When children feel sad, tired, or uninterested in things they used to enjoy for a long time, it may be more than just a “bad mood.” Depression in kids can look different from adults, and it’s important to know that different types of childhood depression exist.
Each type of depression has its own set of signs and patterns. Some forms last for a shorter time but feel very intense, while others linger for months or even years with milder symptoms. Certain types may be linked to changes in seasons or hormones.
Recognizing them can help parents and caregivers respond appropriately and make sure the child gets the care they need.
Major Depressive Disorder (MDD)
Major Depressive Disorder (MDD) is a mood disorder in which a child experiences a persistent period of low or irritable mood lasting at least two weeks. It is more than a temporary “bad mood” and can impact a child’s emotional, social, and cognitive development if left unaddressed.
MDD is increasingly affecting children aged 5–14 worldwide. Cases have risen steadily over the past 30 years, with girls more affected than boys, especially after early puberty. Children aged 10–14 are most at risk, with MDD rates jumping about 32% during the COVID-19 pandemic [*].
Children with MDD may lose interest in activities they once enjoyed, withdraw from friends or family, or experience a decline in school performance. They may feel persistently tired, have changes in sleep or appetite, or express feelings of hopelessness, guilt, or worthlessness. Some children may have thoughts of death or suicidal ideation.
Younger children may show more irritability or physical complaints, such as headaches or stomachaches.
Persistent Depressive Disorder (Dysthymia)
Persistent Depressive Disorder (PDD), also known as dysthymia, is chronic and long-lasting. In children and teens, the diagnostic criteria typically require a depressed mood for at least one year (unlike two years in adults).
Precise prevalence data in children are more limited, but a meta‑analysis reported that PDD occurs in about 0.3% of children. This means that about 3 children out of every 1,000 may have dysthymia, although the exact number could be somewhat lower or higher [*].
A child with PDD may seem sad or “down” most of the time for many months. They may still take part in activities, but with little enjoyment. These children commonly struggle with low self-esteem, feelings of failure, difficulty concentrating or making decisions, and feel hopeless about the future.
Because these signs are subtle, families may mistakenly see them as part of the child’s personality.
Disruptive Mood Dysregulation Disorder (DMDD)
Disruptive Mood Dysregulation Disorder (DMDD) is a newer diagnosis that describes children who struggle with constant irritability and intense, frequent temper outbursts. It’s considered a depressive disorder since persistent irritability is the main symptom that defines it.
About 3.3% of children and adolescents in the community have DMDD, but the rate is much higher in clinical settings, around 22%, because irritability and temper outbursts lead parents to seek help [*].
Research also shows that many children with DMDD also have other mental health conditions, such as anxiety, conduct disorders, and attention-deficit hyperactivity disorder (ADHD).
The temper outbursts in DMDD usually happen three or more times per week. They can be verbal, like yelling or screaming, or behavioral, like hitting or breaking things. They are much stronger than the situation calls for and don’t match what would be expected for the child’s age.
For example, a child with DMDD might scream and throw things when asked to stop playing and start their homework.
Seasonal Affective Disorder (SAD)
Seasonal Affective Disorder (SAD) is a form of depression that tends to develop during the colder months when daylight is limited. As the days grow shorter, some individuals, children included, may feel more tired or less interested in activities.
Research shows that people with SAD have lower serotonin levels, a key chemical that affects mood. Winter’s limited daylight and low vitamin D (which the body makes from sunlight) may intensify symptoms [*].
Millions in the U.S. experience SAD, especially women and those in places where winter days are shortest. Although SAD usually appears in young adults, children and teens can experience it too. Children with major depressive disorder, bipolar disorder, or anxiety disorders are at higher risk for developing the condition [*].
Children with SAD may seem more irritable, sad, or tired than usual. They might lose interest in favorite activities, sleep more, or crave sweets and comfort foods. Trouble concentrating or keeping up at school is also common. In more severe cases, they may feel hopeless or talk about self-harm, which will need immediate support.
Premenstrual Dysphoric Disorder (PMDD)
Premenstrual Dysphoric Disorder (PMDD) is a condition where adolescent girls feel intense mood changes and physical symptoms in the days before their period. These symptoms usually go away once their period starts.
Most women experience mild premenstrual syndrome (PMS) symptoms that don’t really interfere with everyday life, but about 20% have more intense symptoms. PMDD is a much more serious type of PMS, and it affects about 3 to 9 out of every 100 women [*].
During the week leading up to menstruation, girls with PMDD may experience strong mood changes, such as deep sadness, heightened anxiety, or irritability. They may feel constantly overwhelmed, have difficulty focusing on schoolwork, withdraw from favorite activities, or lash out unexpectedly.
Physical symptoms such as bloating, menstrual cramps, headaches, breast tenderness, and muscle aches occur alongside the emotional changes.
Resources
If you’re looking for additional guidance and information about childhood depression, you can learn more here:
