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Last Updated on January 12, 2021

Signs of Depression in Children (And How to Help Them to Overcome It)

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Signs of Depression in Children (And How to Help Them to Overcome It)

Children, just like adults, can be depressed. Sometimes seemingly normal children with no major life issues can become depressed. It is the result of a chemical imbalance in the brain that causes clinical depression to occur. There are specific signs that you should recognize in your child if they are depressed. Getting them help and treatment is crucial to their mental wellness.

In this article, we will look into the signs of depression in children and how parents can help them to overcome it.

Signs of depression in children

The DSM (Diagnostic and Statistical Manual of Mental Disorder) is the widely accepted instruction guide that professionals utilize for diagnosing mental disorders. The DSM characterizes a Major Depressive Episode as depressed behaviors that consistently last for two weeks or longer. Therefore, if your child has been “down in the dumps”, feeling hopeless or having sadness for more than two weeks, it should be cause for concern and investigated.

Below are signs of depression according to the DSM manual. The individual must have at least five of these behaviors present for a period of two weeks or longer to be officially diagnosed as having MDD (Major Depressive Disorder). Below is a summary/generalization from the DSM manual:

  • Feelings of deep sadness or depressed mood that last most of the day (for two weeks or more). For children they can present as irritable rather than sad.
  • Diminished interest in activities (again majority of the day or all the time).
  • Significant weight loss (not through dieting), or a decrease in appetite. In children, they fail to make expected weight gains while growing.
  • Difficulty sleeping (insomnia).
  • Either a slowing of psychomotor abilities/actions or an apparent agitation of these psychomotor abilities. This means that they either have moments that lack purpose and seem to be done because of agitation and tension or there is a significant slowness/retardation of their speech and physical actions.
  • Fatigue and loss of energy.
  • Feelings of worthlessness or excessive guilt every day.
  • Difficulty thinking, making decisions, or concentrating every day. This may be reflected in their grades.
  • Preoccupation with death and dying or suicidal thoughts.

Please note that if your child is suffering from the loss of a loved one and is processing through the stages of grief, it is normal to have these signs of depression. If they seem to be stuck in the depression stage, then it is time to pursue grief counseling to help them along in the grieving process.

However, if they are not suffering from a bereavement or a medical condition that would cause the above symptoms, then they should be taken to a professional for possible diagnosis and treatment of MDD (Major Depressive Disorder).

How to help your child with depression

Depression is not to be taken lightly. Especially if suicidal thoughts are present. The child’s feelings and emotions are real and must be taken seriously. According to the National Institute of Mental Health (NIMH), suicide is the number two cause of death for individuals between the ages of 10 and 34.[1]

Professional help is recommended if you believe your child fits the criterion for MDD (Major Depressive Disorder). You can take your child to their paediatrician for an evaluation and referral. Depending on the severity of the symptoms, they may benefit from medication such as anti-depressants.

Most professionals do not dispense medication as the first remedy for depression. Instead therapy is the first line of defense against depression, with medication being paired with therapy if the therapy is not enough or the symptoms are severe enough.

Testing

There are assessment tools that professionals can utilize to help in properly determining whether your child is depressed. The three tools used in assessing depression in children are:

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  • The Children’s Depression Rating Scale (CDRS)
  • Children’s Depression Inventory (CDI)
  • Clinical Global Impression (CGI)

Taking your child to a professional mental health counselor, psychologist or psychiatrist can help ensure proper testing and assessment occurs.

Therapy

There are many types of therapy available today. It is important to find a professional that specializes in childhood depression and the treatment of such.

Cognitive behavioral therapy is one of the leading therapy methods in treating childhood depression. For younger children, play therapy is useful in treating childhood depression as children are often able to better communicate through play than conversation alone.

What parents can do at home to help their depressed child

Besides seeking for professional help, there are a couple of things that parents can do at home to help their depressed child:

1. Talk with your child about their feelings in a compassionate and empathetic manner.

It can feel high pressure to sit face to face and ask your child about their feelings. However, going on a walk, playing a board game or playing alongside your child (chose whichever is age appropriate for your child) can allow them to relax and open up about their feelings.

