Depression can sometimes look different in children than adults, experts say.

Depression in children is more common than some parents may realize. Approximately 2.7 million children in the United States have depression, according to the Centers for Disease Control and Prevention (CDC).

Research shows depression is on the rise in kids and teens. The proportion of children who’ve been diagnosed with depression increased by 24 percent from 2016 to 2019, and the direction of these trends continued in 2020, according to a study published in March 2022 in JAMA Pediatrics.

Factors such as social media, mass violence, the fallout from COVID-19, natural disasters, climate change, and political polarization have all contributed to rising depression rates among kids and teens in the United States, according to a report published in January 2023 by the American Psychological Association.

“There are also significant disparities when it comes to racial and ethnic minority youth and youth that identify as LGBTQ+,” says Ernesto Lira de la Rosa, PhD, New York City–based psychologist and media advisor for the Hope for Depression Research Foundation. That’s because of factors including discrimination, lack of access to high quality mental health care, and cultural stigma related to mental health care, among other contributors, according to the American Psychiatric Association.

Some signs of depression may appear differently in kids than adults, which is why knowing the signs of childhood depression is crucial, says Mayra Mendez, PhD, a licensed marriage and family therapist and program coordinator for intellectual and developmental disabilities and mental health services at Providence Saint John’s Child and Family Development Center in Santa Monica, California.

One reason it can be difficult to recognize depression in children is that they may explain or express their depression differently than adults do, especially if they’re young and learning how to express their emotions. A “tantrum,” for example, may not just be a kid being mad at the moment, but a sign that they are emotionally struggling, notes Dr. Mendez.

“When a child struggles with depressive symptoms but does not show behaviors that are typically associated and recognized as signaling depression, the negative behaviors may be misinterpreted, and the signs of depression missed,” says Mendez.

7 Key Signs of Depression in Children

It’s normal for kids to experience emotional ups and downs, but feeling down for at least two weeks could mean that a child has depression, especially if what they’re experiencing interferes with their usual routines, activities, and interests, according to the Cleveland Clinic.

Missed signs of childhood depression can lead to delayed diagnosis and treatment. “Without early intervention, depressive symptoms can worsen and lead to many emotional, behavioral, and academic challenges in a kid’s life,” Dr. Lira de la Rosa says, “This may mean that by the time a child receives mental health treatment, their depression may have worsened and may take longer to treat.”

Here are seven signs your child may be experiencing depression.

1. They Seem Angrier or More Irritable Than Usual

For some kids, depression may show up in the form of angry outbursts at the dinner table or in class, for instance. This sign of depression in children is sometimes mistaken for troublemaking, according to the CDC.

“Some of the common signs may include anger and irritability more so than feelings of sadness that may be more common in adults who have depression,” says Lira de la Rosa. “They may also begin to act out or misbehave at home and at school or experience significant fluctuations in their mood.”

2. They’ve Withdrawn From Friends and Their Favorite Activities

Similar to adults, kids who have depression may also have behavioral changes such as withdrawal from friends or social activities they normally love, Mendez says. This is often due to anhedonia, a common sign of depression involving loss of interest or pleasure in activities they used to enjoy.

3. You’ve Noticed Changes in Their Appetite

“Typically, I would recommend keeping an eye out for changes in a child’s appetite,” Lira de la Rosa says. Consistently eating more or less than they usually do — and resulting weight loss or gain — are potential signs of depression in children, according to Boston Children’s Hospital.

4. Their Sleeping Patterns Have Changed

Sleeping more than usual — or having trouble falling or staying asleep — can signal depression in a child, says Lira de la Rosa.

Not only are sleep issues a potential sign of depression in kids, but they’re also a risk factor for developing depression in the first place, according to a systematic review and meta-analysis of 16 studies published in JAMA Network Open.

5. Their Academic Performance Has Slipped

A decline in grades at school can be a sign of depression, especially among middle and high school students, says Mendez. Survey data published in the fall of 2022 by the nonprofit YouthTruth showed that among nearly 223,000 students in grades 6 through 12 across the country, depression, stress, and anxiety were the biggest obstacles to learning at every grade level.

6. They Have Unexplained Aches and Pains

Unexplained physical symptoms such as headaches or stomachaches can be a sign of depression, according to the U.K. National Health Service. Headaches in particular can be common among kids with depression who have difficulty recognizing feelings of loneliness or sadness, according to Mayo Clinic.

7. They Talk About Death or Dying

Talking about death or dying can be a sign of suicidal thoughts, according to the Cleveland Clinic. Thoughts of death or suicide are a potential sign of depression, and having depression is a known risk factor for suicide. Suicide is the second leading cause of death among children ages 10 to 14, CDC data show. Other warning signs that a child may be thinking of suicide, per the Cleveland Clinic, are:

• Self-harm and increased risky or self-destructive behaviors
• Social withdrawal
• Feelings of hopelessness
• Giving away their possessions without a logical reason for doing so

What Should You Do if You Think Your Child Has Depression?

If you suspect your child has depression, start by talking to them about it. Consider these tips for getting the conversation started, suggests Lira de la Rosa:

• For younger kids, make the conversation part of play time or another activity, and bring up feelings like sadness. Lira de la Rosa recommends Sesame Workshop’s Emotional Well-Being resource as a potential tool to help young children learn about their emotions.
• For older kids and teens, consider planning a fun activity with them, such as getting ice cream or going to their favorite store, and ask them how they’re doing emotionally. Oftentimes, older kids and teens have already been exposed to the topic of depression through media and school, Lira de la Rosa adds.
• When talking to your child about depression, try to emphasize how common this mental health condition is. If it’s relevant, consider sharing your own experiences with depression in an age-appropriate way.

It’s important to note that the aforementioned signs don’t automatically mean your child has depression, but if you notice them in your child, it’s worth talking to a doctor. Your child’s pediatrician — or a licensed mental health professional — can screen your child for depression if they’ve experienced the signs for at least two weeks. This means they’ll ask you and your child some questions to determine if what your child is experiencing is depression or something else.

If your child does have depression, it’s important to work closely with their pediatrician or a mental health professional to come up with a treatment plan. Evidence-based treatments for childhood depression, according to Boston Children’s Hospital, include:

• Talk therapy, which can help children learn how to navigate their emotions, manage sad feelings, and cope with situations they find difficult.
• Antidepressant medications, if more support is needed beyond talk therapy. However, antidepressants are less likely to be prescribed as first-line treatment for kids and teens than adults — fewer studies of antidepressants have been performed in youths than adults, according to the American Psychological Association.
• Assessing your child’s environment to see what factors could be contributing to their symptoms. For example, if a situation at home is triggering their depression, family therapy could be helpful.

Important Notice: This article was also published at www.everydayhealth.com by Julia Métraux where all credits are due. Medically reviewed by Chester Wu, MD

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