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Depression in Children: How Young Can It Start?

Depression is estimated to affect 16 million adults in the U.S., but it doesn’t affect only adults, which may be an easy fact to forget since depression in adults gets a lot of attention.

According to the U.S. Centers for Disease Control (CDC), depression can start in children as young as age 3. The data it shares says 3.2% of children aged 3-17 years (about 1.9 million) have diagnosed depression, and 7.1% of children aged 3-17 years (about 4.4 million) have diagnosed anxiety. Children can have both at the same time.

What Does Depression in Children Look Like?

Medical sources, such as the CDC and Cleveland Clinic, say children will experience sadness from time to time and experience life’s highs and lows, just as adults do. However, if the “blues” last for a prolonged period, then depression could be possible. Clinical depression is a more serious form of depression known as major depressive disorder (MDD), as Mayo Clinic explains. 

“Clinical depression can affect people of any age, including children,” it says.

The CDC says a child struggling with depression may exhibit symptoms such as:

  • Appetite changes (eating more or less than usual)
  • Sleep schedule changes (sleeping more less than usual)
  • Noticeable energy changes (bursts of energy one minute followed by tiredness)
  • Constant feelings of sadness, hopelessness, or irritability much of the time
  • Loss of interest in enjoyable activities
  • Increased social isolation or withdrawal from others
  • Decline in school performance
  • Complaints about physical aches and ailments (stomachaches, headaches)
  • Inattention issues
  • Feelings of worthlessness, guilt
  • Engaging in self-harming behavior or self-destructive behavior
  • Suicidal thoughts or behaviors

Depression in children can affect their relationships with family members and their ability to socialize with others and make friends. Their schoolwork can be affected, as well.

Your child may have other symptoms of depression not listed here. You can consult your doctor to find out if any signs or behavior you have monitored in your child could mean they are struggling with depression.

If you suspect depression is a problem, you want to consider getting professional help for your child as soon as you can. Depression can impair a child’s ability to function, and leaving the mental health condition untreated could bring a host of problems down the line.

Suicide, unfortunately, is one of them. The American Academy of Child & Adolescent Psychiatry shares that suicide is the second leading cause of death for children, adolescents, and young adults between the ages of 15 and 24. Those who attempt suicide usually suffer from severe depression, the academy reports.

Depression Can Be Symptom of Other Conditions

Depression is a disorder on its own, but it can also be a symptom of other mental health disorders and medical conditions, such as:

  • Persistent depressive disorder (PPD; also known as dysthymia)
  • Bipolar disorder
  • Substance abuse (withdrawal)

MedicineNet says PPD can last at least a year in children. It can co-occur with anxiety, MDD, and substance abuse. People with bipolar disorder can also struggle with depressive episodes that can lead to a misdiagnosis of their condition. This is one reason why getting a professional mental health professional to help determine the cause of one’s depression is critical to them getting the help they need.

There are different kinds of bipolar disorder, as well, further complicating the task of determining if a child has bipolar or a depressive disorder, or possibly even both. Healthline gives a quick overview of the differences between bipolar disorder 1 and bipolar disorder 2. 

In bipolar disorder 1, there are more than one bouts of depression and one manic episode, and a person with it can go back-and-forth between depression and mania. In bipolar 2, a person has at least one bout of depression and hypomania, a milder form of mania.

If your child’s depression is linked to substances they are or were using, you may want to consider a dual diagnosis treatment program that addresses their substance use disorder and mental health disorder at the same time. Treatment of this kind can give your child the tools needed to manage both daily.

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Getting Treatment for Depression for Your Child

Children with depression can be treated with psychotherapy and medications or a combination of both. If you think your child could benefit from these treatment approaches, Cleveland Clinic advises first talking with a pediatrician who could refer you to a mental health professional who could perform a thorough assessment of your child’s needs.

The pediatrician or family doctor would likely check for physical ailments that could be causing your child’s depression, such as anemia, diabetes, hypothyroidism, and other conditions. 

