Depression in Children and Adolescents

 

Children and teenagers experience a wide range of emotions, and ups and downs. Depression is different from sadness, however. It is a serious mental health condition that could benefit from professional support and treatment. There is a wide array of options from medication to talking therapy for you and your child to explore.

Childhood depression 

Children who experience a depressive episode often go on to have another within five years.

Children who suffer with depression are also more likely to suffer with depression and other mental health conditions later in life. Many children and teenagers with depression also suffer with other mental health conditions – ADHD and behavioural problems can be common in 40% of depressed children.

 

What should I do if I think my child or teenager is depressed?

It can be hard for parents to know if their child is suffering with depression if it is just part of their character or a perfectly normal stage of growing up.

Parents can hold back from seeking help because they may not be sure if there is a problem and may even worry that are making an unnecessary fuss.

In our experience, if you think there might be a problem it is worth seeking help. We have worked with hundreds of families and often, a parent’s instinct is often right.

Causes of depression in children and teenagers

There are many reasons that children and teenagers can suffer with depression including:

 

Genetic vulnerability

Research has shown that children whose parents suffer with depression are three times more likely to suffer themselves, suggesting a genetic link.

 

Stressful, traumatic life events

These can leave lasting impressions on a child. If a child has experienced a traumatic event this may have affected their learning of good coping mechanisms for dealing with complex emotions, this can sometimes result in depression.

 

Neurobiological

Studies show that abnormal levels of hormones, such as the stress hormone cortisol, can be a causal factor for childhood depression. The part of the brain needed for emotional regulation has been shown to differ in size in some children (this has been linked to maternal depression) and this is thought to increase the child’s likelihood to suffer with depression.

 

Environmental factors

A family death, divorce, pressures at school or social difficulties can all be causes of depression. Not all children will be affected in the same way by these events, so it is not unusual for only one sibling to develop depression following a stressful family event, each child is unique and will cope with stressful situations in different ways.

 

Treatment can work

Young brains have the amazing ability to be moulded – a term called neuroplasticity.

This is fantastic news in terms of treatment outcomes for depression – with early intervention and the right treatment your child can recover and go on to lead a happy, fulfilling life. Getting help early makes a big difference.

Depression in Children - Signs

For many it makes sense, adults with depression often say they have felt this way for as long as they can remember. 

Depression can be hard to spot in young children

Children experience a daily rollercoaster of emotions such as excitement, disappointment and frustration. A lack of communication skills, tiredness or simply being overwhelmed can mean that young children’s behaviour is frequently up and down. Depression is different to ‘normal’ sadness, it is a serious illness that benefits tremendously from professional help.

 

Common signs of depression in young children:

• Not enjoying play very much – apathy towards previously favourite items
• Difficulties socialising, clinginess or becoming socially withdrawn
• Often being sad and crying
• Dramatic mood swings, angry or hysterical outbursts over small things
• Regressing back to a younger age, for instance toilet training
• Disagreeable and defiant for much of the time
• Complaining of physical aches and pains
• Whining and unhappy a great deal
• Orchestrating scenarios around violence or death

Happy children can display some of these signs at times, after all part of growing up is to push boundaries and experiencing a wide range of emotions is perfectly normal. 

Early diagnosis is key

Research has shown that early accessing treatment early can really improve a child’s chances of not experiencing further problems later on in life, with early intervention and the right treatment your child can recover and go on to lead a happy, fulfilling life.

What should I do?

If you have noticed your child is experiencing some of the symptoms of depression listed above for two weeks or more, in different settings and with different people then it might be helpful to speak to a professional. 

Teenage Depression - Signs

Signs of depression in teens

It’s often hard to know if your teenager is depressed.

We expect teenagers to be moody, irritable, and emotional at times; hormones and growing up can be hard to deal with. Teenagers are often quite secretive and can hide symptoms. They may be reluctant to talk openly about their feelings and as they become more independent you may have less involvement in their day-to-day life.

 

So how do you know if your teenager’s mood is part of normal growing up or something more serious?

In our experience, parent’s instinct is often right, so if you are worried about your teenager and notice some of the following signs, it might be helpful to seek professional help.