Ask your child open ended questions that require more than a simple yes or no to engage in more meaningful conversations. Never judge while they are being open and honest with you because it will inevitably cause them to shut down and move away from being open with you.

It is okay to allow for periods of silence during the conversations because sometimes the child is processing their thoughts and emotions during your time together. You don’t have to fill the space and entire time with talking as silence at times is helpful.

2. Provide activities that help them relax and de-stress.

For smaller children, there are simple ways to help them relax.

Provide play opportunities that they find relaxing such as coloring, painting, working with Play-do or clay, or playing with sand and sand toys. Again, find activities that interest your child and are age appropriate are helpful in making them relaxed.

3. Limit screen time.

Technology is not helpful in making your child less depressed. It can often be an escape that keeps them from further opening up about their feelings and emotions.

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Limit time in front of the TV, laptop, smart phone, video games and tablets, etc. Any electronics that seem to prevent your child from face to face interactions should be limited. Ask Dr. Sears cites that researchers have found kids who have higher levels of screen time are at greater risk for anxiety and depression.[2]

Provide alternate activities to replace the screen time such as hiking, crafting, drawing, constructing, biking and playing outside, etc. Some children may be so dependent on their screen time as their source for entertainment that they may need you to participate in alternate activities alongside them in order to get engaged in the activities.

You can’t simply tell your child to go outside to play if they are suffering from depression, lack friends and are used to sitting down and playing video games each day after school. Go outside with your child and do a nature hike or take your child to a playground and have fun together to get them engaged in these alternate activities.

4. Promote outdoor time and physical activities.

Encourage your children to take part in activities that especially involve nature such as nature hikes. Do these activities with them to help them engage in the activities. Again this is an opportunity for open conversations to occur and quality time to take place.

5. Help your child when problems and difficult tasks arise.

Assist them by helping them break down the task into smaller and more manageable parts. Children with depression often have difficulty taking on large problems and tasks and find them overwhelming. Helping them by breaking down the task into smaller and more manageable tasks will assist in helping raise their confidence when the small tasks are mastered.

Small tasks mastered lead to bigger tasks being mastered over time. It is a process over time, patience and a willingness to work alongside your child. This does not mean doing the task or taking on the problem solely yourself. Many times all the child needs is for you to break down the larger task into smaller more manageable tasks and for you to patiently talk your child through the completion of these smaller tasks.

6. Help your child reduce life stress.

When children are depressed, they have greater difficulty handling life activities in general. Cut back on activities that cause stress to increase and look for ways to help reduce stress in your child’s life.

7. Foster a positive home atmosphere.

Reduce or eliminate negative attitudes, language and conversations. Also avoid raised voices, passive aggressive behaviors and any form of physical violence in the home.

Make your home a safe haven for your child instead of an atmosphere that is ever volatile (in words, emotions or physically). Make it a calm environment that makes your child feel safe and secure mentally, emotionally and physically.

8. Help your child see the positive in life situations.

Point out the positives in a situation rather than the negatives. Help them see the bright side of any situation.

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Be a model of seeing the positive in life by speaking words that are uplifting, encouraging and positive. Resist the temptation to voice negative thoughts that come to mind as your child can feed off your emotions and words.

9. Believe your child when they talk about how they are feeling.

Listen to them patiently and take their words seriously. Do not discount or minimize their feelings. Express empathy and compassion when they do open up about their feelings. Help them utilize “I feel” statements in expressing their emotions.

10. Keep watch for suicidal behaviors.

Such behaviors include your child/teen researching this topic online, them giving away their possessions and a preoccupation with death.

Seek professional help immediately with the presentation of suicidal behaviors or thoughts. Keep this number on hand and use it when in doubt: National Suicide Prevention Lifeline Phone Number 1-800-273-8255.

11. Keep all prescriptions, alcohol, drugs and weapons locked and away from children and teens.

This is a given for all children, but even more imperative for children who are depressed as they have an increased likelihood to abuse drugs and alcohol. They also have an increased likelihood to attempt suicide. So keep weapons and tools such as ropes and knives that can used for suicide out of the child’s ability to use.

