I Think My Child Is Depressed. What Should I Do?

By Child Mind Institute, Understood Founding Partner

I think my child is depressed. She’s irritable and is sleeping a lot. What should I do?

There’s a lot of truth to the old saying, “a parent is only as happy as her unhappiest child.” So what can you do if you suspect that your daughter is having emotional difficulties?

The first step is to begin by talking to her. Find out what’s happening in her life. This is not the time to take “no” or “leave me alone” as an answer from your kid. Her well-being is your primary consideration.

If she won’t tell you herself, make an appointment to speak with her teacher. You need to find out whether your child is upset over a particular event. Has she experienced bullying at school, a fight with a close friend or some disturbing experience she may be keeping a secret?

Regardless of the root cause, if your child has been oversleeping and irritable every day for more than two or three weeks—unable to “bounce back” from the setback in her life—you should consider what other symptoms of depression she might have and seek treatment.

Symptoms of Depression in Younger Children

Depression begins to rear its ugly head in school-age kids at the rate of about 2 percent, or one child for every two classrooms. Signs and symptoms of depression in children include:

  • Irritability or anger
  • Feelings of sadness and hopelessness that don’t get better over time
  • Social withdrawal
  • Feeling easily rejected
  • Changes in appetite—either increased or decreased
  • Sleeping a lot less or a lot more
  • Frequent bouts of yelling or crying
  • Low energy over several weeks
  • Physical complaints (such as stomachaches or headaches) that don’t get better with treatment
  • Trouble functioning the way she normally does at home or with friends, in school, during extracurricular activities, and in other hobbies or interests
  • Feeling worthless or guilty
  • Trouble with concentration
  • Talking or thinking about death or suicide

Depression in Adolescents

Figuring out the difference between depression and normal teen angst can be tricky. A certain amount of moodiness and irritability is normal for teens.

Big changes are going on in your teenager’s brain. Often her emotions are more powerful than her ability to regulate them. On top of that, she is dealing with puberty, facing more responsibilities at school, and trying to be more independent from you. It’s a lot to handle!

It also puts teens at risk for true depression. The number of kids who have it rises steeply to about 9 percent in adolescence. When your teenager experiences symptoms that last most of the day, every day for several weeks, you should have her evaluated for depression.

If your daughter talks about suicide or wanting to harm herself, don’t wait. Call your pediatrician right away and be upfront about how concerned you are. (If you think she is at immediate risk of harming herself, call 911.) Depression is very treatable but early treatment is key. Studies show that untreated depression puts a child at higher risk for more depressive episodes in the future.

Symptoms of Adolescent Depression

  • Loss of interest in hobbies and activities that used to give her pleasure
  • Withdrawal from friends and family
  • Changes in appetite
  • Changes in sleep
  • Irritability or sadness
  • Change in academic performance

What Are the Risk Factors?

  • Being a girl: Boys and girls are equally affected in pre-adolescence. But after puberty, twice as many girls have depression. Also, girls are more likely to stay depressed longer. And a girl who goes through puberty at 10 is more likely to get depressed than a girl who matures at 13.
  • Genetics: Having a family member, especially a parent with depression or other mental illness.
  • Temperament: This is the “hard-wiring” your kid is born with. If she has always been the “glass is half-empty” type, she is more likely to be prone to negativity and to experiencing depression, particularly in adolescence.

Where to Go for Help

Start with your pediatrician or a school guidance counselor. Either one should be able to refer you to a clinician who specializes in child and adolescent depression. According to the current federal law, your insurance carrier is required to treat serious mental health care issues the same way it treats medical issues.

What Are the Best Treatment Options?

There are several kinds of behavioral therapy and medications that are effective for depression.

  • Cognitive behavioral therapy (CBT) is based on the idea that depressed kids tend to evaluate themselves negatively, interpret the actions of others in a negative way, and assume the worst. If she walks by another student laughing in the hall, for instance, she assumes he is laughing at her, rather than at a joke he just heard. In CBT, a psychologist works with your child to challenge negative thoughts like those, to recognize the pattern and train herself to think outside it. In many cases, particularly with teenagers, this treatment is very successful.
  • Interpersonal therapy (IPT) is based on the idea that what keeps us happy is our interpersonal relationships with friends and family. In IPT, the therapist focuses helping kids relate to their friends and family in ways that make them healthier and happier. That might involve encouraging a teen to ask for help even though she doesn’t want to feel dependent on her parents.
  • Medication such as antidepressants may be used if the depression is moderate to severe. For more serious depression, a combination of psychotherapy and medication usually works better than either alone.

What If My Child Refuses Treatment?

It’s common for adolescents to avoid treatment because it’s an acknowledgment that something’s wrong. Kids this age desperately want to be “normal,” not different from their peers. Talking about painful feelings can seem like a violation. “They would rather pretend that nothing’s wrong,” says Alan Ravitz, a child and adolescent psychiatrist at the Child Mind Institute. “It’s very hard to drag an unwilling teen into therapy and even less likely that it will be successful.”

If you find yourself in this situation, Dr. Ravitz recommends beginning with family therapy. “This is a good route into therapy for teens,” he says, “because a lot of times they identify their emotional problems with their life situation—she might say, ‘I’m not depressed, I just hate my family.’” It’s also extremely important to find a therapist your daughter likes and trusts. A good fit between patient and doctor means success is more likely.

About the Author

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Child Mind Institute, Understood Founding Partner is dedicated to transforming mental health care for children everywhere.

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