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Depression in Children: Signs, Symptoms and How to Help

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Depression in Children: Signs, Symptoms and How to Help

Childhood is often considered a carefree, happy time for kids as they grow, learn and become independent. However, it can be a confusing time, leading some kids to feel anxious or depressed. UnityPoint Health Mental Health Counselor, Roxanne Fevold, LMHC, CADC, CFLE, explains the signs and symptoms of childhood and teen depression and anxiety and how parents can help.

Signs & Symptoms of Depression in Children

Depression is typically thought of as someone who appears sad and withdrawn but that is not always the case. Fevold says depression is more than a day or two of feeling sad, down or “off.” She describes the signs and symptoms of depression in children as:

  • Loss of enjoyment and interests in activities that used to be enjoyable
  • Lack of energy or persistent tiredness (child complaining of being tired even if they are sleeping more than usual)
  • Sleep difficulties
  • Increased irritation toward family members, teachers and other students or friends>
  • Changes in eating habits
  • Changes in grades (not doing homework)

“Any combination of depression symptoms would be present for more than a two-week period,” Fevold says. “Younger children may also show aggressive behaviors, be fearful of new people and challenges, show delays or regression in developmental milestones, such as reverting back to infancy behaviors like hitting, biting, spitting, bedwetting/incontinence.”

When looking at signs of depression, Fevold encourages parents to consider what’s “normal” for their child.

“We rely on parents and teachers to explain what is normal for the child, because a child does not always know what is normal for them. If a child starts behaving differently than he/she used to in one of these areas, it is something to discuss with your child’s primary care provider,” Fevold says.

Depression vs. Anxiety

Fevold says it can be tough to tell the difference between anxiety and depression in children without the help of a trained professional.

“Anxiety is described as globalized worry that persists. An individual worries about everything or has apprehension over what’s about to happen or what could happen in the future,” Fevold says.

Anxiety symptoms include:

  • Feelings of avoidance or a desire to run away from things to prevent more anxiety
  • Physical signs, such as fussing, fidgeting and sleeplessness
  • Not wanting to try anything new
  • Fear of separation

How Parents Can Help

Fevold says parents play an important role in helping their child get medical help, as well as being supportive. She recommends the following steps to parents, if they’ve noticed their child showing symptoms of depression or anxiety:

Medical Care

  • Schedule an evaluation to determine if there is depression or anxiety present, especially if there is non-suicidal injury present (cutting/pulling hair/banging head on the wall/punching legs). Therapy is a great first step to alleviate symptoms and gain the skills necessary to control anxiety and depression, instead of it controlling the child. A therapist can help to make additional recommendations for other treatment options.
  • Assess for risk of suicide or harm. If suicidal thoughts or behaviors are present, they need to be taken to the emergency department (ED) for immediate help. When in doubt, call 911.

Non-medical Care

  • Be patient and understanding. It is easy to be frustrated while your child experiences anxiety and depression.
  • Listen, non-judgmentally and adopt an attitude of acceptance by having validating responses to your child’s feelings, culture, values and experiences.
    • “A breakup with a significant other during this time is often seen as catastrophic event for an adolescent. Instead of using phrases like, ‘It will be okay,’ or ‘There are other people out there,’ offer a response from your own experience of going through a similar situation and what helped your copy during that time,” Fevold says.
  • Use effective communication skills, and set aside time with your child that is absent of distractions on a daily basis. 
  • Parents should be aware of their child’s screen time and have access to passwords for all devices and social media accounts. Screen time should be used with supervision, meaning no screens in bedrooms or behind closed doors.
  • Family meal time is shown to decrease the potential for high-risk activities and increase the willingness of children/adolescents to see their parents as approachable, safe and trusting.
  • Make sure to include outdoor activities. Exercise and vitamin D from the sun can be beneficial in preventing depression and anxiety symptoms.
  • Parents need to walk the walk. Talking about mental health can reduce the stigma of asking for help. 

Suicide Prevention in Children

Not everyone with a diagnosis of depression will have thoughts of suicide, but Fevold says it’s always necessary to be on the lookout for signs of suicidal thoughts, gestures and plans.

“From ages 7-8 to 18, children are trying to fit in, and it is easy to fit in with depression. Every single time a child has harmful thoughts, it is a cause to be concerned. Suicidal thoughts/gestures should not be assumed as just bids for attention. They are cries for help, and a child should be brought to the emergency room,” Fevold says.

Sadly, sometimes communities and schools experience suicide cases, which can be difficult for youth to cope. Fevold encourages parents to have open, honest conversations with their children.

“Talk to your child about how he/she is feeling based on the event. Don’t treat it like a secret or something that they should be ashamed to bring up,” Fevold says.

If you’re concerned your child is having suicidal thoughts or behaviors, call 911. The National Suicide Prevention Lifeline is another resource, 1-800-273-8255.

Contact your UnityPoint Health primary care provider, to discuss any depression or anxiety symptoms your child or teen experiences.