If You Worry Your Child Is Depressed

Depression is far more common in teens than in young children, but I often hear families wondering how to know if they should worry about their child’s mood. As many as 1 in 5 teens can have a depressed episode so concerns about depression are a common challenge. Many of us wonder if young kids get depressed (yes, but not too often), what are the signs (detailed below), and what to do about it (6 tips below). It’s scary for every parent who thinks a child is depressed. It can be terrifying to worry about a teen. There is a certain innocence we reserve for childhood and no question for some, depression can seem antithetic to that. Depression can be very real, influenced by life events, inherited, and wildly disruptive. But there is great research to help guide what we do to support children, teens, and our families if depression becomes a challenge.
I talked with clinical psychologist and depression expert at Seattle Children’s Hospital, Dr. Gretchen Gudmundsen on this 20-minute podcast. I learned a lot as we covered the definitions of depression, which children are at risk for depression, classic depression symptoms, and when parents should seek help for their depressed child.
You can listen to the podcast right here on the blog, or you can listen while you’re commuting on your phone by going to iTunes (search “Seattle Mama Doc”) or Google Play or on Soundcloud. A quick summary of high-level points below:

What Is Depression In Children and Teens:

• Depression is more than just feeling sad or going through a rough patch in life. When a child or adult is depressed it affects the way they feel, act, and think. Depression can penetrate every hour of the day for some, and the burden of depression can touch every interaction and relationship. Depression in children and teens is real and isn’t “made up.” The good news is that it doesn’t always last a lifetime. With support and intervention children and teens can recover from depression.
• Changes in child’s day-to-day functioning that persist for at least a couple of weeks, that span multiple domains, including mood (e.g. sad, grumpy; nothing is fun), their behavior (e.g. slowed movement, low energy), their thoughts (e.g. difficulty with concentration, low self-esteem) and biological functions (e.g. changes in sleep, appetite, body aches and pains).
• Not just sadness and crying, depression can also show up as being easily aggravated, having irrational outbursts—your child may withdraw more to his or her room or computer or may be especially touchy.
• May come out of nowhere or it may start in concert or soon after a big stress or life event.

Who Typically Has Depression?

• Teenagers! Depression can happen in younger children, but it’s quite rare.
• Gender and age differences — may be different depression expressions and triggers for teen girls, versus teen boys. Puberty drives this often more than a child or teen’s age.
• Runs in families — no question children can inherit a tendency toward depression. Children with a family history are at a 4 times risk of developing depression.
• Early adversity or trauma increases risk for children. But clearly not all children who experience trauma or adversity have depression.
• Other medical & psychiatric issues (ADHD, learning disorders, anxiety, oppositional defiance problems)
• Stressful life events or significant loss can bring on a depressed episode.
• LGBTQ youth are significantly higher risk for both depression and suicide.

Symptoms & Signs Depression In Children And Teens:

• Symptoms: depressed or irritable mood, loss of interest/pleasure in usual activities, change in appetite, eating or weight, sleep difficulties or changes (too much, too little, poor), fatigue, excessive guilt, concentration difficulties, dark or negative thoughts, including thoughts about wanting to be dead or suicide.
• Signals To Watch For: living & behaving in a “going through the motions” way, feeling hopeless, body aches and pains, anxiety, decline in grades.

When To Get Help For Your Depressed Child:

• When multiple signs or symptoms occur at the same time.
• When symptoms persist for most of the day, nearly every day for at least two weeks.
• When symptoms are associated with significant decline in the child’s ability to participate successfully in school, family, and social activities or declining interest in friends, family or school or activities.

6 Steps To Help A Kid Struggling With Depression

1. If you are worried about it, get it checked out. I mean call today. There is truly no benefit for you or a child in waiting.
2. Get a comprehensive evaluation (pediatrician, psychologist, psychiatrist, therapist), including ruling out underlying medical issues (e.g. thyroid problems) and doing official screening evaluations (often survey-like questions paired with a medical exam, and a detailed history).
3. Some may just experience clinical depression once, but for most people it recurs, so it’s important to know what to do and how to identify and manage it. Learning how to manage depression and symptoms of sadness early in life can help to support an individual their whole life.
4. Lifestyle – sleep, diet, exercise, get outside (vitamin D/light) do play a role.
   -Psychotherapy – Cognitive Behavioral Therapy (CBT), Interpersonal Therapy (IPT) or Behavioral Activation (BA). Tips to know:
   -CBT should have a parent component, either parent-teen sessions or family sessions
   -Moved to more modular type approach. Gain independence and skills and then keep an eye on progress. Learn and know vulnerabilities for your child or teen and when to get back in for a booster of time with a therapist or more treatment.
   -Medication – Pediatrician or Psychiatrist or Psychiatric nurse practitioner will sometimes use medicine to help teens with depressed symptoms.
5. Untreated depression does not go away and could result in more serious issues, such as suicide, substance abuse and missing out on making a fun, fulfilling life. There is no reason to wait to help support your child if you’re worried they may be depressed.
6. Teach your kids to share any concerns they have about their friends. Many kids feel pressured to keep each other’s secrets. Build your and your child’s community and village and confirm with them that you will support, without judgment, if your child or a friend is depressed.