12. Spend quality one-on-one time with your child.

Make the time during your day, every day, to spend quality time with your child. You may have limited time and cannot provide an hour or more a day to dedicate to one-on-one time with your child, but you should provide a minimum of 20 minutes a day with your child spending quality one-on-one time together. Try the suggested activities listed in point #3.

13. Be an encouragement and supporter of your child.

Show love and not frustration or anger because of the situation and your child’s condition. Help keep your attitude positive so your child can also see the positive.

Provide daily words of affirmation that are not based on end results (such as a grade or a win) but instead praise the effort they put forth. If you praise the outcome, they will be disappointed when their efforts don’t pan out. If they are praised for their efforts regardless of the outcome, their confidence is built based upon something that they can control (the effort they put into things).

14. Help your child to live a healthy lifestyle.

Sleep is a very important factor in your child’s mood. Not getting enough sleep can cause an entire day to be upset. According to Sleep Aid Resource, children between the ages of 3 and 18 need between 8 and 12 hours of sleep each night:[3]

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    Ensure your child is eating a healthy and balanced diet, getting physical activity/exercise daily and plenty of sleep time.

    15. Help your child foster positive relationships and friendships with their peers.

    Set up play dates for your younger child and encourage older children to invite friends over to your home.

    16. Talk about bullying.

    It can be one of the causes of your child’s depression, so discuss their life outside of home and their interactions with their peers. Help them recognize bullying and discuss how to handle bullying properly.

    17. Help your child follow the treatment plan outlined by their doctor, counselor, psychologist or psychiatrist.

    Make sure you know the treatment plan that your child’s health care professional has outlined for child. This may include counseling session recommendations, medications and recommendations to follow through with in the home. Completing the plan will help provide optimal results for your child in the long run. A plan doesn’t work unless it is followed.

    18. Recognize that professional treatment takes time to show results.

    Don’t expect results for the first few weeks. It may take a month or longer, so be patient and understanding with your child.

    Depression in children is curable

    Depression in children can happen for a variety of reasons. It is quite treatable.

    Professional help is recommended if your child can possibly be diagnosed with a depressive episode. There are interventions that can be implemented in a professional setting, at home and at school. The key is having a plan of action to help your child.

    Ignoring the problem or hoping the depression will just go away is not a good plan. Treatment is imperative to curing depression in children.

    The first step is talking to your child’s paediatrician to get the ball rolling. He or she will refer you to specialists in your area that can help your child overcome and conquer their depression one day at a time. With you by their side, each step of the way you will get through it together and it is quite possible for your relationship with your child to be strengthened in the process as well. That can be your silver lining or positive outlook on the situation at hand.

    Featured photo credit: Unsplash via unsplash.com

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    Reference

    [1] National Institute of Mental Health: Suicide
    [2] Ask Dr. Sears: It’s a Virtual World: Setting Practical Screen Time Limits
    [3] Sleep Aid Resource: Sleep Chart

    More by this author

    Dr. Magdalena Battles

    A Doctor of Psychology with specialties include children, family relationships, domestic violence, and sexual assault

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    Published on October 15, 2021

    Does Anxiety Make You Tired And Why?

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    Does Anxiety Make You Tired And Why?

    When you think of anxiety, several scenarios may come to mind: the endless tossing and turning of a restless night, dread over potential future events, pandemic-related overwhelm, or full-blown panic attacks. Even if you’re not diagnosed with an anxiety disorder, you’ve likely experienced anxiety symptoms at some point in your life. In these situations, you might feel a queasiness in your stomach, racing heartbeat, excessive sweating, chest tightness, some tension in your jaw/neck/shoulders, or worrisome thoughts as you prepare for the worst possible scenario. But does anxiety also make you tired?

    After experiencing these symptoms, you may indeed feel fatigued. The sensation could fall anywhere on the exhaustion spectrum, from feeling like you just ran a marathon and need to sleep for two days, to just a little worn down and wanting a quick nap to recover.

    Below are 7 ways anxiety zaps your energy and how to restore it.

    1. Stress Hormone Overload

    Anxiety can make you tired via overloading your body with stress hormones. The “fight or flight” response is a key connection between anxiety and fatigue. In fact, this process is made up of three stages: Alarm, Resistance, and Exhaustion. Anxiety triggers our body systems to go into high alert. This is a natural, involuntary reaction that developed in the human brain for survival.

