Depression in children
All children can experience temporary sadness, even intense sadness, and irritability. However, sometimes these emotions do not correspond to what is usually observed in children of the same age. Depression can be said to occur when a child experiences episodes of intense sadness that last for a long time. Only a health care professional can make a diagnosis of depression.
What is depression in children?
Depression is a mood disorder that affects about 3% of children between the ages of 3 and 17.
It most often appears around the age of 10 to 12. However, it can occur before this time, and in rare cases even in early childhood.
People with depression, including children, experience persistent feelings of sadness, helplessness, emptiness, hopelessness and worthlessness. They lose interest in life and enjoyment of daily life.
Depression affects the child’s thinking, mood and behaviour. Some children may also experience physical symptoms.
Depression must be diagnosed or confirmed by a doctor. When a medical diagnosis is made, it is called “major depression. Major depression can be classified as mild, moderate or severe. It is the doctor who assesses the severity of a depression. In all cases, it is more serious than a simple temporary depression.
Possible causes of depression in children
There are several causes that can lead to depression in a child. These causes can be grouped into one of three areas
the child’s temperament
the environment in which the child grows up.
A child who is vulnerable in these three areas is more likely to suffer from depression, although this is not automatic. A child can also be vulnerable in only one of these areas and still develop depression.
Here are the main causes of depression in a child:
One of the two biological parents has or has had a mental health disorder (especially depression and bipolar illness)
A biological imbalance in brain function
Health status: a child who lives with a particular medical condition or chronic illness is at greater risk
Family environment: physical or sexual abuse, violence, conflict in the home or neglect
Stressors: failure, rejection, bullying or indifference from family members, for example
Recent changes: separation from parents, bereavement, illness of a parent, loss of a pet, moving, change of school or daycare, etc.
Links between depression and other conditions
In both toddlers and school-aged children, anxiety is more common than depression. Although they are two different disorders, the two are strongly linked. Before diagnosing a child with depression, the doctor will look for the presence of anxiety.
Other conditions, such as ADHD, ASD (Autism Spectrum Disorder), Tourette’s Syndrome and Bipolar Disorder, are also associated with depression in children.
What are the signs of depression in children?
Here are the most common signs of depression in children. Not all children have the same symptoms. For example, some will sleep more than usual and others less. A child with depression may have one or more of the following signs:
If you have symptoms of depression yourself, get help right away. Your whole family will benefit.
A persistent feeling of sadness;
Physical aches and pains, such as stomach aches or headaches;
Loss of appetite or weight (the child is no longer following his or her growth curve);
Low energy levels;
Frequent or constant isolation of the child;
Loss of interest in play, hobbies or other activities;
Changes at school or daycare (in the child’s behaviour, habits or performance);
Low self-esteem, for example, a child who thinks “I suck”.
Younger children are more likely to show different signs of depression because they have less understanding of the emotions they are experiencing and still have difficulty expressing them. For example, they may have crying spells or tantrums.
What to do if your child shows signs of depression?
Child with depression
If your child shows signs of depression, you should consult a health care professional. However, as a parent, you also have a role to play in supporting your child’s well-being and providing good structure in daily life. For example:
show your child that you are present;
Spend quality time with your child;
Be empathetic and show your child that you understand his or her emotions (“I understand that what you’re going through is difficult”)
Show him how to do simple relaxation or meditation exercises;
Make sure he/she has a healthy lifestyle: balanced and varied meals, sufficient sleep, regular physical exercise, etc.
When to seek help?
If you notice that your child’s signs of depression last for more than two weeks, do not hesitate to consult a health professional.
On the other hand, if you’re not sure what’s happening to your child and you’re worried about him or her, don’t hesitate to follow your intuition and seek help as well. It is better to seek help “for nothing” than not to help your child.
The sooner your child gets help, the better his or her chances of making a full recovery and avoiding relapses later in life.
Where to go for help?
If your child is showing signs of depression, you can go to
quickly speak to a social worker.
A family doctor or pediatrician;
a nurse, psychologist or social worker in the community or school
a psychologist in private practice.
Don’t hesitate to ask your family doctor questions or ask for resources specific to your community or referrals to other professionals. The doctor will also be able to determine if your child needs a consultation with a child psychiatrist.
Treatment of depression in children
The first step is to assess the child and his/her environment. This step is very important and must be done with the help of the child’s family and friends. It allows for the implementation of various psycho-educational measures to improve the child’s environment, such as providing a soothing routine.
Psychoeducation includes all the basic measures that professionals can put in place to explain the situation to the parents (or family) and advise them on the best ways to improve the situation. One of these basic steps is to explain to the parents what depression is, what the follow-up is, and how long the treatment will last. The advice offered may include routine or lifestyle changes that could help the child.
This stage also serves to help the parents and sometimes other relatives involved (grandparents, brothers and sisters, etc.) to better recognize and understand the emotions experienced by the child and to better support him/her.
Psychotherapy can be carried out within the family, from the age of 3, with approaches adapted to toddlers: therapy through play, drawing, etc. An older child can also begin individual psychotherapy, if he or she feels able to be alone with a therapist. This can usually happen around age 8.
Finally, only if these psychoeducational measures and psychotherapy do not improve the child’s situation will the doctor consider the use of medication such as antidepressants.
Usually, this treatment is prescribed in conjunction with the other two interventions already mentioned, for moderate to severe depression. However, it is uncommon for antidepressants to be prescribed before the age of 12, although they can be offered from the age of 8.
There are exceptions or special situations where medication may be prescribed earlier or to younger children: for example, in the presence of severe anxiety or when treatment has not been successful after a certain period of time.
Medication must always be approved by both parents, even if they are separated. The child should be closely monitored by a doctor or child psychiatrist throughout the treatment.
Depression in toddlers (under age 5)
Although depression is rare in toddlers, it can occur as early as age 3. Very young children are more likely to develop depression if they have a family history of depression. Similarly, toddlers who have had a “difficult” temperament (in terms of self-control, attachment and seizures) and who have been sensitive since birth are also at greater risk.
A child whose mother suffered from depression during pregnancy or up to three years after delivery is also more vulnerable to depression. This may be because, during her depression, the mother was unable to develop a strong emotional bond with her child. Depression in the father can also have an effect on the child.
The risk of developing depression is 3 to 5 times higher when the biological parents have suffered from it themselves. If you are experiencing symptoms of depression, it is very important to get help. Your whole family will benefit.
Things to remember
Depression is a mental health disorder that affects a child’s thinking, mood and behaviour.
Although depression is rare in early childhood, it can affect children as young as 3 years old.
If you are concerned about your child, don’t hesitate to seek help because depression needs to be treated.