Recognizing Depression in Your Child or Teen: Two Key Signs

It’s normal for children and teens to have unhappy days and even an occasional emotionally down week. But when feelings of sadness persist and interfere with life’s activities — with friendships, schoolwork, sports and family life — you should reach out to your child’s primary care provider to find out if your child may be suffering from depression.

Jennifer Keller, DNP, MSN, CPNP, PMHS, a nurse practitioner with expertise in mental health at CHOP’s Primary Care location in Flourtown, PA, explains how to recognize the signs of depression in your child and how to seek help.

Signs of depression

“The difference between normal downs and depression is a matter of degree,” says Keller. “It’s in how long the emotional lows continue and in your teen’s ability to cope.” With ordinary mood fluctuations, teens bounce back within a few hours or a few days. With depression, feelings of sadness can spiral downward into a sense of hopelessness or impossibility, beyond the point where kids can pull themselves back up without help.

Different children experience depression in different ways. Keller lists two key signs to look for:

• Feelings of sadness, frustration or irritability that last for two weeks or longer
• Loss of interest in the activities your child normally enjoys

Other symptoms of depression can include:

• Difficulty concentrating
• A drop in school performance or lower grades
• Feeling helpless or hopeless
• Feeling worthless or inadequate, low self-esteem
• Feeling excessive guilt or shame
• Giving up on efforts perceived as impossible
• Withdrawal from friends and family
• Problems with social relationships
• Low energy
• Changes in appetite or weight
• Changes in sleep patterns, either difficulty sleeping or sleeping too much
• Thoughts of wishing to be dead
• Thoughts of suicide or of harming others

What you can do to help your child

As a parent, you can help by paying attention to your child’s emotional state. All teens can withdraw from their parents at times, but this tendency may be more extreme when a child is depressed. Make an effort to connect with your child, to ask how they are doing and how they are feeling so you notice when there are changes. Even if you have trouble talking with your child, you can observe their behavior.

If you think your child may be depressed, reach out to your child’s primary care provider. The provider will talk with your child to assess the severity of the situation. For some children and teens, talking to an unbiased professional can help get to the root of the issue and offer a solution. A few such conversations may be all that’s needed to improve the situation. If the concerns and symptoms are beyond the help of these initial conversations, teens may need regular therapy sessions or treatment with an anti-depressant medication. Your child's primary care provider can connect you to those resources and services.

If your child talks about self-harm or harming others, be sure to mention this when you contact your primary care provider. Thoughts of harming oneself or others will require a more urgent response.

It's important not to ignore or discount your child’s persistent sadness as something they can deal with on their own or something they will just "get over."

“Depression is a medical condition,” Keller says. “I would never tell a parent to ‘brush off’ their child’s diabetes. In the same way, parents should take depression seriously and seek appropriate support for their child.

"Quick, timely intervention and support are key to successfully treating depression.”