Depression is far more than transient feelings of sadness. It is a persistent low mood that interrupts the functioning of the child socially, emotionally and academically. Children suffering from clinical depression experience persistent feelings of sadness (most or all of each day), and may also feel irritable (that may or may not be “set off” by something that happens in day to day life). They may also experience difficulties sustaining their attention on school work, homework, reading, and other tasks, and show changes in their sleep patterns and eating.
Children with depression may cry, be frequently irritable or angry, or behave in ways that are out of character and otherwise be difﬁcult to calm. School staff may comment that the child is withdrawing from their friends or classroom activities or encountering difficulties with their school work.
Children with depression may not be able to articulate how they are feeling, especially if they are feeling sad or angry. However, many symptoms of child depression can be directly observed, such as the following:
- Less interest and enjoyment in their usual activities
- Boredom, apathy and lack of attitude (“can’t be bothered”)
- Anxiety and worry (including being more sensitive or reactive)
- Dawdling, sluggishness and otherwise slowed physical movements
- Restlessness or fidgeting
- Nervous, jumpy, easily frightened
- Difficulties going to and staying asleep (e.g. waking early) or sleeping much more than usual
- Sadness and crying
- Feeling unloved, reporting they ‘hate’ themselves
- Feeling more lonely or saying that no-one likes them
- Difficulty staying focused on tasks (e.g. school work) or in making decisions
- Pessimism (predicting things won’t be fun)
- Pictures or preoccupation with death (which may be accompanied by reports that they want to die)
Difficulties seen alongside child depression
Many children who have depression are also anxious. Anxiety can be seen as clinginess, self-doubt, inhibition, and levels of fear that are disproportionate to the threat of an actual situation. Adolescents who are depressed can also experience difficulties with their learning. Memory and concentration problems are common symptoms of depression, so it can often look like the young person has learning difficulties in the classroom. Worsening grades and falling behind in school work can in turn, perpetuate the child’s low mood and feelings of hopelessness. Some children with depression show disruptive or ‘oppositional’ behaviours – picking fights or arguments at school or at home with siblings, or displaying vindictive behaviours. Children with physical illnesses are also more at risk of developing child depression. Children with depression can also get sick more easily with colds, flu, aches and pains.
What drives child depression?
‘Nature’ and ‘nurture’ interact to moderate a child’s risk of developing depression. Children with a family history of maternal and/or paternal depression, anxiety or other particular psychological difficulties are genetically more at risk of developing mood disorders such as depression. Environmental triggers that typically precipitate depression can include major loss events (e.g. loss of a physical ability, loss of a pet, loss of a friend, death of a relative), change and adjustment (e.g. renovations, moving house, changing schools, hospitalisation) or other major stressors (e.g. parental separation or divorce, illness of a sibling or parent, and stress from school work and homework, and friendship issues).
Therapy for depression in children
A number of therapies assist adolescents and their families to learn skills for to manage their feelings and behaviours and develop a tool kit to build resilience. In all of these therapies, components include activation of behaviour (where there has been a withdrawal from activities, socialisation and tasks from which the adolescent otherwise derives achievement and joy), mood management and the development of coping skills. The most evidence-based therapy for depression for people of all ages is cognitive-behaviour therapy (CBT).
Where to go from here?
If you would like to find out more about our treatment for child depression, or to book an appointment with one of our child clinical psychologists who provides treatment for this condition, please email or call the clinic on 02 9438 2511.