One of the biggest myths about childhood depression (also known as pediatric depression) is that it doesn't exist.
However, depression is a real illness that affects both adults and kids. In fact, kids as young as 3 years old can have depression.
Depression can even affect babies, who tend to exhibit symptoms such as unresponsiveness, lethargy, inconsolable crying and feeding problems, writes Deborah Serani, PsyD, a clinical psychologist who specializes in mood disorders, in her new book Depression and Your Child: A Guide for Parents and Caregivers.
Below, she revealed what pediatric depression looks like, along with what you can do if you spot these signs.
Signs & Symptoms of Pediatric Depression
Depression tends to manifest differently in kids than it does in adults. "For the most part, children and teens experience fatigue and irritability and other physical complaints," such as aches and pains, Serani said.
Kids also may seem bored and withdrawn and experience loss of interest. In her book Depression and Your Child, Serani writes, "This is called anhedonia, and children show this deflated disposition in play, with sports, friends, in school, and in other previously loved hobbies or activities."
Hopelessness and helplessness can manifest as negative self-talk with phrases such as "I am bad" and "I can't do anything right," she said.
Because depression distorts thinking, it can shrink a child's self-worth. Kids may "feel worthless or unlovable, useless or stupid," Serani writes in her book.
Another sign is behavior change, she said. A child who typically does well in school might start getting failing grades. They also might give away beloved toys or start sleeping more, said Serani, also author of the book Living with Depression.
In addition, kids might hide or sequester themselves, she said. "Young children who experience depression like to tuck themselves in their room when they're sad or to avoid family or social interactions."
When she was depressed as a child, Serani had a secret hiding place near the basement boiler that made her feel safe. "It was quiet and warm there, and I could just rest without anyone asking anything of me."
What Caregivers Can Do
If you notice the above signs, Serani suggested the following:
Pay attention to the duration of the symptoms.
"Is this just a bad day, or has it been a few bad days in a row?" For instance, your child might be struggling with something serious if their fatigue, irritability and sadness last longer than one or two weeks and permeate different parts of their lives, she said.
Take your child for a full medical checkup.
Many conditions can look like depression, Serani said. "For example, diabetes, anemia, mononucleosis or a simple streptococcus infection can mimic depressive symptoms." That's why ruling out medical conditions first is key.
Get a comprehensive evaluation from a mental health professional.
If there's no medical condition that accounts for the symptoms, take your child to a practitioner who specializes in mood disorders. An extensive assessment will help determine if your child has depression, and what treatments are best. It'll also let you know if your child is struggling with subclinical issues, which Serani calls "a low boil." This means that your child has symptoms of depression but doesn't meet the diagnostic criteria for the disorder. This is important to know because you "can learn what kinds of interventions can be used to prevent a full-blown disorder from developing."
Get effective treatment.
Depression doesn't go away on its own. "It's a chronic illness that can't be willed away or brushed aside with a change in attitude. It won't go away if a parent yells, gets extra strict or ignores the problem either." Play therapy and family therapy are helpful for toddlers and preschoolers. Individual talk therapy is helpful for teens. Medication also may be necessary for some kids.
"My best advice is for parents to become well read on the subject of pediatric depression and find an experienced professional team to work with."
Having a child who's depressed is challenging, Serani said. But there's also insight and growth that can come from managing this illness, she said.
"I was a child who had depression, and though I have to contend with taking medication for the rest of my life, there is so much more to who I am than my depression. And in fact, I'd say that what I've come to appreciate in life has happened not in spite of having depression, but, in truth, because of it."
