How to spot the signs that your child is depressed

What causes depression in children?

It is often believed that young people cannot have depression. Signs of depression in children are frequently dismissed as normal emotional and psychological developments as they get older. However, depression in children is possible and they can experience forms of sadness and worry that differ from their everyday troubles.

Rachel Melville-Thomas, child and adolescent psychotherapist and spokesperson for the Association of Child Psychotherapists (ACP), says it is often thought children are "too young" to be depressed. Particularly in teenagers or high-schoolers, signs of depression are seen as "typical teenager" mood swings and the effect of hormones.

But, she states that depression in children and teenagers can be caused by a combination of factors. These can include:

• Loss.
• Stressful school experiences.
• Early years' hopelessness due to attachment problems in the family.
• Witnessing, or being a victim of, violence.
• Sexual abuse.
• Low self-esteem.
• Peer problems.
• Long-term bullying.

A child's depression could derive from one singular life event - such as their parent's' divorce or a family death - or a string of events, like bullying, academic struggles, and low self-esteem.

"Inherited tendencies to depression also play a significant part," Melville-Thomas says, since mental illness tends to run in families.

It is thought that 280 million people in the world have depression, and genes as well as environmental factors and trauma can play a part with depression in children. Some studies have indicated that someone whose parent, sibling, or child is diagnosed with depression could be three times more likely to be diagnosed with depression in their own life, compared to the general population.

Signs of depression in children

There are many ways that depression in children and young people can present itself. These include:

• Continued sadness.
• Listlessness and not enjoying things they previously liked (for a minimum period of two weeks).
• Being indecisive.
• Feeling tired all the time.
• Irritability or unexplained grumpiness.
• Being less interactive with family members.
• Lacking in confidence.
• Fluctuations in weight (gaining or losing).
• Being unable to relax and feeling on edge.
• Talking negatively about themselves.
• Having ideations about self-harm or suicide (or actually attempting these things).

"Parents need to look carefully beyond the appearance of a child simply being 'fed-up' to recognise if their mood is really flat, with negative comments like, 'Nothing goes right for me,' 'I don’t have any friends,' or 'I wish I wasn’t here'," adds Melville-Thomas.

She says parents might notice a variety of depressive symptoms in their child - such as becoming withdrawn and silent, crying uncontrollably, and becoming aggressive. In adolescents, there's an increased chance of risky behaviour and engaging in drinking alcohol or taking drugs.

"Younger children may also show their low mood by reporting physical symptoms such as headaches, tummy aches, or sleep and/or eating disruption."

Depression in children - what should your first steps be?

It's understandable why parents or guardians might approach symptoms of depression in their child with panic and worry. However, you should try to take a gentle, supportive approach that is inquisitive and genuinely caring, rather than invasive or angry.

You can do this by not placing all the focus on "cheering them up", but rather encouraging them to open up about how they're feeling.

"Talk to your child without judgement. Encouraging them simply to 'think positive' often doesn't work against the neurochemical changes in their brain that drive depression," says Melville-Thomas.

Therefore, listening is just as important as talking, if not more so. This gives you an insight into what they are going through, and a different perspective on situations you didn't question at the time. Listening to how your child describes their feelings also offers a view of how they see the world around them, which is particularly helpful if they are very young. Children do not see things with adult mindsets, so it might take your child describing a situation to you for you to see it from their point of view.

"Be there for your child and remind them that you are trying to understand their experiences. If your concerns continue, consult your GP for guidance about the next steps and referrals for therapy."

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How to treat depression in children

Acknowledging symptoms of depression in your child and intervening early are key to addressing the problem before it escalates. There are various forms of treatment available to encourage your child to be open about what is making them depressed.

If a young child is diagnosed with depression (below 12 years of age), they can be treated through various forms of talking or playing therapy as well as cognitive behavioural therapy, where their feelings can be further heard and understood. This might come from play therapists, child psychotherapists or psychologists.

The British Association of Play Therapists defines play therapy as a means of "helping children understand muddled feelings and upsetting events that they haven't had the chance to sort out properly".

Rather than forcing them to talk, play therapy encourages children to use play to communicate at their own level and at their own pace, without feeling questioned or threatened.

Melville-Thomas adds that older children and teenagers can also respond to talking therapies. These might include cognitive behavioural therapy (CBT), during which the link between thoughts and feelings is examined.

She says that in her opinion the best combination for adolescents tends to be talking therapy plus antidepressant medication. Antidepressants are very rarely prescribed by GPs for young people. Instead, they should be monitored by Child and Adolescent Mental Health Services (CAMHS), although GPs may issue follow-up prescriptions in partnership with CAMHS. Research shows that all of these approaches work best when parents are very involved and engaged in the support that is being offered.

Finding support

If you suspect your child is showing symptoms of depression, seek a medical diagnosis to ensure appropriate treatment is given. A clear diagnosis can be available through your local NHS services (CAMHS). However, there may be waiting lists involved, so parents can find immediate help and support through various organisations such as:

• Young Minds.
• Anna Freud Centre.
• Action For Children.
• Campaign Against Living Miserably (CALM).
• Childline.
• FRANK.
• Hope Again.
• Association of Child Psychotherapists.

The Charlie Waller Trust's PLACE network also offers parent peer support.