Childhood Depression: Prevalence, Symptoms, And Treatment

Childhood depression may go unnoticed or untreated due to a lack of understanding of its prevalence and the unique signs and symptoms children may experience. While it can be normal for children to feel sad, upset, or irritated, childhood depression goes beyond these emotions and can be long-lasting. 

It may be difficult for parents to recognize when their child is depressed or in distress, as they might assume their child is feeling moody or experiencing a behavioral challenge that’s expected for children and teens. For this reason, if you suspect that your child is depressed, it can be valuable to understand the signs and symptoms to look out for. 

Note that childhood depression is also treatable. If you're concerned about your child's diagnosis, there are a few treatment options you can consider, including therapy. This article explores childhood depressive disorder, signs of depression in children, and options like cognitive behavioral therapy that can help improve symptoms. 

About childhood depression

According to the American Psychiatric Association, childhood depression refers to a major depressive episode in a child’s life. Symptoms of major depressive disorder in children may differ from those seen in adults. 

Physical symptoms like stomach aches, for example, are common symptoms of depression diagnosed in children but they are less common in adults. These physical symptoms may not always accompany the child telling their caregiver that they “feel sad” or are experiencing changes in their moods. Other behavioral health changes might include changes in sleep patterns, increased or decreased appetite, loss of interest in activities, sadness, and irritability. 

Children may be at a greater risk of developing depression if they have a family history of depression diagnoses. 

What is the prevalence of childhood depression? 

According to the CDC, over 4.4% (2.7 million) of all children aged three to 17 years live with depression in the US. Eight out of every ten children known to have diagnosed depression go on to receive mental health treatment, as it is a highly treatable condition once caught.  

However, children developing depression may be more prevalent than sources show, as many children go undiagnosed and untreated. Because many people with depression do not seek treatment until adulthood, the statistics surrounding childhood depression are often an estimate. Understanding the symptoms of this condition may help you ensure your child is healthy and has access to any treatments they need.  

What are the symptoms of childhood depression? 

As a parent, it can be vital to understand that symptoms of childhood depression can differ from adult depression and may look different in various age groups. For example, younger children may experience vastly different symptoms from adolescents in high school, as they don't often have the same forms of communication. 

In addition, if you notice an individual or short-term symptom in your child, it might not indicate childhood depression. However, if they are experiencing several of the following symptoms for over a week, consider reaching out to healthcare providers, such as your pediatrician or a child therapist, for further guidance. 

Profound and prolonged sadness 

A common symptom of depression at any age is prolonged and profound sadness. However, children may try to hide their feelings or be uncertain about how to communicate them in words. Even if your child feels sad, they might stay quiet about it or show their sadness in other ways, such as struggling to make conversation or not showing interest in their favorite toys.

Irritability

Many children with childhood depression experience irritability. Their feelings of sadness may come out as anger or difficulty accepting change. If your child seems easily frustrated with schoolwork or chores or lashes out frequently at the slightest provocation, they may be experiencing childhood depression. However, consider having your child complete a depression screening with their doctor, as irritability is a symptom of many childhood mental illnesses. 

Sleep changes

Sleep changes are also prevalent with childhood depression. Your child may have insomnia, have trouble sleeping as much as usual, or sleep too much (hypersomnia). Addressing these symptoms as soon as possible can be essential, as sleep irregularities can exacerbate symptoms of other mental or physical illnesses. 

Difficulty concentrating

Many children with depression have difficulty concentrating. For this reason, some children with depression are misdiagnosed with attention deficit hyperactivity disorder (ADHD) because they struggle to focus in class or on schoolwork. However, depression itself can cause this lack of concentration, which is why a professional evaluation may be beneficial. 

Changes in grades or school performance 

Many children with depression experience failing grades in school when experiencing symptoms. If your child previously had excellent grades and suddenly or gradually drops to low marks, this may be an indication to look further into their mental health. With childhood depression, lower grades might occur due to low self-esteem or a lack of concentration, interest, or care about their grades or schoolwork. 

Changes in eating habits

Many children with depression experience a change in eating habits. Some children eat more when they are depressed, while other children with depression have little or no appetite at all. If you notice that your child's eating habits have suddenly changed and other symptoms of depression are present, this may be an indicator to seek treatment. 

Mood swings

Mood swings might also accompany childhood depression. Your child may laugh at a joke or television show one minute and feel irritable or cry the next. These mood swings can happen because many children with depression have moments where they can laugh, smile, and joke. However, they may return to experiencing sadness or irritability within the same day. 

