Understanding Depression in Children

Deep sadness which lasts too long and disrupts a child’s ability to be himself or herself, to have fun, to be socially active with family and friends or to do his or her best in school may be a sign of the biologically-driven mental illness called depression.

By Peter Dozier, MD

All children experience sadness at times, most likely when there’s stress from change or loss in their lives, such as a family move, parental separation or the death of a close relative. Sadness in these situations is an appropriate response in an emotionally healthy child.

However, deep sadness which lasts too long and disrupts a child’s ability to be himself or herself, to have fun, to be socially active with family and friends or to do his or her best in school may be a sign of the biologically-driven mental illness called depression. This is especially true of children whose family members have suffered from depression, as the vulnerability to depression does appear to be inheritable.

Doctors today appreciate that there is no minimum age for this disorder of mood. The challenge is to recognize how depression may express itself in different ways at different stages in development and to overcome our adult reluctance to believe that children can suffer so deeply.

Imagine that there is a chemical “thermostat” in the brain that regulates our moods by supporting our ability to “bounce back” from the stresses of life. A shortage of these chemicals may make it difficult for genetically vulnerable children to return to a good mood.

It is a rare child, especially in elementary school and younger years, who can recognize that his or her feelings are just not right, much less put these unhappy emotions into words that will convince an adult that he or she is depressed. It is the nature of childhood to express emotion through behavior, which makes the diagnosis of depression tricky. Parents must recognize what behaviors, such as irritability or anger, may be manifestations of depression.

The happy news is that once childhood depression is correctly diagnosed, it can be treated very effectively with combinations of talk therapy and medication.

Consult your pediatrician if your child has:

  • Frequent sadness, crying, hopelessness
  • Low self-esteem and/or guilt
  • Loss of interest in favorite activities
  • Persistent boredom, low energy
  • Unusual irritability or anger
  • Sensitivity to rejection
  • Thoughts or expressions of wanting to die
  • Poor concentration
  • Changes in eating or sleeping patterns
  • Withdrawal from family and friends
  • Frequent absences from or poor performance in school
  • Excessive physical complaints such as headaches and stomachaches

By Dr. Dozier is a child psychiatrist with Children’s Specialty Group PLLC at CHKD.