An Overview of Depressive Disorders in Children


An Overview of Depressive Disorders in Children

A mood disorder is a class of serious mental illnesses. The term broadly describes all types of depression and bipolar disorders.

Children, teens, and adults can all have mood disorders. But children and teens don’t always have the same symptoms as adults. It’s harder to diagnose mood disorders in children. That's because they can't always express how they feel.

Therapy, medicines, and support and self-care can help treat mood disorders.

What are the different types of mood disorders?

These are the most common types of mood disorders:

  • Major depression. Having less interest in normal activities, feeling sad or hopeless, and other symptoms for at least 2 weeks may mean depression.
  • Dysthymia. This is an ongoing (chronic), low-grade, depressed, or irritable mood that lasts for at least 2 years.
  • Bipolar disorder. With this condition a person has times of depression alternating with times of mania or a higher mood.
  • Mood disorder linked to another health condition. Many health conditions (including cancer, injuries, infections, and chronic illnesses) can trigger symptoms of depression.
  • Substance-induced mood disorder.Symptoms of depression that are due to the effects of medicine, drug abuse, alcoholism, exposure to toxins, or other forms of treatment.

Many factors help lead to mood disorders. They are ly caused by an imbalance of brain chemicals. Life events (such as stressful life changes) may also help lead to a depressed mood. Mood disorders also tend to run in families.

Anyone can feel sad or depressed at times. But mood disorders are more intense and last longer. They are also harder to manage than normal feelings of sadness.

Children, teens, or adults who have a parent with a mood disorder have a greater chance of also having a mood disorder. But life events and stress can expose or worsen feelings of sadness or depression.

This makes the feelings harder to manage.

Sometimes life's problems can trigger depression. Things such as being fired from a job, getting divorced, losing a loved one, having a death in the family, and financial trouble, all can be difficult. Coping with the pressure may be troublesome. These life events and stress can bring on feelings of sadness or depression. Or they can make a mood disorder harder to manage.

The risk of depression in women is nearly twice as high as it is for men. Once a person in the family has this diagnosis, their siblings and their children have a higher chance of the same diagnosis.

Depending on age and the type of mood disorder, a person may have different symptoms when they become depressed. The following are the most common symptoms of a mood disorder:

  • Ongoing sad, anxious, or “empty” mood
  • Feeling hopeless or helpless
  • Having low self-esteem
  • Feeling inadequate or worthless
  • Excessive guilt
  • Not interested in normal activities or activities that were once enjoyed, including sex
  • Relationship problems
  • Trouble sleeping or sleeping too much
  • Changes in appetite or weight
  • Decreased energy
  • Trouble focusing
  • Less able to make decisions
  • Frequent physical complaints (for example, headache, stomachache, or tiredness) that don’t get better with treatment
  • Running away or threats of running away from home
  • Very sensitive to failure or rejection
  • Irritability, hostility, or aggression
  • Repeated thoughts of death or suicide, planning for death, or wishing to die

In mood disorders, these feelings are more intense than what a person may normally feel from time to time. It’s also of concern if these feelings continue over time. Or if they interfere with someone's interest in family, friends, community, or work.

Any person who has thoughts of suicide should get medical help right away. If you can't get in immediately to your primary care provider, go to a reputable mental health facility in your community. Don't put it off.

The symptoms of mood disorders may seem other conditions or mental health problems. Always talk with a healthcare provider for a diagnosis.

When suicide is a risk

Mood disorders can cause repeated thoughts of death or suicide, planning for death, or wishing to die. People with these symptoms should get treatment right away.

Call 911 if a person has suicidal thoughts, a suicide plan, and the means to carry out the plan. Don't leave the person alone, even for a moment.

Call the National Suicide Prevention Lifeline at 800-273-8255.

Mood disorders are serious illnesses. A psychiatrist or other mental health provider often diagnoses mood disorders with a complete health history and psychiatric evaluation.

Mood disorders can often be treated with success. Treatment may include:

  • Antidepressant and mood-stabilizing medicines.These medicines work very well in treating mood disorders, especially when combined with psychotherapy.
  • Psychotherapy (most often cognitive-behavioral or interpersonal therapy). This kind of therapy is focused on changing the person’s distorted view of themselves and their environment. It also helps to improve relationship skills. And it can help the person find stressors in the environment and learn how to stay away from them.
  • Family therapy. A mood disorder can affect all aspects of a family (emotional, physical, and financial). Professional support can help both the person with the diagnosis and family members.
  • Other therapies. These may include electroconvulsive therapy and transcranial stimulation.

Families play a vital supportive role in any treatment process.

Someone with a mood disorder may have times of stability and times when symptoms return. Long-term, continuous treatment can help the person stay healthy and control symptoms.

When correctly diagnosed and treated, people with mood disorders can live, stable, productive, healthy lives.

At this time, there are no ways to prevent or reduce mood disorders. But early diagnosis and treatment can reduce the severity of symptoms. It can also enhance the person’s normal growth and development, and improve their quality of life.

Key points about mood disorders

  • A mood disorder is a class of serious mental illnesses. The term broadly describes all types of depression and bipolar disorders.
  • Children, teens, and adults can all have mood disorders.
  • Many factors help lead to mood disorders. They are ly caused by an imbalance of brain chemicals.
  • Most people with a mood disorder have ongoing feelings of sadness. They may feel helpless and hopeless.
  • Without treatment, symptoms can last for weeks, months, or years. They can affect quality of life.
  • Mood disorders are most often treated with medicine, psychotherapy or cognitive behavioral therapy, family therapy, or a combination of medicine and therapy.
  • Long-term, comprehensive follow-up care will help ensure the support needed for a full, productive life.

