Depression in Children and Teens

What Happens

Depression in a child or teen may first appear as irritability, sadness, or sudden, unexplained crying. He or she may lose interest in activities once enjoyed or feel unloved and hopeless. He or she may have problems in school and become withdrawn or defiant.

Often a child who is depressed will have other disorders along with depression, such as an anxiety disorder, a behavior disorder like attention deficit hyperactivity disorder (ADHD), an eating disorder, or a learning disorder. These problems may occur before a young person becomes depressed. Some children with depression develop serious behavior problems (conduct disorder), often after becoming depressed. If your child develops one of these disorders, it may require treatment along with depression.

A child or teen with depression is much more likely to use drugs, alcohol, or cigarettes than a young person who is not depressed. About 30% of teens will develop alcohol or drug use problems along with depression.⁷ This can make depression more difficult to treat, can increase the length of time before treatment is successful, and increases the risk of suicide. Early diagnosis and treatment of depression and good communication with your child can help prevent substance abuse. For more information about substance abuse in young people, see the topic Teen Alcohol and Drug Abuse.

Children and teens with depression are also at a higher risk for developing problems such as:^{8, 9}

• Poor school or job performance.
• Problems in relationships with peers and family members.
• Early pregnancy.
• Physical illness.

For severe depression, your child may need to be hospitalized, especially if he or she is out of touch with reality (psychotic) or having thoughts of suicide.

A depressive episode lasts an average of 8 months.¹⁰ Even with successful treatment, as many as 40% of children with depression will have another episode within a few years.¹¹ During treatment for depression, make sure that your child takes medicines and attends counseling appointments as directed, even if he or she feels better. A common cause of relapse is stopping treatment too soon.

To prevent another episode of depression, learn to recognize early warning signs, and seek diagnosis and treatment right away if symptoms develop. A balanced diet, exercise, and a good social support system may also help prevent depression.

Suicide and depression

It's important to watch for warning signs of suicide in your child or teen. These signs may change with age. Warning signs of suicide in children and teens may include preoccupation with death or suicide or a recent breakup of a relationship. Teens with depression are at particularly high risk for suicide and suicide attempts. In the United States, approximately 2,000 teens commit suicide each year.¹² While teen girls attempt suicide almost twice as often as teen boys, boys are more likely to succeed because girls usually use less lethal means and survive the attempt. Suicide attempts in children younger than age 12 are uncommon.

A young person is at increased risk for suicide attempts if he or she has:¹³

• Current suicidal thoughts.
• Other mental health or disruptive disorders, such as conduct disorder or substance abuse.¹²
• Impulsive or aggressive behaviors.
• Feelings of hopelessness.
• A history of past suicide attempts.
• A family history of suicidal behavior or mood disorders.
• A history of being exposed to family violence or abuse.
• Access to firearms or other potentially lethal means.

You should carefully watch for signs of suicidal behavior if your child has recently:

• Broken up with a girlfriend or boyfriend.
• Had disciplinary troubles in school or with the law.
• Had problems with poor grades or difficulty learning.
• Had family problems.
• Had substance abuse problems.
• Started, stopped, or changed doses of an antidepressant medicine.

If your child is suicidal, call911or other emergency services immediately.

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Author:	Jeannette Curtis Lila Havens	Last Updated: April 25, 2007
Medical Review:	Michael J. Sexton, MD - Pediatrics Gisele Ferguson, MD, FRCPC - Psychiatry, Child and Youth Psychiatry
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