Signs of Depression in Children and Teens

Depression in children and teens can be hard to diagnose because every child behaves differently.

Some children and teens say they feel sad and “blue.” Others act out, and are irritable or aggressive toward others. Some begin to withdraw and become less social. Still others become anxious and fearful.

Elementary-age children often describe their depression as feeling empty. They may think that no one likes them and believe that they don’t have any friends. Sometimes young children won’t play or do things that they once thought were fun. Physical symptoms such as stomachaches, headaches, and other aches and pains may also be a sign of depression.

Teenagers in general are often described as moody, so it can be hard to recognize the difference between just being a teen and depression. Teens with depression are often irritable, may not be depressed all the time, and often still see their friends. Below are signs of depression and examples for parents to look for.

Signs of Depression	What Parents may Notice
Depressed, irritable, sad, or empty mood for at least 2 weeks	Irritable or cranky mood, preoccupation with song lyrics that suggest life is meaningless
Decreased interest or enjoyment in once-favorite activities and people	Loss of interest in sports or other activities, withdrawal from friends and family, relationship problems
Changes in appetite, eating too much or too little, significant weight loss or gain	Failure to gain weight as normally expected
Sleeping too much or too little	Excessive late-night TV, having difficulty falling asleep or staying asleep, having trouble getting up in the morning
Physical agitation or slowness	Inability to sit still, taking a long time to complete normal tasks, pacing back and forth, and/or excessive repetition of behaviors
Fatigue or loss of energy	Social withdrawal, napping, withdrawal from usual activities, boredom
Low self-esteem, feeling guilty	Making critical comments about themselves, having behavior problems at home or school, being overly sensitive to rejection
Decreased ability to concentrate, indecisive	Poor performance at school, drop in grades, frequent absences
Unexplained aches and pains	Frequent complaints of physical pain (headache, stomachache)
*Recurrent suicidal thoughts or behavior	Writing about death, giving away favorite toys or belongings, "You'd be better off without me."

If you child is suicidal, get immediate medical help.
Having one or more of these symptoms does not necessarily mean that your child has depression. A child who is feeling sad after failing a test or losing a beloved pet is having a normal reaction to disappointment or upset. When the symptoms last longer than two weeks and are severe, depression is a possibility. Only a trained clinician can make a diagnosis of depression.

In order to be diagnosed with depression, your child's symptoms must lead to significant difficulties in one or more of the following areas of your child's life:

Social activities
School grades
Family relationships
Normal social and emotional development

Watching for suicidal behavior

Asking your child if he/she feels suicidal will not cause your child to take his or her life

One of the most terrifying and saddening thoughts parents can have is that their child may want to permanently end his or her own life. If your child talks about hurting himself or herself, or has a preoccupation with death, always take it seriously

Where to get help

Call your clinician, call 911, or go to the nearest emergency room

Teens with depression are at higher risk of suicide than young children. Suicide is the third leading cause of death among 15- to 24-year-olds. Nearly 20% of high school students have considered attempting suicide and about 9% have made a suicide attempt.

Although uncommon, suicides have been reported in children as young as five. Even though young children may not fully understand the concept of death, they can still think about, plan, attempt, and even succeed at taking their own lives.

For a period of time after a child begins taking antidepressants, he or she may have more energy to act on suicidal thoughts. During this time, a child's mood may not be improved, but his or her energy level may be higher. It is important to watch your child closely during this time.

Some children and teens may be at greater risk of suicide than others. If there is a family history of suicide or bipolar disorder, there may be greater risk. Be certain to discuss the risk factors with the clinician.