    When humans lived with the real, imminent threat of being attacked by a predator, it made sense for our bodies to spring into action without much preparatory thought. Such dangers are rare in modern times, but our brains continue to respond in the same way they did thousands of years ago.

    The hormones and chemicals that flood our bodies to prepare us for safety can both affect and be affected by several body systems, and this interaction itself contributes to exhaustion. Adrenaline and cortisol are the two most notable hormones to address here. First, adrenaline is sent out, tensing the muscles and increasing heart rate and blood pressure in preparation to run. Later in the stress response, cortisol is released, enhancing the brain’s use of glucose. This is one of our main fuel sources, so it’s no wonder this contributes to fatigue (see #2).

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    You can regulate baseline levels of these stress hormones by regularly practicing yoga, breathwork, meditation, and/or engaging in aerobic exercise.[1] It’s easier to lean into these routines for relief during stress when you’ve already mastered using them during times when you feel calm.

    2. Elevated Blood Sugar Levels

    Fatigue is one of the most common symptoms of hyperglycemia (high blood sugar), which is shown to be associated with anxiety in diabetic patients.[2] Many people who experience hyperglycemia report feeling tired all the time regardless of their quantity or quality of sleep, nutrition, or exercise.

    Although this connection has shown more prevalent and prolonged effects in diabetics, it also occurs with nondiabetics exposed to psychiatric stress.[3] In fact, for all people, the natural stress response elevates blood pressure and heart rate as well as cortisol levels, all of which increase blood sugar levels.[4] This means that anxiety causes a double-hit of exhaustion related to blood sugar fluctuations.

    Instead of reaching for comfort foods like chocolate during times of stress, take a calming walk around the block. Gentle movement alone is a great stress reliever that incidentally also helps to regulate blood sugars.[5]

    3. Negative Mindset

    Anxiety can also make you tired because of repetitive negative thinking (RNT), which is a common symptom of anxiety. RNT involves continuous thoughts via rumination (dwelling on sad or dark thoughts focused on the past) and worry (angst regarding the future). Some researchers argue that having a longtime habit of RNT can harm the brain’s capacity to think, reason, and form memories.[6] While the brain is busy using its energy stores to fuel negative thought patterns, the energy available for these other more productive endeavors is thereby reduced.

    Negative thoughts can also disrupt or prevent healthy sleep patterns, keeping our minds racing at night and effectively wreaking havoc on daytime energy. (See #7)

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    Reduce these patterns by reframing your feelings over anxious thoughts. Instead of staying stuck on “what if,” focus on what you can do in the here and now. What activity can you engage in for five minutes (or more) that brings you joy? What are you grateful for, no matter what’s going on around you?

    4. Digestive Issues

    It’s common for people to experience both intestinal and mental issues simultaneously. This suggests a strong connection between the central nervous system and the gastrointestinal (GI) tract, which is known as the gut-brain axis.[7] Simply put, what happens in our digestive tract (and as a result of what we eat) affects the brain and vice versa.

    The gut microbiota is a complex population of GI tract microorganisms. When its balance is altered, the body can develop conditions that affect the gut-brain-endocrine relationship. The endocrine system produces and manages adrenaline, for starters. And the gut bacteria’s production of feel-good hormones (serotonin and dopamine—see #5) ties into this relationship as well.

    GABA (gamma-aminobutyric acid) receptors are also found in gut bacteria. GABA is a natural brain relaxant that makes us feel good by helping the body to unwind after a stress-induced neurotransmitter release (e.g., cortisol and adrenaline). When GABA activity is low, it leads to anxiety, depression, insomnia, and mood disorders. These are just a few of the manifestations that demonstrate how gut bacteria influences behavior. All of these contribute to feeling both physically and mentally tired.

    You can minimize the symptoms of depression and anxiety by keeping your gut microbiota balanced with probiotic-rich fermented foods. Yogurt with live cultures, sauerkraut, kombucha, kefir, kimchi, miso soup, and tempeh are great foods to include in your diet.[8]

    5. Depression

    Anxiety and depression often go hand in hand. Research continues to indicate a complex relationship between depression and decreased serotonin—a key neurotransmitter for regulating mood and feelings of wellbeing and happiness. Anxiety is also a direct symptom of serotonin deficiency. Serotonin helps with healthy sleep, mood, and digestion.

