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Depression in Children

Is anything so agonizing in divorce as seeing the effect it has on your child? Children react in so many negative ways to divorce, but perhaps the most painful is the depression that children sometimes experience during or after divorce.

How Common Is It?

Our best estimates are that about 2.5% of children about about 8% of adolescents suffer from depression. A person who struggles with depression as a child or as a teenager is at substantially higher risk for depression (and other illnesses) as an adult. Depression in children and teenagers often comes side by side with other forms of mental illness, with substance abuse, with anxiety, and/or with diabetes. For obvious reasons, children and adolescents who suffer from depression are at materially higher risk for suicide.

Depression appears to be gender-neutral for children. In adolescents, however, girls are about twice as likely as boys to be affected.

Depression in children does not have a high correlation with a family history of depression. Among adolescents, however, there is a high rate of correlation.

Signs To Watch For

Clinically speaking, the symptoms of depression in children are identical to those for adults. Five or more of the following, persisting for more than two weeks, indicates the presence of "major depression."

  • Persistent sad or irritable mood 
  • Loss of interest in activities once enjoyed 
  • Significant change in weight or appetite
  • Difficulty sleeping, or sleeping too much
  • Unusual agitation or retardation 
  • Loss of energy 
  • Feelings of worthlessness or inappropriate guilt 
  • Difficulty concentrating 
  • Recurrent thoughts of death or suicide

More specifically to children, however, parents and other adults often have difficulty spotting the symptoms of depression in children and teenagers. One study showed that parents were actually less effective than the children themselves in recognizing and dealing with depression. Here are some of the signs:

  • Physical complaints, such as headache, nausea, or sore muscles
  • Recurrent thoughts of running away from home, or actually running away
  • Alcohol or substance abuse
  • Frequent absences from school
  • Poor performance in school
  • Frequent outbursts of shouting, crying, or irritability
  • Lack of interests in friends
  • Reckless behavior
  • Difficulty with relationships
  • Fear of death, or fascination with death
  • Social isolation

Please understand that I raised two children, and I know how much the list above looks like a list of what every teenager goes through. Obviously, then, it's easy to see why parents and other adults often miss the presence of depression

What Can I Do?

It's interesting that we know so much about the incidence and diagnosis of depression in children and so little about how to treat it. As with adults, most treatment involves a combination of medication and therapy, although with children, the use of psychoactive drugs is more controversial than with adults.

Ask about Cognitive Behavior Therapy (CBT), which has been helpful to some children and teenagers. The idea of CBT is that children and adolescents with depression often have a distorted view of themselves and of the world around them. CBT focuses on identifying and correcting those distortions.

When it comes to medication, there's every reason to use a psychiatrist who specializes in treating children. That's because we are gathering new information every day about which medications are most effective with selective populations. Ask about Selective Serotonin Reuptake Inhibitors (SSRI's), which have been shown to be effective in treating depression in children and adolescents.

The most important thing you can do is to stay thoroughly informed about your child's interests, habits, activities, and performance. Please know that your first reaction when confronted with the signs of depression will be to attribute them to something else. This is one of those areas where your judgment will be clouded, however. If you have any inkling that your child is struggling with depression, ask to visit with his or her guidance counselor, or make an appointment with a qualified mental health professional who can help you think through a thorough diagnosis and a review of your options.

Other Resources

You can (and probably should) start with Deborah Deren's excellent introduction to depression in children on her Wings of Madness site.

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