Adults often think of childhood as a time of joy, carefree abandon, and happiness. We associate those early years with play, laughter, and curiosity, as if children were immune to emotional problems. However, reality isn’t always so rosy. Children can also suffer from depression, although it manifests itself differently than in adults.
What is childhood depression?
One of the most persistent (and dangerous) myths about depression is the idea that it can’t happen to children, that it’s a problem exclusive to adults, or that “they’ll grow out of it.” However, scientific evidence says otherwise: depression is a disorder that can affect children (exactly 1% of them), and it’s observed even at very early stages of development (children as young as 3 years old can already experience its clinical symptoms, although such cases are rare).
Childhood depression, specifically, is considered a mood disorder that affects children, characterized by persistent sadness, irritability, loss of interest in previously enjoyed activities, and changes in sleep, appetite, or behavior. Unlike occasional sadness, which all children may experience, childhood depression is more long-lasting and disrupts daily life, affecting their ability to play, learn, and interact with others.
What are the main symptoms of childhood depression?
Depression often manifests itself differently in children, so it’s easy for parents to overlook it.
- Irritability and fatigue . Instead of obvious sadness, many depressed children appear more irritable or fatigued. They lack the energy typical of childhood.
- Unexplained physical symptoms . Headaches, stomach aches, or other discomforts without a clear medical cause also often accompany depression in children.
- Anhedonia. The child loses interest in activities they previously enjoyed, especially play. In fact, it is a key symptom of childhood depression and can be noticed because children simply no longer want to play or spend time with their friends.
- Negative thoughts and low self-esteem. Although young children don’t always directly express how they feel, they may say things like “I can’t,” “I’m bad,” or “nobody loves me,” reflecting cognitive distortions associated with depression. This often translates into low self-esteem. Children may feel worthless or unworthy of love, useless, or stupid.
- Changes in behavior. Decreased school performance, giving away important toys, or significant sleep disturbances (sleeping too much or having difficulty falling asleep) are other symptoms of childhood depression.
- Social isolation. Some children with depression “self-isolate.” They feel so sad that they isolate themselves in their rooms to avoid family or social interactions. They often find a secret hiding place where they feel safer and more comfortable, so they retreat there when they feel bad.
What can parents do?
If you notice the symptoms mentioned above, it’s advisable to start paying attention. It’s crucial to assess their duration, as feeling unwell for a day or two after something that happened is normal, but being sad and irritable for several days or even weeks is a sign that something is wrong.
In that case, it is advisable to first consult a pediatrician for a complete examination, as there are other diseases that can cause symptoms similar to those of depression, so the first step is always to rule out a physiological problem.
If the tests don’t indicate any health problems, it’s advisable to take your child to a child psychologist. This professional will analyze what’s happening, be able to make a diagnosis, and recommend the most effective treatment, as well as provide guidelines to follow at home.
Remember that, as a rule, depression doesn’t go away on its own. It’s a chronic condition that can’t be ignored or resolved through willpower alone. Having a depressed child can be challenging and even frightening, but it’s also an opportunity to strengthen your bond. Just make sure they have the support they need.
What is the psychological treatment for childhood depression?
Psychological treatment is essential to help a child with depression. In fact, a study conducted at Stony Brook University revealed that childhood depression is not simply a “passing sadness.” Children who experience depression at ages 3 to 6 are more likely to experience anxiety, attention deficit hyperactivity disorder (ADHD), and suicidal tendencies later in childhood or adolescence, so it is not a problem that can be minimized.
However, unlike adults, children cannot always explain what they feel, so therapeutic intervention is adapted to their age, development, and level of understanding.
The psychologist typically adapts cognitive behavioral therapy to the child’s age to help them identify and change negative thoughts, learn emotional management skills, and regain interest in activities they previously enjoyed. Activities such as role-playing and storytelling are used to facilitate emotional expression.
Obviously, in most cases, parental involvement is necessary. Family therapy teaches adults to recognize the symptoms of childhood depression, reinforce healthy behaviors, and communicate better with their child. It is also helpful in resolving family conflicts that may be worsening the depression.
With younger children, the psychologist uses a more playful approach to therapy, incorporating guided games, drawing, music, and expressive activities as tools to help them express difficult emotions without needing to verbalize everything. This allows us to observe their behavioral patterns, frustration, sadness, or fear and work on them naturally.
In the long term, therapy for childhood depression works, prevents relapses and avoids the appearance of other disorders, so it is important to see a psychologist if you suspect that the child has something more than just passing sadness.
References:
Spoelma, M. J. (2023) Estimated Prevalence of Depressive Disorders in Children From 2004 to 2019A Systematic Review and Meta-Analysis. JAMA Pediatr; 177(10): 1017-1027.
Silver, J. et. Al. (2022) Depression in 3/6-year-old children: clinical and psychosocial outcomes in later childhood and adolescence. J Child Psychol Psychiatry; 63(9): 984-991.
Crowe, K. & McKay, D. (2017) Efficacy of cognitive-behavioral therapy for childhood anxiety and depression. J Anxiety Disord; 49: 76-87.
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