What is depression in children and teens?

Taking good care of yourself is important as you recover from depression. In time, your symptoms may fade as your treatment takes hold. Don't give up. Instead, focus your energy on getting better.

Your mood could improve over time. Focus on things that can help you feel better, such as being with friends and family, eating well, and getting enough rest. But take things slowly. Don't do too much too soon. You may start to feel better gradually.

Children or teens with depression may be sad most of the time and show a loss of interest in activities they usually enjoy. They may have changes in their sleeping or eating patterns. They might also think about death or suicide. These symptoms occur nearly every day and last at least 2 weeks.

Treatment usually includes education about depression, professional counseling, and medicine. If your child's symptoms are mild to moderate, counseling or lifestyle changes may be enough to help your child feel better. But if your child's symptoms don't improve with counseling, your child's doctor may recommend that medicine be added. If your child's symptoms are severe, a combination of antidepressants and counseling may work better than if only one of these treatments is used.

Education

Education about depression can be provided by a doctor or in family therapy. Some important things for you and your child to learn include how to:

• Be sure your child is following a treatment plan. This often includes taking medicine correctly and going to counseling appointments.
• Know the signs of a relapse. Learn what to do to prevent depression from returning.
• Know the signs of suicidal behavior, how serious they are, and how to respond. Your child and your child's doctor may develop a plan to keep your child safe if your child shows signs of self-harm.
• Identify signs of a manic episode. This is a bout of extremely high mood and energy or irritability. It's a sign of bipolar disorder.
• Seek treatment if you are a parent with depression. If you have depression that isn't treated, it may be harder for your child to recover.

Counseling

Several types of counseling can be used to treat depression. They may include:

• Cognitive behavioral therapy. It can help children and teens change negative thoughts that make them feel bad.
• Interpersonal therapy. It focuses on helping teens with relationships. It helps them find solutions for problems that are bothering them.

It's important to find a mental health professional you and your child trust and feel comfortable with. Together you will develop an action plan to treat your child's depression.

Medicine

Antidepressant medicine may be an option if a child is very depressed. Combining antidepressant treatment with counseling may work best. But what works best may depend on the age of your child.

There are several types of antidepressants. Some common ones include:

• Fluoxetine.
• Escitalopram.
• Sertraline.

Before prescribing an antidepressant, your doctor will ask your child some questions to check for suicidal thoughts. The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. Talk to your doctor about these possible side effects and the warning signs of suicide.

The safety and long-term effects of medicines used to treat depression in children and teens are not fully known. Talk to your child's doctor about the risks and benefits of these medicines. Together you can decide if medicine is right for your child.

Other treatment

In some cases, the doctor may recommend electroconvulsive therapy for an older child or a teen who has severe depression or doesn't respond to other treatment.

The sooner your child starts treatment, the sooner your child will start to feel better. Waiting to seek treatment for depression may mean a longer and more difficult recovery.

• Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
  • Continue to take your medicine after your symptoms improve. Don't stop taking them without talking to your doctor.
  • If your depression keeps coming back, your doctor may recommend that you take medicine even longer.
• Continue counseling. It may help prevent depression from returning, especially if you've had multiple episodes of depression. Talk with your counselor if you are having a hard time attending your sessions or you think the sessions aren't working. Don't just stop going.
• Eat healthy foods. Include fruits, vegetables, beans, and whole grains in your diet each day.
• Get regular exercise. Go for a walk or jog, ride your bike, or play sports with friends.
• See your doctor right away if you have new symptoms or feel that your depression is coming back.
• Keep a regular sleep schedule. Try for 8 to 10 hours of sleep a night.
• Avoid using illegal drugs or marijuana and drinking alcohol.

Where to get help 24 hours a day, 7 days a week

If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away. You can:

• Call the Suicide and Crisis Lifeline at 988.
• Call 1-800-273-TALK (1-800-273-8255).
• Text HOME to 741741 to access the Crisis Text Line.

Consider saving these numbers in your phone.

Go to 988lifeline.org for more information or to chat online.

A doctor may do a physical exam and ask questions about your child's past health. The doctor may ask your child about their feelings, changes in eating habits, energy level, and interest in daily tasks. The doctor may also ask how well your child is sleeping and how well they can focus on tasks. This may be a talk between the doctor and your child, or your child may fill out a form. The doctor may also ask you questions.

The doctor may also ask questions about other problems. Children with depression often have other problems too, such as anxiety, attention deficit hyperactivity disorder (ADHD), or an eating disorder. Finding other problems can help your child get the right diagnosis and treatment.

Some diseases can cause symptoms that look like depression. So your child may have tests to help rule out physical problems, such as a low thyroid level or anemia.

