What you should know about depression in children and teens

Depression can appear seemingly out of nowhere, or it can be triggered by personal or global events. Families have reported significant mental health effects on their children from COVID-19, and a recent study found the rate of depression in children may have doubled during the pandemic. 

We sat down with Katarzyna Litak, MD, a child and adolescent psychiatrist with M Health Fairview, for more information about the causes and signs of depression in children – and how you can get help. Read on for what you should know.

We don’t always know what causes depression, but the pandemic has had an impact.

“The pandemic has caused an increase of psychological distress in all populations, but we’re seeing a lot of symptoms in children,” said Litak. “Their personal lives were completely disrupted, including school and family dynamics. Prolonged social isolation, loneliness caused by the pandemic, the feelings of uncertainty, grief over the loss of loved ones, and financial insecurity had a significant impact on all of us and our mental health.”

Beyond the stress of illness and loss in their communities, children and teens’ screen time also significantly increased during the pandemic, which Litak warns can be linked to a higher likelihood of depression-related symptoms. She identifies video games and social media as two of the things her patients struggle with.

“Generally speaking, it’s best when there’s parental supervision. Children can be exposed to traumatizing images, frightening news, and have trouble distinguishing what’s real and what’s fake—especially online and in the case of social media,” said Litak.

“I usually recommend limiting screen time or, in some cases, stopping the use of video games or social media altogether,” she added. “I have met with a lot of children who lost access to the use of social media and, after several days, they reported feeling a lot better.”

Depression looks different in different age groups, but common symptoms include loss of interest, appetite and sleep changes, and irritability.  

Depression symptoms can vary in children and teens. It’s important to look out for signs of depression in children so you can support them in getting help before symptoms become severe.

“In teenagers, the most pronounced symptom I’ve seen is irritability. They can be withdrawn and angry,” said Litak. “They may also lose interest in going out with their friends or want to give up activities they recently enjoyed. They may start to not see themselves finishing high school or going past high school to college or a career.”

Younger children with depression may also seem crankier or more withdrawn. They can also show appetite or sleep changes. Suddenly, they’re a lot hungrier or a lot less hungry, or they’re sleepier and almost “deflated,” said Litak.

Children and teens with depression can also seem more reactive to other people, or more sensitive in their relationships with family and friends. Little things they may not have worried about before are now perceived as personal attacks.

Even young children can experience depression, said Litak, so it’s important not to rule it out.

“We often think small children don’t suffer from anxiety and depression, because they may still be able to go through their day and engage with their activities and school,” said Litak. “But internally they may be struggling. Even young children can have suicidal thoughts.

“Even before the pandemic, the rate of suicide attempts in kids as young as 5 to 12 was about 1.5 percent,” Litak said.

Seek out support from your doctor and other adults in your child’s life as soon as symptoms get in the way of daily life.

Parents should watch for any disruptions in a child’s home or school life, Litak said. For example, refusal to join in family dinners, refusal to go to school, or a sudden decline in school performance.

“If you notice changes that persist for a week or two, start taking notes. Talk to your child’s pediatrician and begin exploring options for help,” said Litak. “Talk to your kid’s teacher and coaches, as well, to see how school is going. Often, what’s happening at home is also happening in school or other areas of their life. We want to get as comprehensive of a picture as we can.”

If you think treatment is needed, Litak recommends reaching out to your child’s pediatrician or primary care provider. They can discuss options and connect you with the appropriate resources.