month). Seeming “down” more often than “up.” Showing little interest in activities that were once enjoyable.

Dependence on drugs or alcohol.

Frequent crying.

Frequent or constant expression of feelings of guilt, worthlessness, or extreme self-criticism.

“Talk with your child about bullying. Being the victim of bullying is a major cause of mental health problems.”
—healthychildren.org

Anxiety that intensifies dramatically or rapidly, causing panic, severe agitation, and/or an inability to calm oneself.

Social isolation. Avoiding friends. Cutting off relationships that used to be important. Spending all their time alone in their room.

Changes in appetite, including significant weight loss or gain.

Sleep problems, including sleeping too much or having trouble sleeping. Fatigue during the day.

Complaints about health problems that appear to have no physical cause. Headaches, stomachaches, or other aches and pains. Requests to miss school frequently due to aches and pains. It’s important to rule out medical issues by consulting a physician.

Difficulty getting along with others. Having trouble relating to peers. Getting into arguments or fights or bullying others. Having conflicts with teachers, coaches, or other authority figures.

Problems with schoolwork. A drop in grades, neglecting homework, not completing projects. Difficulty focusing or concentrating.

Causes of depression

Experts believe that depression results from a combination of genetic, biochemical, environmental, and psychological factors. A family history of depression can increase the risk that a child or teenager will become depressed, but depression can also occur in children with no history of depression in their families. Depression may also be associated with:

Stress. Pressure to excel, peer pressure, or adjusting to a significant change, such as a divorce in the family, may trigger episodes of depression.

Loss. Children and teenagers often show signs of depression after losing the love or affection of someone they depend on—a parent or other relative, a caregiver, or a special teacher. They may also become depressed when a romance ends, when they move to a new home or start a new school, or when a close friend moves away. If a child was already depressed prior to a significant loss, these feelings can intensify, so close observation is key.

Chronic illness. Depression can occur along with some chronic or serious illnesses, such as diabetes or cancer, which may make a child feel afraid, “different,” or alone. This type of depression should be treated along with the illness.

Biological changes. The normal biological changes of adolescence can make a child feel upset or confused about what is happening to their body. These changes can be especially unsettling if children are also coping with other changes, such as a move.