Is Your Child Struggling? How to Look Out for Signs of Childhood Depression

Constant exhaustion, loss of interest, and feelings of crushing guilt and worthlessness can be overwhelming for any adult — now imagine how much harder it is for a child. In India, up to 8% of adolescents suffer from major depressive disorder. Globally, around 3% of children and teens between the ages of 3 and 17 experience depression, with rates rising as they approach their teenage years. Despite these statistics, parents may miss the early signs of childhood depression, mistaking them for moodiness or adolescent tantrums. This is why it's essential to understand the key symptoms and causes of childhood depression. Let’s answer some common questions to help you recognise childhood depression early.

The early signs of childhood depression can often be subtle and easily missed, particularly when they appear as normal fluctuations in mood or behaviour. Considering the increase in mental health issues among all ages, especially in children, it is crucial to pay attention to these subtle changes before they lead to larger issues. Let’s understand the warning signs that indicate a child may have depression:

• Persistent tiredness:
  Your child may always appear tired, even after a full night’s sleep. Fatigue that isn’t relieved by rest could be a sign of childhood depression.
• Persistent irritability:
  While we often associate depression with sadness, some children (especially teens) may express persistent irritability or anger, which is beyond a point of relevance to the ongoing life situation. This can easily be mistaken for typical teenage moodiness but may indicate underlying childhood depression.
• Struggling to focus or make decisions:
  Children with depression may have trouble concentrating, making decisions, or remembering things. These symptoms are tied to sad emotional states, such as repetitive negative thinking, which persistently interferes with their information processing ability, hindering focus and decision-making. These cognitive challenges are often dismissed as stress or distraction. However, with stress or distraction, the problems in focusing and decision-making are not tied to sad emotional states and improve once the stress or distraction is removed. 

• Changes in sleep patterns:
  Depression can cause either insomnia or excessive sleeping. 
• Withdrawing from activities and social interactions:
  A child who used to enjoy hobbies, sports, or spending time with friends may gradually withdraw from these activities. This is often mistaken for laziness or a lack of interest. 
• Changes in eating habits:
  Look out for sudden changes in appetite, leading to either weight gain or loss. This may manifest as overeating or a significant loss of appetite.
• Unexplained aches and pains:
  Persistent physical complaints such as headaches, digestive problems, or back pain may occur without apparent medical reason.
• Constant restlessness or edginess:
  Children with depression may feel constantly restless, on edge, or unable to relax. This may be misinterpreted as anxiety or hyperactivity.
• Excessive self-criticism or feelings of guilt:
  Depressed children often feel overly guilty about small things or make self-defeating comments, such as believing they are a burden to others. These signs can easily go unnoticed but may indicate deeper emotional struggles.
• Avoiding responsibilities:
  Tasks and responsibilities that were once part of the child's routine, such as going to school or participating in family activities, may be avoided. Avoidance behaviours are another red flag for depression.

A form of depression often overlooked, high-functioning depression (also known as Persistent Depressive Disorder, or PDD) can impact a child's quality of life without noticeable outward signs. Since children with high-functioning depression maintain their daily responsibilities, their struggles may go unnoticed. They often hide their feelings, thinking they should be “fine” due to their outward success. High-functioning depression may coexist with anxiety or other mental health issues.

Understanding the root causes of childhood depression can help parents identify risks and take preventative measures. There is no single cause of childhood depression — it usually results from a combination of factors.

• Genetic factors
  Children with a family history of depression or other mental health conditions may be more susceptible to developing depression themselves. 
• Environmental factors
  Major life changes — such as divorce, moving to a new place, or the loss of a loved one — can trigger feelings of insecurity, sadness, and anxiety, which may evolve into depression. Exposure to violence, bullying, or traumatic events also significantly increases the risk. Children who feel unsafe or unsupported in their environment are more likely to struggle with depression.
• Psychological factors
  Children facing academic pressure, social isolation, or problems fitting in with peers often experience increased stress, which may cause mental health issues over time.

While not all cases of childhood depression can be prevented, fostering a positive environment and building healthy habits can reduce the likelihood of developing depression.

• Healthy routines:
  Ensure your child has regular sleep patterns, healthy meals, and plenty of physical activity.
• Limit screen time:
  Excessive screen time, especially on social media, can contribute to feelings of inadequacy or anxiety. Set clear limits on digital consumption.
• Teach coping skills:
  Assist your child in cultivating effective stress management techniques, such as deep breathing exercises, journaling, or physical activity.
• Encourage social interaction: 
  Foster strong family bonds and friendships. Engage your child in group activities or hobbies they enjoy.
• Model positive behaviour: 
  Children often mimic parental behaviours. Show them how to manage stress effectively through healthy habits.

A combination of professional intervention and home care is crucial for recovery.

• Identify stressors
  Encourage open conversations about their day-to-day experiences. Understanding what may be troubling your child is the first step toward managing these stressors effectively.
• Address environmental changes
  If your child has experienced major life changes — such as starting at a new school or dealing with a family separation — provide emotional support and help them adapt to these new circumstances. Keeping an open line of communication can ease their adjustment.
• Seek professional guidance
  If you notice ongoing behavioural changes or signs of distress, consider consulting a therapist. Professional guidance can help your child work through trauma, anxiety, or other psychological concerns, ultimately reducing the risk of depression. The therapist can suggest effective treatments to help identify negative thought patterns and embrace healthier coping methods.
• Medication
  In some cases, a doctor may recommend suitable medications, but this is generally reserved for moderate to severe depression.

Untreated childhood depression can have significant long-term effects on both brain and physical development, as well as social and emotional well-being. 

• Cognitive function:
  Depression can affect areas of the brain responsible for memory, decision-making, and emotional regulation. This can lead to challenges in focusing, problem-solving and verbal skills, impacting academic and social performance even after symptoms improve.
• Emotional growth:
  Untreated depression can cause lasting issues with self-esteem and relationships, potentially affecting a child's ability to form healthy connections into adulthood.
• Stunted growth:
  Chronic depression raises levels of stress hormones like cortisol, which can interfere with physical development and growth. Children experiencing long-term depression may also be at higher risk for anxiety, substance use disorders, and compromised overall health later in life.
• Suicidal behaviour:
  Depression is one of the leading causes of suicide in children and adolescents.

If you're unsure how to find help for your child with depression, start by consulting a paediatrician or mental health professional who can provide resources for therapy or counselling. Children can recover and thrive with the right support, early recognition, and treatment. Understanding the symptoms, causes, and solutions helps parents create a safe haven that encourages emotional well-being.