Understanding Depression in Kids and Teens

I’m Dr. Micaela Thordarson. I’m a child psychologist here at CHOC, and today we’ll be discussing depression.

I would define depression as a condition that children or youth experience where their emotions really take control of their lives. And for depression, that’s predominantly sadness.

Depression is different than typical sadness or distress in that it takes over your life—it takes over your brain and takes over your body.

Depression is unfortunately relatively common. About one in five high school teens will have suffered a major depressive episode before they’ve graduated.

In some situations, things like genetics really take control more so than environment. But with certain preventions that teachers and parents can do, depression can be prevented.

Depression can develop as early as age 3, 4 or 5. The younger the age, the more irritable depression looks—more angry than sad. The closer to adulthood a person gets, the more sad and empty-seeming depression may look. With teens and adolescents, we get the combination of irritability, lots of sadness, sometimes numb feelings and oftentimes anxiety.

One of the common misconceptions about depression is that kids or people with depression look sad all the time, when in fact, on the outside, that can look sad actually none of the time, or it can look sad some of the time. When we’re looking at clinical depression, more often these people are sad than not. So we’re really looking at a mixture of emotions and experiences for people with depression.

Another misconception about depression is that people can just snap out of it or turn it off if they try hard enough. The problem with depression is that it is controlled by many different factors, including your brain, your body and life circumstances. So there are many different things that really need to come together to be able to create a pathway towards wellness.

If a caregiver is concerned that their child may be experiencing depression, the first step can be just talking to the kid about it: “What’s going on? How are things going for you?” A pediatrician is a great resource to consult first.

If you’re worried that your child may be suffering from depression, you can tell if a child needs to see a therapist or psychologist simply based on how they are doing in life. Are they meeting their basic daily goals? Then they are probably okay. But when in doubt, always seek therapy.

There are a handful of different treatments for depression. Most of them are behaviorally based, which means that therapy is going to involve teaching new skills or new ways of responding to stressful situations and strong emotions.

There are a multitude of resources for parents to seek information about depression, starting with the Center for Disease Control (CDC), the National Institute for Mental Health (NIMH) and the American Academy of Pediatrics (AAP). And then of course we have our very own set of resources here at CHOC, including the mental health toolkit, which is available in three languages on our website.

Depression can look like a lot of different things, and I think one of the things that’s most important when we’re thinking about depression is what it looks like in it’s most scary form. What I’m talking about is thoughts of suicide or self-harm behaviors. Any form of those thoughts and behaviors are very serious. I would encourage you, if you have a child who is having these thoughts and behaviors, to absolutely seek support immediately—not to dismiss those as signs that they’re trying to get attention or that they aren’t serious. Because any presence of these thoughts of behaviors is absolutely serious and what we call life threatening.

If you do have immediate concerns for the safety of your child, I recommend calling 9-1-1, if you’re not sure you can transport them safely, or going to your nearest local emergency department.

There are also crisis resources that are available 24 hours a day, seven days a week—hotlines you can call that can be found through a simple internet search, or you can call the national suicide hotline at 1-800-273-8255.

I would also just like to give parents a reminder that thoughts of suicide or self-harming behaviors are a symptom, which means they can be treated—and treated very effectively. There is hope if your child is experiencing these thoughts or behaviors. They can get better.