Issues at school:

• Truancy
• Reluctance in going to school / lack of engagement in school activities
• Difficulties concentrating
• Changes in performance / approach to schoolwork

 

Social issues:

• Not enjoying once preferred activities
• Withdrawing socially – not seeing friends
• Complaining of feeling lonely
• Complaining of being bored

 

Physical signs of depression:

• Changes to sleep patterns; too little, too much or finding it hard to go to sleep
• Complaining of muscle aches, stomach-aches, headaches
• Weight changes, lack of appetite or excessive eating

 

Emotional signs of depression:

• Tearfulness, crying a great deal
• Outbursts of violence or anger
• Low self esteem
• Self-harm
• Moodiness
• Unusual reactions to things – for instance being really upset over small things
• Talk of suicide or death 

Treatment for Depression in Teenagers and Children

What should I do if I think my child is depressed?

 

Research has shown that early accessing treatment early can really improve a child’s chances of not experiencing further problems later in life, with early intervention and the right treatment your child can recover and go on to lead a happy, fulfilling life.

Benefits of early diagnosis:

• Depression often reoccurs – preschool children with depression are almost three times as likely to suffer with depression in primary or secondary school.
• Early detection and treatment make it less likely that your child will suffer later in life.

 

What should I do if I think my child or teenager is depressed?

1. Talk to them– if possible, talk to your child about how they are feeling. It is very reassuring for children and teenagers to feel that their parents are interested in them. Talking to them can be hard – they may be too young and depressed children and teenagers are often withdrawn and not willing to open. Try not to trivialise their problems – they may seem small to you, but they are really important to them. Children sometimes ‘test’ their parent’s reactions with small problems before divulging their real concerns.

Starting a discussion can, if nothing else, show them that you care.

2. Seek help– child mental health is complicated so seeking help from a professional specifically trained is important. Child and adolescent psychiatrists are trained to understand the specific issues that young people may struggle with. An assessment with a psychiatrist will indicate what the problem may be and will look across a spectrum of disorders – sometimes the symptoms of depression can be due to something else.

 

What to expect from the assessment appointment

• The assessment is tailored towards your child’s age and symptoms
• Assessments last on average 2 hours
• Questions are sent to the parent before the assessment to gather background information and help the psychiatrist tailor the assessment session
• Depending on circumstances parents may be involved in the assessment – your clinical advisor will be able to answer any questions you have
• A full report is sent to the parents within 10-15 days following the assessment. This will give a diagnosis, if there is one, as well as advise on treatment options.
• We can arrange further treatment such as counselling, CBT, psychotherapy and where advised, medication. Alternatively, parents can take the psychiatric report to their GP, who may or may not choose to use this to determine future treatment for your child. We can guide you through this process.

 

Support for the whole family

Parents can feel completely helpless, frustrated and extremely worried. Siblings can also find the time stressful - there are often more arguments and seeing their brother or sister suffering can be distressing.

Family therapy and parenting support can be incredibly helpful for the whole family but also for the depressed child. Working with a family therapist can teach parents coping mechanisms and ways of dealing with the negative thought patterns and behaviours displayed by depressed children. Therapy sessions can be invaluable to diffusing tension and creating happy and healthy experiences for the whole family.

 

Depression and anxiety in children

Depression with anxiety is the most common mental health condition in the UK and over half of people with anxiety will also have depression.

 

What is the relationship between anxiety and depression?

Anxiety is an emotion closely linked to avoidance. Children with anxiety will often shy away from new situations and may not try out new activities, often because their anxiety can leave them feeling helpless.

Depression is a condition linked to withdrawal. Depressed children will feel hopeless and lack the motivation to engage in activities. Whilst avoidance and withdrawal are not the same, they are very similar and can ‘feed’ from each other.

It makes sense that if you feel unable to partake in activities and are excessively worried about your performance or abilities, you may end up feeling depressed as you become more socially reclusive. Equally, if you are struggling with depression, feel emotionally numb and useless, you may end up suffering with feelings of anxiety, as you worry about everything you are not able to do or what people think about you.

Depression and anxiety symptoms

The symptoms of depression and anxiety in children and teenagers can vary hugely – which makes it understandably difficult for parents to know what is going on and how they can best help.