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Medical Reviewer: Paul Ballas MD

Medical Reviewer: Marianne Fraser MSN RN

Medical Reviewer: L Renee Watson MSN RN

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.


Depression in Children: Symptoms, Suicide Signs & Treatment

An Overview of Depressive Disorders in Children

Depression is a mood disorder that can cause someone to feel sad, irritable or hopeless. It may affect your sleep, appetite or relationships with others. Depression can also cause you to lose interest in hobbies or activities you once enjoyed. In severe cases, depression can lead to thoughts of suicide.

Depression is typically diagnosed if symptoms last two weeks or longer. It should only get evaluated, diagnosed and treated by a healthcare provider. Although depression is a serious medical condition, it’s usually treatable.

Does depression affect children?

Depression can affect people of any age, including children. Although children naturally have mood swings as they grow and develop, depression is different. The disorder can affect how children interact with friends and family. It may prevent them from enjoying school, sports, hobbies or other normal childhood activities.

In children, depression and anxiety often go hand in hand. Anxiety is a medical condition that causes feelings of fear, panic or worry about everyday situations. Sometimes, depression or anxiety in children gets chalked up to “growing pains.” But if you have any concerns about behavioral or mental health, talk to a healthcare provider.

How common is childhood depression and anxiety?

Depression and anxiety are among the most common mental health disorders in children. About 7% of children ages 3 to 17 have anxiety; about 3% deal with depression.

Both depression and anxiety tend to be higher in older children and teenagers between the ages of 12 and 17. An estimated 3.2 million adolescents aged 12 to 17 in the United States had at least one major depressive episode. This number represented 13.3% of the U.S. population aged 12 to 17. An estimated 31.9% of adolescents have had an anxiety disorder.

Depression and anxiety in children can have many causes, including:

  • Alcohol or drug use.
  • Environment (including family problems).
  • Family history (others in the family have depression).
  • Physical illness.
  • Stressful life events.

What are the signs of depression in children?

Parents should look out for the following signs of depression in children:

  • Behavioral problems at school.
  • Changes in eating or sleeping habits.
  • Feelings of sadness or hopelessness.
  • Lack of interest in fun activities.
  • Low energy levels or general tiredness.
  • Mood changes, such as irritability.

What are the signs of anxiety in children?

Signs of anxiety in children may include:

  • Anxiety about the future.
  • Fear of being away from a parent.
  • Physical symptoms of panic, such as sweating or dizziness.
  • Refusal to go to school or take part in social activities.
  • Worry that a parent or loved one may die.

Should I worry that my child will commit suicide?

National surveys from the government show the overall risk. In 2019, for example, nearly 9% of high school students attempted suicide at least once over the course of a year. Thinking about suicide also continued to rise from previous years . Although less common, young children do attempt suicide as well.

Watch your child closely for the warning signs of suicidal behavior, including:

  • Focus on death and dying.
  • Giving away possessions.
  • Increased risk-taking.
  • Self-destructive behavior or self-harm.
  • Social isolation.
  • Talk of suicide or hopelessness.

If you think your child is showing signs of depression or anxiety, talk to a healthcare provider. Start with your child’s pediatrician. Your pediatrician may refer you to a mental health professional for a more detailed evaluation.

A healthcare provider will ly start by ruling out conditions that may be causing your child’s mood issues. Illnesses known to cause symptoms of depression include:

There are no tests to diagnose depression. A mental health evaluation should include interviews with you (the parents) and your child. Information from teachers, friends and classmates can also shed light on your child’s mood and behavior changes.

Treatment options for children with depression are those for adults. Your child’s healthcare provider may recommend:

  • Psychotherapy (counseling).
  • Medication.
  • Combination of the two.

How does psychotherapy work?

Cognitive-behavioral therapy (CBT) is a form of psychotherapy that can treat anxiety or depression in children. CBT helps children learn to think more positively and control negative behaviors. It can also help children manage anxiety by getting to the root of their fears and worries. Therapy gives children tools to cope with anxiety and depression in healthier ways.

How do antidepressants work?

The most common antidepressant medications for children are selective serotonin reuptake inhibitors (SSRIs). These medications increase the level of serotonin in the brain. Serotonin is a chemical that can help increase feelings of happiness and well-being.

Use extra caution with antidepressants in children. Some children show no improvement with the medications, or may even feel more depressed. If a healthcare provider recommends antidepressants, watch your child’s condition closely. Never allow your child to stop taking antidepressants suddenly. Doing so can cause serious side effects or make depression worse.

Depression can result from certain situations in life or may have a biological cause. As a parent, you can’t always control the stressors in your child’s life. But you can help improve your child’s mental health by ensuring they get:

  • Daily exercise.
  • Safe, supportive environment at home and school.
  • Plenty of sleep.
  • Well-balanced meals.

Every child is different. Some children may outgrow depression or anxiety. Others may need to manage these conditions for the rest of their lives. You can help your child now by making sure they get a proper diagnosis and the right treatment.

Call a healthcare provider if your child has any signs of depression or anxiety. If your child is showing signs of suicide, get help right away. You can call the National Suicide Prevention Lifeline at 800.273.8255.

This hotline connects you to a national network of local crisis centers for free and confidential emotional support. The centers support people in suicidal crisis or emotional distress 24 hours a day, 7 days a week.

In an emergency, call 911.

A note from Cleveland Clinic

While it may be difficult to watch your child dealing with depression or anxiety, help is available. The right treatment can ensure your child continues to grow and thrive throughout their development.

In addition to medical help, you can support your child by making sure they have a healthy environment at home, at school and in the community.

Always let your child know they can communicate openly and honestly about their feelings.

Last reviewed by a Cleveland Clinic medical professional on 11/17/2020.



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