Feeling worthless

Many children with depression may express or experience feelings of worthlessness. These feelings can deepen as other symptoms of depression are present, such as failing grades or lack of interest in extracurricular activities. Pay attention to your child's words and actions and talk to them calmly if they express statements about themselves that concern you. Poor self-esteem can be common among children with depression. 

Frequent crying

Many children with depression cry frequently. They may cry without an understood reason, during a significant transition, at school, when alone, or due to struggles with their mental health. If you notice your child crying often, talk to them and try to discover the cause. If other symptoms are also present, crying may be a sign of depression. Many children cry to express emotions because they struggle to put words to their experiences. 

Social withdrawal 

Many children with childhood depression withdraw from friends and family members. They may spend more and more time alone in their room or express disinterest or upset when asked to spend time with others. They may also take frequent walks or spend time outside alone. If your child has friends, they might stop asking them to come over or spend less time talking to them at school. 

Lack of interest in activities

If your child was frequently active in sports or other extracurricular activities and suddenly withdrew from those activities, it may be a sign that they are depressed. Try talking to them to discover the reason for this change. If they cannot articulate a reason, it might be a sign of childhood depression. 

Loss of energy

Children with depression may feel as though they are tired constantly and might struggle to be as active as they once were. If your child used to run outside, play games, and talk to others and are suddenly always inside, sitting alone, and remaining quiet, it could signify an underlying mental health condition. 

Thoughts of death or suicide

Many people associate thoughts of suicide with adults. However, children, including those under ten, can and do experience these thoughts. As children often struggle to add a label to their thoughts, you might not know they're thinking of death or suicide until they take action to harm themselves. 

Knowing if your child is feeling this way can be beneficial, as it can offer an opportunity to talk about the realities of mental health without stigmatizing them. Let them know they can always come to you to discuss their thoughts and feelings and that you're a resource they can rely on for support if they feel the urge to harm themselves in any way.  

Related or cooccurring conditions like anxiety disorder

Childhood major depressive disorder often develops alongside co-occurring disorders like anxiety disorders. Mood disorders like bipolar disorder may also manifest alongside major depression. This may make it more challenging to understand your child’s behavior without the help of a mental health professional who specializes in adolescent psychiatry, talk therapy, and treatments like cognitive behavior therapy.

How is childhood depression treated? 

The sooner you seek treatment for your child's depression, the sooner they may be able to receive relief from their symptoms. There are two primary types of treatment for childhood depression commonly seen in individualized treatment plans, including psychotherapy and antidepressant medication. However, if you're unsure which treatment to choose, consider consulting your child's pediatrician for an informed referral. 

Psychotherapy

Two primary forms of psychotherapy may be recommended for childhood depression, including individual therapy and family therapy. Studies have found that children who undergo individual and family therapy have a high success rate of recovering from childhood depression and learning helpful coping skills. A combination of these two forms of therapy may assist parents in helping their children cope with their symptoms. 

In individual therapy, the child’s therapist can guide your child as they explore their feelings. The therapist may offer age-appropriate exercises to help your child examine their thoughts to replace them with more positive self-beliefs. They can also give your child healthy coping mechanisms they can use and practice at home. If any factors brought on your child's depression, they can discuss these with the therapist and develop ways to reduce outside factors' impact on their mental health. 

In family therapy, caregivers and their children can attend therapy together. Family therapy may be helpful because it allows you to understand your child's feelings better and receive professional guidance simultaneously. In sessions, the therapist may lead discussions using popular family therapy methods. 

Medication

Few medications are approved for use in children to treat childhood depression. While there are many antidepressants on the market, many are not approved for use in children. However, consult your child's pediatrician or psychiatrist before starting, changing, or stopping your child's mental health medications. 

Counseling options for teens and parents: Speak with a mental health professional

If your child is experiencing symptoms of childhood depression, consider seeking support from a therapist or psychiatrist. Many children are treated for this condition, and you can reach out for help anytime. In addition, if you are experiencing mental health concerns related to your child's depression or want to talk to a professional about how to help them best, you might benefit from therapy yourself. 

Many parents and caregivers feel that treatment may not be attainable for themselves or their children due to a busy schedule, cost, or availability. If you relate, you might also consider online therapy through platforms like BetterHelp for adults or TeenCounseling for those aged 13 to 19. Through an online platform, you or your child can connect with a therapist over the phone, via video chat, or through messaging. Many children also prefer online therapy because they are more comfortable using messaging platforms to discuss their feelings, and it can seem more discreet than in-person therapy. 

Studies have also found online therapy for depression to be highly effective. One study looked at mindfulness-based cognitive-behavioral therapy (CBT) in treating symptoms of depression and found that it was effective in reducing emotional distress and increasing mindfulness. Children can also learn mindfulness techniques for depression, and many therapists use these in online practice.