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    Serotonin is produced in the gut, almost exclusively, at an estimated 90 percent. However, a small quantity is also produced in the hypothalamus, an area of the brain that is pivotal for transmitting energy balance signals. This small cone-shaped structure receives and relays signals transmitted via the vagus nerve from the gastrointestinal tract. It has a central role in mediating stress responses, regulating sleep, and establishing circadian rhythms. It senses and responds to a myriad of circulating hormones and nutrients, directly affecting our mood and energy.[9]

    Dopamine is another mood-boosting neurochemical that is depleted in depression. It creates feelings of alertness and wakefulness and, when the body is operating normally, is released in higher amounts in the morning (allowing for daytime energy) and lower at night (preparing for healthy sleep). Stress is one factor that can deplete dopamine, thereby leading to depression, sleep disorders, and fatigue.

    Studies show that dopamine levels in the brain can be elevated by increasing dietary intake of tyrosine and phenylalanine.[10] Both of these amino acids are naturally found in protein-rich foods like turkey, beef, eggs, dairy, soy, peas, lentils, and beans.

    6. Breathing Problems

    Breathlessness and anxiety are closely linked, and this is one of the ways anxiety can make you feel tired. Anxiety can lead to shallow breathing, which can cause shortness of breath while feeling breathless can exacerbate anxiety.[11] It’s a vicious cycle that often leads people to take rapid and shallow breaths, breathing into their upper chest and shoulders.

    This type of breathing minimizes oxygen intake and usability. Despite comprising only two percent of the body, our brains consume 20 percent of the body’s oxygen supply. Oxygen is fuel for both mental and physical tasks. When breathing patterns compromise healthy oxygen levels, this can cause considerable fatigue.[12]

    End the anxiety-fatigue cycle with focused breathing exercises. It’s important to practice this regularly while you’re not experiencing anxiety or stress, as this will help you to be prepared should a moment of breathless anxiety hit unexpectedly.

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    There are several different styles of breathing exercises. There’s an easy one to try, called “Resonant Breathing.” Simply breathe in slowly through your nose as you count to five, then exhale for a count of five. Repeat this for a few minutes. It’s helpful to bring your awareness to any tension, deliberately relaxing your neck, shoulders, and jaw in particular.

    7. Sleep Issues

    Most of the elements we’ve already discussed inherently tie into sleep issues, which is often the reason why anxiety can make you feel tired. But it’s important to note that this is not always a directly linear cause-and-effect process. Much of it is cyclic. If we don’t get enough quality sleep, we increase our risk of excessive cortisol production, elevated blood pressure and blood sugar levels, depressed mood and mindset disorders, and dysregulation of appetite/craving hormones that affect our digestive health.

    Sleep is obviously the number one antidote to feeling tired as a result of anxiety. But at the same time, many of these elements—including anxiety itself—lead to less-than-restorative sleep. We can improve our energy levels by addressing each element discussed here, as well as taking a proactive approach to our sleep health.

    One simple habit to help recalibrate your circadian rhythm for healthy sleep patterns is to get outside in the morning. Sunlight exposure in the early hours of the day regulates melatonin production, helping us to feel sleepy at night.

    You Don’t Have to Live Your Life Anxious and Exhausted

    Times of extreme stress, like driving in heavy traffic or nerve-wracking situations like public speaking, can easily induce an anxiety response. Even “normal” everyday stressors, like feeling overwhelmed with work and home responsibilities, can build up to anxious feelings over time.

    Our bodies’ response to stress and anxiety affects many of its functions in complex ways. When we unravel the interconnections of these processes, we can see how each part plays an intrinsic role in contributing to fatigue. By addressing each element individually, we can make simple lifestyle changes that resolve anxiety and diminish the ways it makes us tired as a result.

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    More Tips on Coping With Anxiety

    Featured photo credit: Joice Kelly via unsplash.com

    Reference

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