As parents, one of our goals is to raise happy, healthy kids and when we notice our children upset more than content we start to worry. How do we know if what our child is experiencing is a momentary "blip" or something more? Understanding and knowing what signs to look for in childhood depression is important. The DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders) has 3 distinct diagnostic criteria for children which all fall under the umbrella of depression (Major Depressive Disorder/MDD, Persistent Depressive Disorder/PDD, and the newest one Disruptive Mood Dysregulation Disorder/DMDD).
Before we talk about specific symptoms, we should first acknowledge the fact that children and parents have been living and coping during unprecedented times. Resources are minimal and everyone is holding on by a mere thread. While kids are young and resilient, they are often impacted much more by the "energy" in their environment than adults. This means they pick up on the non-verbal stress levels around them such as parents fighting and a pandemic raging across the globe.
Children have also experienced a significant loss of touch. Touch is vital to the developing brain as well as helping kids feel connected to family and friends. The natural touches from peers at recess, a pat on the shoulder from a teacher or a hug from a grandparent are now considered dangerous. It's a confusing time for adults and children alike. Given what we know about childhood depression, our current life's added stressors are placing many children at a higher risk of developing depression than ever before.
So what signs of depression in children should parents be on the lookout for? Depression often looks different in children compared to adults. The primary difference is the amount of anger and rage a child with depression exhibits versus an adult. Just because a child exhibits anger doesn't automatically mean they are defiant or unruly—anger is one of the symptoms many children with depression struggle with and one that is the most misunderstood by parents. "My kid is just mad….he's not depressed" is a phrase I hear often.
Symptoms of depression in children
Along with anger, below are other symptoms a child with depression may feel or display. Symptoms must be present in 2 or more settings (home/school/church/etc.) and must persist consistently for a minimum of 2 weeks to meet the criteria of a depressive disorder.
- Feeling sad, hopeless or irritable a lot of the time
- Not wanting to do or enjoy doing fun things
- Social withdrawal
- Feeling worthless, useless or guilty
- Exhibiting self-injury and self-destructive behavior (such as cutting)
- Increased sensitivity to rejection
- Changes in energy—being tired and sluggish or tense and restless a lot of the time
- Changes in appetite—increased or decreased
- Changes in sleep—sleeplessness or excessive sleep
- Vocal outbursts or crying
- Trouble concentrating
- Physical complaints (such as stomachaches, headaches) that don't respond to treatment
- Reduced ability to function during events and activities at home or in school, in extracurricular activities or other hobbies and interests, or with friends
- Thoughts of or talking about death or suicide
Remember, depression is an illness. As a parent, you may be doing everything "right" and your child still may develop depression. This is because several other factors impact the likelihood a child will develop a depressive disorder. They include:
- Children who have negative temperaments (For example, kids who see the glass as half empty. It's important to note that our temperament is encoded in our DNA.)
- Kids who have first-degree family members who have depression
- Children who have had traumatic childhood experiences
- Having another major disorder or a chronic or disabling medical condition
- Having another mental health disorder such as ADHD and/or a learning disability
What to do if you suspect your child is depressed
If you think your child may be suffering from depression, your first step is to take a deep breath— and now one more—and remind yourself you are doing your best living through a pandemic and it's never too late to get help.
The next step is to schedule an appointment with your child's pediatrician. There are a few medical conditions that can mimic the signs of depression (thyroid disorders, anemia, infectious mononucleosis, drug use, etc.) A simple blood test can rule these out.
Once you've ruled out a medical condition you should seek an appointment with a child psychologist or therapist. In addition, if you have access to creative arts therapists (dance, drama, art and music) use them! Children find it much easier to tell and share their concerns/fears/anxieties through creativity (drawing pictures, acting out scenes in a movie, singing/listening to a song or dancing) than simply sitting and having a 1:1 chat with someone. Don't get me wrong, talk therapy works too!
The past year has been difficult and the current year is full of unknowns. Don't forget to also be on the lookout for your kid's friends who may not be doing well. Check on parents you know who may be struggling and offer a helping hand. Never before in our lifetime have parents needed a support network more than what we do now.
Getting your child help doesn't mean you are failing as a parent. We all will have times in our lives when we need help with our child(ren). Find a supportive parenting group to be a part of, reach out to family and friends and remember, you are not alone. Childhood depression is a treatable condition, not a life sentence.