Depression In Children: Types, Symptoms, Causes & Treatment

Depression in kids is a mood disorder that causes them to feel repeatedly sad, irritable, and hopeless. The symptoms of depression in children might vary from those in adults and are commonly seen in those with a family history of violence or any other form of abuse.

Depression is a severe mental health disorder that may affect how children interact with their family and peers, almost to an extent where it stops them from enjoying regular activities. As per the Centers for Disease Control and Prevention (CDC), 3.2% of children aged from three to 17 years (approximately 1.9 million) have been diagnosed with depression in the US (1) (2).

Read on to know about the types, causes, signs, symptoms, treatment, and prevention of depression in kids.

Types Of Depression In Children

The following are some of the types of depression that a child may experience (3).

• Persistent depressive disorder: This usually tends to last for about two years and may include episodes of depression, with the symptoms ranging from less severe to major.

• Psychotic depression: It is often associated with severe depression and is accompanied by some form of psychosis, such as delusions or hallucinations.

• Seasonal affective disorder: The onset of seasonal depression is witnessed as the winter months approach, when there is less natural sunlight. It is marked by social withdrawal, increased hours of sleep, and weight gain in children.

Bipolar disorder is not the same as depression, but it is characterized by extremely low moods, which meet the criteria for major depression. Another type of depression that has been added to the list of depressive disorders as per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is disruptive mood dysregulation disorder, which is mostly witnessed in children and teenagers.

Signs And Symptoms Of Depression In Children

The most evident signs of depression in children are sadness, hopelessness, and a series of mood swings for more than two weeks. The other signs or symptoms of depression that you may notice include (2) (4)

• Anger and crankiness
• Social withdrawal
• Oversensitivity to rejections
• Highly increased or decreased appetite
• Lack of sleep or over-sleeping
• Emotional outbursts
• Difficulty in focusing
• Lethargy
• Aches and pains in the body that do not respond to medication
• Disinterest in events
• Constant feeling of guilt or worthlessness
• Impaired thinking skills
• Suicidal thoughts

All children with depression may not show the same symptoms or have all the symptoms mentioned above. Some children continue performing relatively well in structured environments, while others may show significant changes in their social activities and academic performance.

Causes Of Depression In Children

The exact cause of depression is not known. However, a combination of genetic, environmental, and psychological factors is known to cause depression in children (5).

• Genetic factors: Depression is linked with a strong genetic component or a history of depression in the family.

• Environmental factors: Children are more likely to experience depression if they experience trauma, abuse, neglect, or major changes in their lives, such as the loss of someone close to them.

• Psychological factors: Children with chronic medical illnesses and behavioral disorders are also more likely to develop depression.

How Is Depression Diagnosed In Children?

Depression usually coexists with other psychiatric disorders. And often, it is accompanied by a substance abuse disorder, behavior disorder, or anxiety disorder. Early diagnosis is crucial for the child’s recovery. It is best to approach a pediatric psychiatrist or psychologist to diagnose the condition (1) (6).

The expert will enquire about the family and child’s background to get a deeper understanding of the child’s mental health condition. In addition, any input provided by teachers, peers, and relatives may also help make a correct diagnosis.

Since there is no specific test for the diagnosis of depression, the psychologist may conduct an interview or personal interactive sessions with the parents and the child. This, along with the input on the child’s behavior in different environments, may help in understanding the child’s condition better (1) (5) (6).

Treatment For Depression In Children

The healthcare provider determines an effective treatment plan for depression in children based on the following factors (2) (4) (7).

• Medical history, age, and overall health of the child
• Severity of the child’s symptoms
• Tolerance towards medication and therapy

Depression in children is treatable and is based on a comprehensive evaluation of the child and their family as each child copes with it differently. The treatment for depression may include any or a combination of the following.

• Antidepressants: The most common antidepressants include selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft). These are often used as the first-line treatments for moderate to severe depression in children and adolescents. They help increase serotonin levels in the brain, thus fostering feelings of happiness.

• Psychotherapy: The most common therapy adopted for treating depression in children is cognitive-behavioral therapy (CBT). It involves personal interaction with a trained professional. CBT helps elevate the child’s mood and makes them think positively. In some cases, the therapist may also involve the parents and siblings to help nurture a better bond and understand the issues being faced by the child.

• Other therapies, such as play therapy or art therapy may also be used.

• Consultation with the child’s school and school counselor: Most schools have a therapist or counselor to assist children with behavioral differences. Consulting them helps in understanding the day-to-day behavior of the child.

Parents play the most important role through the process of the child’s treatment. Consistent treatment helps avoid the recurrence of any symptom of depression (8). Thus, you should support your child emotionally, encourage them to follow a healthy lifestyle, and make them feel included in family activities.

Can Depression In Children Be Prevented?

The onset of depression in a child cannot be prevented as most factors that influence the onset of depression are not controllable—these include your child’s environment, genes, and chemicals in your child’s brain. Since there is no specific way to prevent the condition, you can take the following steps to prevent the symptoms from worsening.

• Find and suggest ways for your child to handle stress calmly and boost their self-esteem.
• Encourage them to sleep, eat, and exercise well.
• Encourage them to talk to someone they can confide in.
• Be consistent with their medical checkups.
• Maintain a warm and affectionate parental relationship.

References

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Reviewer

Dr. Neha Bhave SalankarMD

 

Dr. Neha Bhave Salankar is a consultant psychiatrist at Bhave Institute of Mental Health based in Nagpur and has around 11 years of experience in the field. Having been a meritorious student throughout, she bagged the prestigious gold medal for medicine in MBBS and MD psychiatry.

Read full bio of Dr. Neha Bhave Salankar