Depression

Depression is a common mental health disorder. Certainly, occasional sadness or low mood is a normal part of life for children, teens, and adults alike. However, children with a depressive disorder, the feelings of sadness, hopelessness, and loss of interest created by depression persist and can get worse over time. Often children and teens with depression find it hard to get out of bed in the morning, sleep for extended periods of time, reduce or stop socializing with peers, and have minimal engagement in activities that used to give them joy. This can negatively impact their academic performance as well as their relational health. There are multiple types of depressive disorders, including major depressive disorders, disruptive mood dysregulation disorders, and dysthymia among others. Outside of pervasive pessimism, hopelessness, and low self-esteem, depression can look like defiance, outbursts of anger or crying, somatic symptoms (e.g., tension headaches, stomachaches), difficulty focusing, irritability, and sensitivity. Loss of interest in pleasurable activities and changes in appetite and energy levels can also occur.

Diagnosis of depression requires a qualified mental health professional to gather information about the child, their behavior, and environment. No single test can diagnose a child as having anxiety, and other problems, like learning disorders, ADHD, and childhood bipolar disorder, can have similar symptoms. Changes in life events, loss of a loved one, or adjusting to other difficult situations may also look similar. Evaluations include a combination of in-office testing procedures; questionnaires completed by parents, teachers, and children; and clinical observations. Diagnostic evaluations not only help the parents and teachers of a child with depression better characterize that child’s difficulties, but they also can help the child more clearly and accurately understand their own personal strengths. Recognizing symptoms of depression and seeking help early will lead to better outcomes for both affected children and their families.

The type, duration, and frequency of supports will vary depending on each child and their needs. Evidence-based supports include school-based evaluations for Individualized Education Plans (IEPs) or 504 Plans that provide the child or adolescent with modifications or accommodations can be beneficial. Often depressed children and teens benefit from having a safe adult to speak with at school, time with a mental health provider to teach coping and mindfulness skills, and a menu of coping skill options to use during the school day (e.g., deep breathing, fidgets).

Regarding academics, providing extended time, reducing workload, and offering a separate space for testing can help children and teens. Sometimes, children will need time with a special education provider to close any academic knowledge or skill gaps. In cases of high school refusal or severe depression, alternate options for schooling may be appropriate (e.g., online school, private or charter schools with small class sizes). Outside therapy with a trained mental health provider is recommended. Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, and family therapy are beneficial treatment modalities, although play therapy and expressive therapies, such as art therapy, are also appropriate. Discovering a child’s interests can be helpful as engaging them in activities and hobbies can help alleviate symptoms of depression.

Explore the types of therapy provided at WCP. Research suggests that coupling interventions such as those outlined above with medication optimize outcomes for children with depression when appropriate. Although including medication is always the caregiver’s decision, in many cases medication can give the brain the “boost” it needs to better learn and apply the skills gleaned in other interventions. Speaking with a child psychiatrist, pediatrician, or other trained healthcare provider is essential for deciding the best type and dose of medication.

Other posts about depression can be found on the WCP blog.

Children and teens with depression are at an increased risk for suicide, self-harm, and substance abuse. If you are worried about your child or adolescent’s safety, call the Suicide and Crisis Hotline by dialing 988. For immediate assistance in an emergency, dial 911 or go to the emergency room.

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