Depression in children and teenagers

Depression doesn't just affect adults – it’s also common in children and teenagers. If your child or teenager is feeling depressed, the sooner they talk to someone who can help them, the better. The longer it goes on, the harder it is to recover from.

Key points

  1. Don’t fall into believing the myths about depression in children and teenagers: they do get depression, so help them to get professional help if they are feeling depressed.
  2. Depression is a key risk factor for suicide in young people, especially if they have feelings of hopelessness. If they are having suicidal thoughts, get help for them immediately by talking to your doctor or free calling Lifeline 0800 543 354 anytime.
  3. Depression is common in children and teenagers: about 1 in 7 young people in New Zealand will experience a major depressive disorder and 1 in 5 will experience a serious mood disorder before the age of 24.
  4. The earlier depression is treated, the sooner your child or teenager will start to feel better. You can help them by initiating conversations if you notice ongoing changes in their mood.
  5. Support their emotional wellbeing by prioritising a healthy lifestyle at home: having meals together, eating healthy food, having daily physical activity, limiting screen time and making sure they get plenty of sleep.  

What are the myths about depression?

All of the following are untrue:

  • Depression is a sign of weakness.
  • A depressed person can just snap out of it.
  • Warning signs of depression are just the normal moodiness of adolescence.
  • Every young person with depressive symptoms has a depressive disorder.
  • Young people will grow out of depression.
  • Young people have nothing to be depressed about.
  • Talking about depression (or suicide) will only make things worse.
  • If a young person is depressed, there's no way they would be suicidal.

 Don’t buy into the myths: take depression seriously.

What are the signs of depression in children and teenagers?

While the signs of depression are similar to those in adults, depressed children and teenagers may show more anger and irritation than adults who are depressed do. One or two of the following signs of depression may be just part of growing up. However, if your child or teenager has had several of them over the past few months, they are likely to be depressed.

  • being irritable and snapping at others
  • persistent low, sad or depressed mood
  • crying easily and often
  • lacking concentration and interest in school work, and may stop wanting to go to school
  • feeling tired all the time
  • feeling stressed or anxious
  • unable to sit still, but pacing and wringing their hands
  • lacking interest in usual activities and going out with friends
  • being forgetful
  • not being able to sleep or wanting to sleep more than usual for their age
  • sitting in one place for long periods, moving, responding and talking very slowly
  • withdrawing from usual social contact
  • being quiet and withdrawn at home
  • losing their appetite or eating more resulting in weight loss or gain
  • experiencing muscle tension and headaches
  • experiencing unexplained physical complaints, especially stomach pains.

Depression in children and young people is often hidden

Young people may not recognise their problem as depression or, if they do, may feel unable to talk about it. Often the feelings that come with depression are so strong they do not tell anyone else because they feel no good or they are scared they are going mad. This is why it’s important that if you notice these symptoms, you ask your children about them.

Depression in young people is often masked by anger and aggression, usually because they can't or don't feel comfortable expressing sadness and hopelessness. This anger is often mistaken for teenage rebelliousness. Younger children tend to isolate themselves when they are feeling depressed, so they may appear quiet and shy at these times.

There is a strong association between depression in young people and anxiety, conduct disorders, substance abuse, attention deficit/hyperactivity disorder (ADHD) and eating disorders. These other problems often mask the depression. This is another reason to see a doctor as soon as possible if you have any concerns about the mental health of your child or teenager.

What causes depression in children and teenagers?

Usually, there is no one single cause of depression in children and teenagers. Sometimes depression appears out of the blue, while at other times something seems to trigger it. Often it is a combination of factors. Your child or teenager is more likely to experience depression if they:

  • experience a stressful event such as the break-up of parents, loss of a loved one or relationship break-up
  • have someone in the family who has depression, such as a parent or sibling
  • have experienced trauma, such as a significant injury or accident, or abuse
  • are going through major life changes, such as starting a new school or going to university
  • have been bullied or had other problems with peers
  • are LGBTI or feel different in some other way
  • use alcohol or recreational drugs.

How is depression diagnosed?

This depression self-test , aimed at children or teenagers, is something you could help them to do as an initial screening tool. However, if they have some, but not necessarily all, the symptoms mentioned above, it’s a good idea they see a doctor.

The doctor will ask questions about their thoughts, feelings and behaviour, including sleeping and eating patterns, as well as how long they have been feeling this way. They will also ask if the young person has had any previous episodes of depression and may ask about what is happening in their life at the moment. They may also do a physical examination and blood tests to rule out other causes for their depression.

The doctor will be assessing not only whether your child or teenager has depression, but ruling out another medical condition or the depressed phase of bipolar disorder. If they have depression, the doctor will also assess what type of depression and whether they have mild, moderate or severe symptoms, as this will affect what treatment they recommend.

Note: Over the age of 16, young people are treated as adults in terms of consent for assessment and treatment. Below this age, caregivers (usually parents, but sometimes organisations such as Child Youth and Family Services when children are in care) have legal responsibility for consenting to any treatments the child or teenager may receive.

How is depression treated?

There is a range of treatments for children and teenagers with depression. Treatment usually focuses on psychological therapies and lifestyle changes. Antidepressants are not routinely used for children and young people but may be recommended in some cases if depression doesn't respond to other treatments. Your GP will be able to talk through options and help work out which are best for your child or teenager. They may also refer them to a mental health specialist. Read more about mental health services for youth.

Talking therapy

One common treatment is talking therapy. Counsellors and therapists will be supportive and understand what is happening to your child and know how to help them. They can offer help with thinking patterns and anxiety, problem-solving skills and self-esteem, as well as any other problems your child or teenager may be experiencing that might be contributing to their depression. Some of the therapy may involve the child or teenager on their own and some may involve parents and/or other family members.

If your child or teenager is at school, they can talk to a school guidance counsellor or your Hauora Youth mental health worker. Some areas in New Zealand have services for Māori, Pasifika and Asian youth – ask your school counsellor about these services.

Online programmes

For mild-to-moderate depression, online programmes are popular and effective and are more convenient than face-to-face sessions for some people.

  • SPARX A free online tool to help young New Zealanders learn to deal with depression and anxiety.
  • The LowdownA website created to help young people understand and deal with depression, with chat room, personal stories, music and more.
  • Aunty Dee Online problem solving tool for young people.

Find more depression apps and e-learning.

Lifestyle changes

Improvements to key aspects of life can greatly affect mood: sleep, food, exercise and the use of alcohol or drugs. As a parent, you can help your child or teenager by supporting them to have a healthy lifestyle. Focus on their basic needs – healthy eatingphysical activity and plenty of sleep. Spend time together as a family, such as daily meals and weekly outings, and limit their screen time.

Medication

Sometimes, with more severe depression, medication is recommended. While antidepressants do not cure depression, if psychological therapy and lifestyle changes have not been effective, the doctor may prescribe an antidepressant.

Note: The use of antidepressants has been linked with suicidal thoughts and behaviour. Children, teenagers, young adults, and people with a history of suicidal behaviour are particularly at risk. This is most likely during the first few weeks of starting the antidepressant or if the dose is changed. It is important to look out for signs of suicidal behaviour such as suicidal thoughts, self-harm, worsening of low mood, agitation or aggression. If you notice any of these signs, contact your doctor immediately.

Learn more

The following links provide further information about depression in children and teenagers. Be aware that websites from other countries may have information that differs from New Zealand recommendations.   

Depression KidsHealth, NZ, 2016
Depression Black Dog Institute, Australia, 2017
Depression – youth Mental Health Foundation, NZ, 2014
depression.org.nz
Depression - for young people Women and Children's Health Network Australia
Understanding and dealing with depression – for young people Headspace Australia
Depression Headmeds UK
Kick depression Download a 
free e-book of scientifically proven ways to get through stuff

References

  1. Facts about young New Zealanders and depression the Lowdown, NZ
  2. Depression in the LGBT population Healthline, US, 2016
  3. Online insomnia treatment also prevents depression Black Dog Institute, Australia, 2016
  4. One hour of exercise a week can prevent depression Black Dog Institute, Australia, 2017
Credits: Health Navigator Editorial Team.