It is common for children and adolescents to feel sad every now and again, or to be more moody or argumentative with their parents. However, when the low or irritable mood becomes overwhelming, grades are dropping, they are sleeping too much or too little, withdrawing from friends, and/or this persists for a prolonged period of time, they could be experiencing depression.
Childhood depression is more common than many people believe - more than one in seven teens experience depression each year. For years people actually believed that teens could not get depressed. What we know now is that teens present with irritability and anger rather than sad mood. Suicidal ideation is perhaps the most severe symptom of childhood depression, with suicide being one of the leading causes of death in 10-24 year olds.
Signs your child or adolescent may have depression include:
Losing interest in things they used to enjoy
Difficulty with concentration
Changes in their usual sleeping patterns
Being less sociable; withdrawing into themselves
Changes in their mood, such as being more irritable or sad
Having negative thoughts about themselves; that they are no good or nobody cares about them
Feelings of emptiness or numbness
The way that childhood depression is diagnosed depends on the specific type of depression that a child or adolescent is experiencing.
Major depressive disorder in children is diagnosed when at least 5 depressive symptoms are present, which range from mild, to moderate, to severe.
Disruptive mood dysregulation disorder is characterized by severe temper tantrums and emotional outbursts that aren’t normal for the child’s age. Diagnosis requires that there has been a disturbance in mood present for at least a year, and that the child is aged between 6 and 17.
A child may be diagnosed with persistent depressive disorder if they have experienced a chronic low or irritable mood for at least one year, alongside two or more additional depressive symptoms.
Childhood depression may be caused by a number of different factors, which can often act in combination to heighten the severity of the depressive symptoms:
Life events, in particular stressful experiences
Biological factors, such as chemical imbalances
Treatment-resistant depression (TRD) in children is actually very common. 30-40% of children remain depressed after their initial treatment, half of which continue to experience depression even after switching medications or trying other types of treatment.
However, TRD is often misdiagnosed. This can be as a result of several factors, such as the wrong dosage or stopping the treatment too soon. Often it is not the case that an individual is treatment resistant, they just haven’t found the right treatment yet.
If your child/adolescent has not fully responded to depression treatment, you may wish to consider an integrative approach to treatment. This can include therapy and dietary interventions.
Therapy for childhood and adolescent depression often takes the form of cognitive-behavioral therapy (CBT) or interpersonal psychotherapy (IPT).
CBT is aimed at identifying negative thoughts and providing strategies to replace them with more helpful ones. CBT aims to provide children and adolescents with the skills needed to maintain positive relationships and manage their emotions.
IPT approaches childhood depression from the angle of interpersonal relationships, and considers the connection between social difficulties and depressive symptoms. IPT focuses on how a child/adolescent’s mood can be impacted by four areas of interpersonal difficulty:
The goal of IPT is to help your child or adolescent develop more beneficial interpersonal skills, and to highlight the reciprocal link between interpersonal events and their own mood.
The quality of a child/adolescent’s diet can play an important role in their experience of depression. Making dietary changes can help to alleviate the symptoms of depression.
Diets lacking in macro- and micronutrients such as omega-3, magnesium, and vitamins B12 and D negatively impact the gut-brain axis and can lead to an increased risk of depression. As mentioned above, the gut is responsible for producing around 95% of the body’s supply of serotonin, a crucial neurochemical for mood stabilization and anxiety regulation.