Be realistic

• If you have a large task to do, break it up into smaller steps you can handle. Then just do what you can.
• Think about putting off important decisions until your depression has lifted. If you have plans that will have a major impact on your life, such as dropping out of school or choosing a college, try to wait a bit. Talk it over with friends and family who can help you look at the overall picture.
• Reach out to people for help. Don't isolate yourself. Let your family and friends help you. Find people you can trust and confide in, and talk to them.
• Be patient, and be kind to yourself. Remember that depression isn't your fault and isn't something you can overcome with willpower alone. Treatment is necessary for depression, just like for any other illness. Feeling better takes time. Your mood will improve little by little.

Stay active

• Stay busy and get outside. Join a school club, or take part in school, church, or other social activities. Become a volunteer.
• Get plenty of exercise every day. Go for a walk or jog, ride your bike, or play sports with friends. Talk with your doctor about an exercise program. Exercise can help with mild depression.
• Ask a friend to do things with you. You could play a computer game, go shopping, or listen to music, for example.

Take care of yourself

• Eat a balanced diet with plenty of fresh fruits and vegetables, whole grains, and lean protein. If you have lost your appetite, eat small snacks rather than large meals.
• Do not drink alcohol or use drugs.
• Get enough sleep. If you have problems sleeping, try to keep your bedroom dark and quiet, go to bed at the same time every night, get up at the same time every morning, and avoid drinks with caffeine after 5 p.m.
• Avoid sleeping pills unless they are prescribed by the doctor treating your depression. Sleeping pills may make you groggy during the day. And they may interact with other medicine you are taking.
• If you have any other illnesses, such as diabetes, make sure to continue with your treatment. Tell your doctor about all of the medicines you take, including those with or without a prescription.

Follow your treatment plan

• If your doctor prescribed medicine, take it exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
  • If you don't notice any improvement in 3 weeks, talk to your doctor.
  • Antidepressants can make you feel tired, dizzy, or nervous. Some people have dry mouth, constipation, headaches, or diarrhea. Many of these side effects are mild and will go away on their own after you have been taking the medicine for a few weeks. Some may last longer. Talk to your doctor if side effects are bothering you too much. You might be able to try a different medicine.
• Do not take medicines that weren't prescribed for you. They may interfere with medicines you may be taking for depression, or they may make your depression worse.
• If you have a counselor, go to all your appointments.
• Work with your doctor to create a safety plan. A plan covers warning signs of self-harm. And it lists coping strategies and trusted family, friends, and professionals you can reach out to if you have thoughts about hurting yourself.

Where to get help 24 hours a day, 7 days a week

If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away. You can:

• Call the Suicide and Crisis Lifeline at 988.
• Call 1-800-273-TALK (1-800-273-8255).
• Text HOME to 741741 to access the Crisis Text Line.

Consider saving these numbers in your phone.

Go to 988lifeline.org for more information or to chat online.

Children or teens may be more likely to have depression if someone in their family has had it. They may also be at a higher risk after experiencing stressful or traumatic events, such as being bullied. Other things that increase the risk of depression include having other mental health conditions or experiencing abuse.

The types of counseling most often used to treat depression in children and teens are:

Cognitive-behavioral therapy.

This type of therapy helps reduce negative patterns of thinking and encourages positive behaviors.

Interpersonal therapy.

This type focuses on the child's relationships with others.

Problem-solving therapy.

This helps the child deal with current problems.

Family therapy.

This type of therapy provides a place for the whole family to express fears and concerns and learn new ways of getting along.

Your child may need to be checked for depression if your child is always sad or grouchy with family and friends or shows less pleasure in doing things that they used to like to do. Ask your doctor about other signs of depression.

There are some things you can do to help lower the chance of your child's depression coming back. Be sure your child stays with their treatment plan. You can encourage healthy choices, like regular exercise. But depression is a complicated condition. Sometimes even the best treatment and support may not prevent depression from returning.

Depression is a serious mental health condition that can take the joy from a child's life. It's normal for a child to be moody or sad at times, such as after the death of a pet. But if these feelings last for more than 2 weeks, they may be a sign of depression.

What causes depression is not well understood. There are many factors that may be involved. It tends to run in families. And if something stressful or traumatic happens to a child or teen, they may be more likely to get depression.

Often a child who has depression will also have one or more other problems. These problems may occur before a young person becomes depressed. For example, a child or teen may have:

• An anxiety disorder.
• Attention deficit hyperactivity disorder (ADHD).
• An eating disorder.
• A learning disorder.
• Serious behavior problems (conduct disorder). Some children develop conduct disorder after they become depressed.

A child or teen with depression is also at a higher risk for other issues. These include:

• Poor school or job performance.
• Problems in relationships with peers and family members.
• Early pregnancy.
• Physical illness.