Children feel many emotions every day, such as happiness, excitement, or sadness. Feeling sad sometimes is normal, especially after an argument with a friend or a big change at school. However, if sadness lasts a long time, feels overwhelming, or makes everyday activities difficult, it may indicate depression in children.
In this guide, we’ll explain what causes childhood depression, how to spot the signs, the types of depression, and ways to get help. Keep reading to learn more.
Overview
Depression in children is a medical condition that affects how a child feels, thinks, and acts. It goes beyond the typical ups and downs of childhood and can significantly affect a child’s well-being.
Unlike normal mood swings or brief periods of sadness, depression can last for weeks or months and interfere with day-to-day functioning. Major depressive disorder (MDD) is one of the leading causes of disability among young people ages 10 to 19 worldwide.
Depression can begin at almost any age, even in early childhood, though it becomes more common during the teenage years. In the U.S., the CDC reports that in 2022–2023, about 4% of children ages 3–17 had diagnosed depression, including 3% of boys and 6% of girls [*].
Causes
The exact cause of depression in children isn’t fully known, but research shows it usually results from a mix of genetic and environmental factors.
Studies of families and twins show that genes account for about 40–50% of the risk for depression, and possibly more for cases where symptoms are more severe. Children with a parent or sibling who has major depression are about 2–3 times more likely to develop it themselves [*].
Stressful life events, family conflict, bullying, chronic illness, or major life changes can increase the risk of depression in kids. These potentially traumatic events are called Adverse Childhood Experiences (ACEs). The more ACEs a child faces, the greater their risk for mental health challenges later on.
Signs and Symptoms
Depression can look different in every child, and it may not appear the same way it does in adults. Some children seem sad or withdrawn, while others act irritable or angry instead.
Emotional symptoms can include frequent sadness, hopelessness, or feelings of guilt and worthlessness. Sometimes children can describe these feelings themselves. Other times, parents or teachers may notice them. For example, when a child cries easily or seems unusually sensitive to criticism.
Behavioral changes are also common. A child may lose interest in activities they once enjoyed, avoid friends or family, or struggle to keep up with schoolwork. Some may sleep or eat much more (or much less) than usual.
Physical symptoms can also appear, such as stomachaches, headaches, or fatigue that don’t have a clear medical cause.
In some cases, children may talk about death or self-harm. Suicide is the second leading cause of death among children ages 10–14, so parents and caregivers should take these signs seriously and contact a mental health professional right away [*].
Types
Different types of depression can affect children [*].
Major depressive disorder (MDD) is the most common and can cause a depressed child to feel intense sadness and lose interest in activities.
Disruptive mood dysregulation disorder (DMDD) may show up as persistent irritability and frequent temper outbursts. Parents might not always realize that a child acting this way is actually struggling with sadness, since it can look like simple anger or misbehavior.
Persistent depressive disorder (PDD), sometimes called dysthymia, involves longer-lasting, milder symptoms. Another type is unspecified depressive disorder, which is used when a child’s symptoms don’t fit clearly into the other categories.
Other types include seasonal affective disorder (SAD), which develops during colder months when daylight is limited, and premenstrual dysphoric disorder (PMDD), which causes intense mood and physical symptoms in adolescent girls before their period.
Diagnosis
If you suspect your child may be experiencing depression, a good first step is to talk with your child’s pediatrician. They can ask questions about your child’s mood, behavior, and daily functioning, and may perform initial screenings to see if further evaluation is needed.
The pediatrician can then refer you to a mental health specialist, such as a child psychologist, therapist, or psychiatrist, for a more in-depth assessment.
Figuring out whether a child is depressed requires a careful look at their health and behavior. Doctors and therapists will make sure to rule out other conditions that can look similar, like ADHD, anxiety, or medical issues (e.g., thyroid problems, anemia, vitamin D deficiency), so your child can get the kind of help that truly fits their needs.
The U.S. Preventive Services Task Force recommends routine depression screening for all adolescents ages 12–18 to help identify symptoms early [*].
Treatment
The good news is that depression in children is treatable. The goal of treatment is to help a child feel better and get back to their normal life.
Most children benefit from talk therapy, such as cognitive behavioral therapy (CBT), where they can share their feelings, learn coping skills, and work on problem-solving in a safe space with a therapist. Sometimes, a doctor may also recommend medication to help balance brain chemicals and improve mood [*].
The best results usually come from a combination of therapy, support at home, and, when needed, medication.
For example, a child who has lost interest in activities they used to enjoy might start to feel better after learning coping strategies in therapy while their doctor monitors whether medication helps improve their mood.
Support
Children with depression do better when they receive care and attention at home and at school. As a parent or caregiver, one of the most important things you can do is listen without judgment and let your child share their feelings in a safe space.
Set up a consistent routine with regular meal times, homework, and bedtime to help your child feel more secure. Encourage healthy habits by having them exercise, eat balanced meals, and get enough sleep.
Make your home warm and loving, so your child feels cared for and accepted. Also, talk with your child’s teachers or school counselors to help them feel comfortable during class or school activities.
Outlook/Prognosis
If your child has depression, it’s normal to feel worried or confused about what to expect. Understanding childhood depression can help you see that, with the right guidance, children can get better.
Therapy is effective for children with depression. The coping skills your child learns work best when parents and caregivers are actively involved [*]. If medication is prescribed, it may take a few weeks to take effect, but it can help improve how your child feels [*].
Keep in mind that depression can be unpredictable. There may be times when your child struggles more than usual, and during these periods, therapy sessions or medications may need to be adjusted.
Resources
Here are some helpful resources for parents and caregivers. Feel free to explore the links below to deepen your understanding of childhood depression and find support when you need it:
