Has your child been acting unusually sad or out-of-sorts lately? Have they been having more trouble functioning at home or at school because of their mood? It’s possible your child may be experiencing depression. Contrary to popular belief, depression is not just an adult issue. The only way to know for sure is to go to a qualified health professional and have them make a diagnosis. However, you as a parent should be aware of the signs and symptoms of depression so you can bring it up to your health professional.
Duration is an important consideration. These warning signs aren’t really a concern if they only last a day or two, but if they last longer than two weeks or so, it can be a red flag for depression. Similarly, if your child is only experiencing one or two of these symptoms, it may not be a big deal, but the more symptoms they are experiencing, the more likely it is that they are experiencing depression. The intensity of the symptom can also play a role in whether they meet criteria for diagnosis. As the parent, you have the best understanding of what is “normal” for your child. Therefore you have the best perspective to compare your child’s behavior to how they normally behave, which is really important in talking to a health professional. A health professional can then compare your child’s behavior to other children at the same developmental stage and investigate other possibilities to let you know whether it’s really depression.
Here are the red flags of depression in kids and teenagers, taken from the DSM-5:
1. Does your child feel sad, empty, hopeless, or irritable for most of the day, every day? In children, depression doesn’t always present as sadness or low mood. Irritability is a very common symptom of depression in kids and teenagers, so even if they may deny feeling sad, they may have a shorter temper and lash out more frequently. This is especially common in kids who have difficulty understanding and expressing their emotions using words. Because young children don’t have the words to express and label their emotions, watch for them crying more than usual, acting less happy than they used to, throwing more tantrums, or acting very cranky.
2. Does your child no longer enjoy the activities they used to? (Fun fact: the technical term for this is anhedonia.) For example, if your child used to love playing with friends, and no longer appears interested, this may be a red flag. If your teenager used to love playing their clarinet, and no longer has interest in practicing or attending band activities, this may be a red flag. It’s important to talk to your child and find out what’s going on. If they have a specific reason for no longer enjoying an activity, it’s likely not due to depression. However, if they say “I just don’t really feel like it” or “I just don’t have fun doing that anymore” then it may be a symptom of depression. This is more likely if you notice them losing interest in multiple activities.
3. Has your child experienced a loss of appetite or an increased appetite, or lost or gained a significant amount of weight? Similar to adult depression, depression in children can affect appetite. But in some ways, it is more difficult to notice in children, whose weight is increasing as they grown. Some children may not lose weight, but they may fail to make the expected weight gains that they should make for their age. There are lots of reasons why kids may have a change in appetite, including the amount of activity they engage in, whether they like the food they’re eating, or if they are trying to go on a diet. In order to be a symptom of depression, their change in appetite should not be due to any of these reasons, but rather due to their mood. They may make comments such as “I’m just not hungry” frequently.
4. Does your child have trouble sleeping or sleep way too much? It’s usually easy for parents to know if their child is having trouble falling asleep, because their child will let them know or they will notice the child awake when they shouldn’t be. It can be tougher for parents to know if their child is sleeping too much. Just remember that kids need a lot of sleep! Most teenagers need at least nine hours of sleep per night. It’s also natural for teenagers to have difficulty falling asleep before 11:00pm or so. Taking this into account, if your child seems to be sleeping much more than they used to, taking lots of naps, or having trouble staying awake during the day, it may be a symptom of depression.
5. Does your child seem more restless than usual, or do their movements appear to be slowed down? If they are more restless, you may notice them having difficulty sitting still, wringing their hands, or picking at their clothes or skin. If they are more slowed than usual, you may notice your child’s speech seems slow, they are speaking more quietly or speaking less than normal, or their body movements seems slow.
6. Does your child seem fatigued and have little energy? This is something that will likely vary by child. Different kids naturally have different amounts of energy, so comparison to prior behavior becomes an important factor. If your child seems much more tired than usual, and it’s not due to not getting enough sleep or being unusually active, this may be a sign of depression.
7. Does your child seem to feel worthless or guilty all the time? They may blame themselves for many things and have an exaggerated feeling of responsibility for negative events in their daily lives. They may comment that they feel like “a bad person” or state “I don’t deserve _(fill in the blank)__.” Everyone feels like this once in a while, but if you notice your child consistently making comments like this, it can be a red flag.
8. Is your child having trouble concentrating or thinking? This is a big one! If your child used to have no problem concentrating, but now is experiencing difficulty, this may be a sign of depression. Many parents notice this symptom and think that their child has suddenly developed an attention-related disorder. If they haven’t had difficulty with attention previously, and now they are struggling, it may be due to depression.
9. Has your child mentioned thinking about death or dying a lot? Do they think about suicide? This can be such a scary thing for parents to hear your child say that they are thinking about death or suicide. Every kid wonders about death sometimes. However, if they seem to be thinking about it a lot and express a desire to die, this may be a symptom of depression. Statements such as, “Things would be better without me” or “I wish I could disappear forever,” indicate this red flag. It may be difficult to know if your child is feeling this way, especially if you have a teenager. It’s okay to ask them if you’re worried about it! You will not “plant” the idea in their mind or make them more likely to think about suicide just by asking. Statements such as, “Things would be better without me” or “I wish I could disappear forever,” If they say they are having thoughts of suicide, take it seriously! Please take them to a mental health professional or emergency room as soon as possible.
10. Are these symptoms causing them significant problems in their friendships or performance at school? Have they lost friends because of their mood? Are their grades lower than they used to be? Have they stopped attending school or important activities?
If you answered yes to five or more of these questions, your child may be experiencing depression. You will likely want to have them evaluated by their pediatrician or a mental health professional.