Many of the symptoms of depression and anxiety combined are similar – tearfulness, irritability, becoming withdrawn and difficulties sleeping. Symptoms will vary with age as well; young children often do not have the language necessary to describe how they are feeling so may ‘act’ out through their behaviour.

How can I help my child with depression and anxiety?

Treating children and teenagers who have anxiety and depression can be complicated as for effective treatment to work, psychiatrists may need to assess which condition to treat first. The symptoms can also be indicative of other conditions such as ADHD or ODD.

As a first step, your child may benefit from an assessment with a psychiatrist – a doctor with expertise in mental health. Not only with this assessment look at the anxiety symptoms your child is experiencing but will look at whether there are any other underlying factors or conditions that need to be considered, in order to find the most effective treatment.

Effective treatments for depression and anxiety include Cognitive Behavioural Therapy (CBT), other talking therapies and, in some cases, medication such as antidepressants.

 

Talk with a qualified professional

A free, confidential call could quickly put you on the path to regaining control. All calls are answered by a trained assistant psychologist who will listen and ask questions, before suggesting the most appropriate treatment.

 

Private psychiatry for children and young people

Knowing when the right time is to get outside help for a loved one isn't easy. If you're considering whether a psychiatrist might be able to help your child, an experienced clinical adviser can listen, offer advice, and help you reach a decision.

It's normal for concerned parents and carers not to know what type of support their child needs. Just call us on 0333 3390115, explain what's been happening, and we'll advise you on what we think will be most helpful for you and your family.

 

How do I choose a therapist for my child?

The first step is a phone call with our friendly, experienced team of assistant psychologists. Then, if you would like to book an appointment, we can arrange a session with a child and adolescent psychiatrist suited to your child's needs. It's essential to get the fit right, so we always try to match you with a clinician with whom we think you and your child will feel comfortable.

 

How we work

• Appointments are available at nationwide locations or online
• Sessions usually last between 60-120 minutes, depending on the type of appointment
• You will receive a report that will include a diagnosis (where one is clear) and treatment recommendations
• Any further treatment, including medication, can be with us, another provider, or through your local NHS GP

 

Preparing for the assessment

It's natural for you and your child to feel a bit apprehensive before the assessment, but rest assured, we select all our clinicians based on their expertise and their ability to make clients feel at ease, so please try not to worry. If your child is nervous about talking to a stranger, they may find it helpful to bring notes or drawings demonstrating how they feel to the session. This approach often helps when a child struggles to explain thoughts and feelings through words alone.

 

Can I attend the appointment?

We ask parents of children under 18 to attend the assessment with their children. The consultant will want to speak to you about your child's history and current health but may also want some time alone with your child so that they can assess behaviour without parental influence.

 

How long with the session last? 

Standard appointments last between 60 and 120 minutes. However, assessments for certain conditions and those with more complex requirements may need longer. We will discuss this with you if we think a longer appointment is required.

 

Should I bring anything to the appointment?

We will send your child's psychiatrist the information you provide in your initial phone call with us. However, before the appointment, we recommend you consider the issues discussed in the call and anything else you feel might be relevant. Make notes if you think it will help and bring them to the appointment to help ensure you don't forget to mention anything.

 

Your child's report

Following your appointment, we will send you a full psychiatric report. The time it takes to produce the report often depends on how quickly we receive responses to any questionnaires needed. The report will include a detailed diagnosis, where one is clear, and any treatment recommendations.

 

Prescriptions

If the psychiatrist recommends medication, we suggest asking your NHS GP if they will be willing to prescribe it. In most cases, your GP will likely issue a prescription upon receipt of your psychiatrist's report. However, they will sometimes refuse to prescribe more expensive medications, such as some of those used to treat ADHD.

 

What happens after the assessment?

Following your appointment with the psychiatrist, we may recommend that your child see a psychologist or Psychotherapist for further treatment. We can help arrange this treatment privately or you may wish to be treated by the NHS.

 

If you have concerns about a child in your family our clinical advisors will be able to advise you on what might help. To speak to someone today call 0333 3390115.