Depression in children looks much different than it does in adults, and this can often be confusing for the adults that surround a child who is displaying behavioral or social difficulties. Children do not have the emotional vocabulary, nor the ability to self-examine and express their inner world as effectively as an adult can. Parents and loved ones also have a difficult time understanding depression, particularly if they haven’t experienced the phenomenon themselves. Many times a well-meaning parent will express disbelief, “There is nothing for them to be depressed about!” or will minimize their child’s experience, “He will be fine.” However, children as young as three years old can experience clinical depression, and treatment can prevent more serious consequences later down the line.
As children get older, their experience of depression looks much more like an adult’s experience. However, for preschool and elementary aged children, and even for some tweens and teens, the most overt symptom that clue us into a depression experience is typically an externalizing behavior, or a behavior that is more outwardly observed. These behaviors include aggression towards others, tantrums, and anger. Additionally, because children do not have the vocabulary, nor the ability to effectively identify their own experience, they may display somatic symptoms, or physical ailments that are associated with emotional experiences. These include headaches and stomach aches, among other symptoms.
Additionally, because these symptoms can look such much like other disorders, a child may not receive a depression diagnosis upon their first visit with a professional. Children with depression may have impacted sleep or appetite, and a treating provider may attempt feeding therapy or sleep therapies. Children may also have concentration difficulties, and may be diagnosed with an attention deficit disorder erroneously. Particularly when paired with acting out behaviors as mentioned above, a child who is truly at risk for depression may be inaccurately diagnosed with ADHD rather than correctly identified as having a mood disorder. This has serious implications for treatment!
The biggest risk factor in childhood depression is suicide. An individual who is experiencing significant depression symptoms may experience suicidal ideation. Parents may assume that their child is not capable of such thoughts, or that they are too young to be a danger to themselves, but it is their very youth that make children and adolescents so vulnerable. A child may express suicidal thoughts quite early in their childhood, though typically it is not until early adolescence that a child attempts to act on these thoughts. Regardless, statements such as not wanting to live anymore, or wishing themselves dead, should be taken very seriously.
In the course of childhood development, a child will experience emotions of sadness, anger, or loneliness. These experiences themselves are normal and a part of growing up. However, if the symptoms or behaviors are evident for a month or longer, it is time to seek help. A professional will first look to external factors, such as the possibility of trauma, or major change in a child’s life. Some children are more susceptible to depression because of a family risk factor, such as having a biological parent who also has a mood disorder. Children tend to respond well to talk therapy techniques, or play therapy for a younger child. Psychiatrists may also consider medication intervention, though because side effects and risk factors are greater for children, a medical professional may wish to have your child try medication first, or in conjunction with a medication treatment.
For children, adolescents, and adults, depression can be a scary and daunting experience, not just for the individual but also for their loved ones. Our providers offer collaborative treatment and we know that there is help, and hope.