Depression in Children: When It’s More Than Just Sadness.

According to the 2015 Child Mind Institute Health Report, 60% of children with diagnosable depression are not getting treatment, despite effective treatment options available. Stigma, lack of awareness, and lack of resources may all play a part in children going untreated.   It can be hard sometimes to know if your child’s mood is a temporary set-back related to a situation or if it’s part of a mental health diagnosis which they may need treatment for.


Depression in children is more than just sadness. Like in adults, depression affects a child’s  ability to see the world in a positive and realistic way, meaning they may see the negative in situations, even when there isn’t realistic evidence for it. It is more common for children to be irritable than adults and children who are experiencing depression will often have behavioral issues of anger, defiance and “attitude” problems.


Depressed children engage in more negative self-talk than their non-depressed peers and may label themselves as “dumb,” “stupid,” “bad” or some variation of, having a hard time reframing or being redirected to more positive thoughts. They usually also have a strong negative bias in which he/she may hyper focus on a negative event from the day. Or may internalize basic  parenting or teaching as criticism, supporting the idea they are “no good.”


Children who experience depression may also have low self-esteem or self-worth due to that world view of helplessness and hopelessness. This may show up as low frustration tolerance or giving up easily or maybe never even trying novel experiences. They may also withdraw from activities they once excelled at, coming up with new reasons for being “not good enough” and may strive for perfection.


Withdrawal and sleep disturbances are other common symptoms. Kids may spend more time alone or on the fringe of family and social situations. They may be tired more and complain of not having enough energy or not getting enough sleep. Sleep disturbances can come in the form of trouble falling asleep, nightmares, bed wetting or early awakening.


The DSM-5 stares that depressive symptoms must be present more often than not for for at least two weeks. This helps us rule out “moodiness” which can be developmentally appropriate and would not require seeing a therapist. The sooner we can recognize depression in children and get them in to see a licensed mental health professional, the less detrimental their symptoms may be long term.


For children 2-8, play therapy is the preferred treatment due to their developmental stage of using more symbols than words to work through emotional pain. For info in play therapy, go here. You can also learn more at the Association for Play Therapy site.


Older children (7-8+) can find relief from symptoms through using Cognitive Behavior Therapy (CBT). This type of therapy focuses on helping children and caretakers understand the connection between their thoughts, actions and feelings, helping children to more effectively handle their emotions. Though CBT may be the focus of treatment, with kids, play and being playful are always important elements of the process!

Noticing the signs and symptoms of depression and other mental health issues is a huge part of helping your child to be as healthy and happy as possible. Email me if you have questions about whether therapy is right for your child. I would love to connect and discuss how we can work together!