Depression in a child or teen may occur suddenly or develop gradually. Your child may seem more irritable than sad or may feel bored or hopeless. It is common for others to notice that a depressed child’s body movements are slow, restless, or agitated. Your child may be self-critical or feel that others are unfairly critical of him or her.
The symptoms of depression are often subtle at first. It can be hard to recognize that symptoms may be connected and that your child might have depression.
Children who are depressed may have the following symptoms:
Unexplained aches and pains, such as headaches or stomach pain
Difficulty thinking and making decisions
Trouble sleeping, or sleeping too much
Changes in eating habits that lead to weight gain or loss or not making expected weight gains
Feelings of guilt and hopelessness
Constant tiredness or lack of energy
Social withdrawal, such as lack of interest in friends
Thinking about death or feeling suicidal
It’s important to watch for warning signs of suicide in your child or teen. These signs may change with age.
Many children who are depressed have symptoms of anxiety, such as worrying too much or fearing separation from a parent. Sometimes these symptoms appear before depression is diagnosed.
Other less common symptoms may occur in severely depressed children, such as hearing voices that aren’t there (hallucinations) or having false but firmly held beliefs (delusions). Hallucinations are more common in young children, while delusions are more common in teens.
Telling the difference between normal moodiness and symptoms of depression can be difficult. Occasional feelings of sadness or irritability are normal. They allow the child to process grief or cope with the challenges of life. For example, grieving (bereavement) is a normal response to loss, such as the death of a family member or even the death a pet, loss of a friendship, or parents’ divorce. After sad incident, a child may still be anxious for a longer period of time. But when these emotions do not go away or begin to interfere with the young person’s life, the child may develop signs of a mood disorder such as depression or dysthymic disorder (long-term, mild depression), which requires treatment.
Some children who are first identified with depression are later identified with bipolar disorder. Children or teens with bipolar disorder have serious changes of mood between depression and bouts of mania (very high energy, agitation, or irritability). Depression can have symptoms that are similar to those caused by other conditions.
It can be difficult to tell the difference between bipolar disorder and depression. It is common for children with bipolar disorder to first be diagnosed with only depression and later to be diagnosed with bipolar disorder after a first manic episode. Although depression is part of the condition, bipolar disorder needs different treatment than depression alone. Like depression, bipolar disorder runs in families, so be sure to tell your doctor if your child has a family history of bipolar disorder.