Children, like adults, can experience a range of emotions. However, extended periods of feeling sad or hopeless may indicate that a child is experiencing depression. Although depression is usually not considered life-threatening, it can lead to thoughts of and attempts at suicide. Pediatric psychiatrist Leslie Miller, M.D., explains important things to know about depression in children.

What Is Childhood Depression?

Depression is a mood disorder that affects children, like adults, and is characterized by a persistent sad or empty feeling and/or a loss of interest in everyday activities. Depression can occur in a child at any age. Unlike normal sadness or grieving, most bouts of depression last for weeks, months or even years.

What Are Signs of Depression in Children?

The symptoms of depression in children may include:

• Regular feelings of sadness or hopelessness lasting more than two weeks
• Loss of interest in daily activities they previously enjoyed
• Loss of appetite, leading to weight loss, or increased appetite, leading to weight gain
• Difficulty falling or staying asleep or an increased need for sleep
• Lack of concentration
• Behavior changes at home or school (e.g., decline in academic functioning, decrease in motivation, increase in arguments)
• General tiredness and low energy

Diagnosis of Depression in Children

Because there are no reliable laboratory tests to diagnose depression, mental health evaluations are essential. Talking to a child’s pediatrician can be the first step toward getting a diagnosis of depression.

A pediatrician can recommend a mental health professional who can help. They may also be able to determine whether the child is suffering from another condition that has symptoms similar to depression, such as low thyroid hormone or anemia.   

In general, a pediatrician will look for feelings of sadness and hopelessness, as well as a lack of interest in daily activities, in conjunction with other symptoms, for a period of two or more consecutive weeks.

A smaller number of children and adolescents may be diagnosed with bipolar disorder, which includes both episodes of depression and episodes of mania (elevated mood and energy).

Anxiety and Depression in Children

Often, children with depression may also be diagnosed with an anxiety disorder. Anxiety is a mental health condition that causes a child to feel panicky or fearful when going through everyday activities. Some anxiety or sad mood can be a normal part of growing up, but it is important to intervene if your child’s mental health is interfering with their day-to-day life. 

Can Children’s Depression Lead to Suicide?

In more severe cases, depression may lead a teen or child to consider or plan for suicide. According to the Centers for Disease Control and Prevention, suicide is the second leading cause of death for children between the ages of 10 and 14, and the third leading cause of death in children ages 15–18.

Parents who are concerned for their child’s mental state should watch for:

• Talking about or focusing on death or dying
• Talking of hopelessness or suicide
• Social isolation from friends or family
• Stopping activities they previously enjoyed
• Giving away favorite possessions
• Increased risk-taking
• Engaging in self-harming behaviors

Treatment for Depression in Children

Just as depression varies from person to person, treatment also varies. It may involve:

• Psychotherapy: In mild cases, therapy is as effective as drug treatment. Psychotherapy may also be used in conjunction with medication therapy for moderate or severe cases of depression.
• Antidepressant medications: Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) are considered first-line medication choices.