Cleveland Clinic advises that there are no tests available to diagnose depression. However, information from your child’s instructors, friends, and family members can help inform professionals about your child’s condition and behaviors.

If it is determined that your child is struggling with depression, they could be prescribed cognitive behavioral therapy (CBT), a form of psychotherapy that helps children to replace negative thoughts with positive ones so that positive behavior follows. Children will also learn how to manage their anxieties and fears, keeping them in perspective.

Your child may also receive prescription medication, such as an antidepressant, for their depression. According to Cleveland Clinic, selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressant medications for children. Antidepressant medications are designed to correct chemical imbalances in the brain, which can take up to four weeks to happen.

A paper cutout of a depressed child

The clinic advises exercising caution when giving children these drugs. Antidepressants are not considered addictive, but according to the clinic, some children do not show gains when taking these medicines, while others may feel more depressed after using them. 

If you notice that your child is acting differently after taking antidepressant medication, call your doctor immediately, but do not abruptly stop your child’s use. If you do, your child’s depression could worsen. 

They could also experience severe side effects that are akin to having the flu, which includes nausea, headaches, sweating, vomiting, and diarrhea. They also could experience nightmares and other disturbing mental images. This condition is known as antidepressant discontinuation syndrome

Your doctor should make a tapering plan for your child to ensure they are weaned off the drugs safely.

How to Help Your Child Manage Depression

Living with depression requires actively managing it so that you can cope in healthy ways. You can help your child create a plan that empowers them to manage their mental health daily. 

This could include making sure they get the proper amount of rest, eat healthy foods with vitamins and minerals they need, and stay active in their surroundings. A nature walk outdoors or exercise can help improve their mood. Encouraging low-stress activities can also benefit one’s mood. 

Help your child identify hobbies and interests they enjoy or ones that allow them to express their creativity. Find ones that encourage them to spend time with others as well as time alone. Having positive interactions with people they trust can help improve their mood and keep the blues at bay.

The American Academy of Pediatrics advises parents to create one-on-one time with their children and praise them for good behavior. Strengthening the parent-child bond is critical at a time when a child is undergoing emotional turmoil. Be an anchor as much as you can. Finding the right balance is the key to optimal health and wellness.

Sources

ADAA. (n.d.). Facts & Statistics. Retrieved from https://adaa.org/about-adaa/press-room/facts-statistics

Anxiety and depression in children: Get the facts. (2020, December 02). Retrieved from https://www.cdc.gov/childrensmentalhealth/features/anxiety-depression-children.html

Daniel K. Hall-Flavin, M. (2017, May 13). Severe, persistent depression. Retrieved from https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/clinical-depression/faq-20057770

American Academy of Child & Adolescent Psychiatry (AACAP). (n.d.). “Suicide in Children and Teens.” Retrieved from https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Teen-Suicide-010.aspx?WebsiteKey=a2785385-0ccf-4047-b76a-64b4094ae07f

Roxanne Dryden-Edwards, M. (2018, August 10). Persistent Depressive Disorder Treatment, Tests & Causes. Retrieved from https://www.medicinenet.com/dysthymia/article.htm

Healthline. (2018, January 18) Everything You Need to Know About Bipolar Disorder. Types of bipolar disorder. Nicholls, E. Holland, K. Retrieved from https://www.healthline.com/health/bipolar-disorder

Cleveland Clinic. Health Essentials. (2020, September 15) When to Get Help for Your Child’s School Anxiety. Retrieved from https://health.clevelandclinic.org/when-to-get-help-for-school-anxiety/

Holland, K. (2020, May 11). The Dangers of Abruptly Stopping Antidepressants. Retrieved from https://www.healthline.com/health/depression/dangers-of-stopping-antidepressants

Adolescent Depression: What Parents Can Do To Help. (n.d.). Retrieved from https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Childhood-Depression-What-Parents-Can-Do-To-Help.aspx

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