Depression in children and adolescents
This page provides you with information about depression in children and adolescents.
The Centre for Child and Adolescent Psychiatry is responsible for the treatment of depression in children and adolescents in Central Denmark Region.
What is depression?
Depression is a disorder that can strike anyone – adults, children and adolescents. If you are depressed, you have been feeling sad or just not very happy for a long time. You tire more easily and are unable to cope with the things you normally do. You often also think that you are no good at anything, and that nothing is fun anymore. You might also feel that life is no longer worth living.
We all have days when we feel sad and find that everything is boring. You can also have days when you do not think that you are particularly good at anything. But if these sad thoughts and feelings persist for a long time, you might be suffering from depression, which means that you need help.
What causes depression?
It is not known precisely why some adolescents suffer from depression while others do not. Research has shown that children and adolescents are at greater risk of suffering from depression if they:
- Are related to a person with a current or previous history of depression
- Have experienced other problems in their life. This may be serious illness or death
- Have other difficulties, such as anxiety or difficulty concentrating
- Tend to have negative expectations and always think the worst
- Have been stressed for a long period and are exposed to more than they can cope with.
There are generally several different reasons why you get a depression. Sometimes it is difficult to find any reason at all.
Symptoms of depression
Examination for depression
To find out if you are depressed, you should talk to a doctor or psychologist who has a special understanding of depression in children and adolescents. During the meeting, you will talk about how you are feeling. Your parents should also participate in the consultation and tell the doctor or psychologist how they experience you. They should also talk about how you have developed from a very young age.
The purpose of these consultations is to discover what signs of depression you have. It is also important to find out whether any other difficulties or problems are putting pressure on you. Your therapist can assess whether you are depressed based on the nature and number of your symptoms.
Treatment of depression
Learning about your disorder is known as psychoeducation. It is important for all adolescents with depression, and for their parents and other persons closest to them, to learn about what depression is.
You will learn about:
- The signs of depression
- What is especially difficult for you
- How your parents can help you.
- What you can do yourself to get well again.
By learning about depression, you and your parents can find out what it takes to provide you with the support you need to gradually feel better.
Relief may also help. Relief means that, for a period, you will not have to meet the same demands as usual. For example, you may spend less time at school, do less homework or have fewer home assignments. The purpose of relief is that you conserve your energy and try to avoid experiences that you cannot cope with because you are tired and sad.
Relief does not mean you are to do nothing at all. You still need to do something and perform some tasks. In fact, doing something has a beneficial effect on a depression. This may, for example, be minor short school assignments or small chores at home. Perhaps tidying your room would be too overwhelming for you, whereas emptying the dishwasher would be easier.
It is also very important for you to do something that could make you more cheerful or content. You might not be able to cope with a class party, but a visit by a friend for a few hours is OK. The important thing about relief is for you and your parents to agree on tasks and activities that you are able to cope with and that are enjoyable.
Psychotherapy is another word for counselling. It means you talk to a therapist (usually a doctor or psychologist) about how you are feeling, and what you can do to get better. Your parents will generally also be involved in such consultations – either for the whole consultation or for parts of it. This also gives your parents an opportunity to talk to you and your therapist about what works best for you.
Some adolescents who have suffered from depression for a long time or who think about suicide a lot also need medication to get well again. Medication is not a magic potion that will suddenly make you happy again. But it can help lift your mood a little and give you more energy. It may take 2-8 weeks for the medication to start working. The effects of the medication can differ from person to person. Some adolescents do not find that they have much benefit from medication.
The doctor, together with you and your parents, decides whether medication will be a good idea. Before you start taking medication, the doctor will inform you about how it works. The doctor also informs you about possible side effects. Side effects are things that happen in your body – things that you do not want, but which are the result of your body being affected by the medication.
Side effects of the medication may, for example, be stomach aches or difficulty sleeping. The side effects generally pass once your body has become accustomed to the medication. But, in some individuals, the side effects persist. If this happens, an agreement will need to be made with your doctor about whether you should stop taking the medication or switch to a different type of medication. When you take the medication, you must attend regular consultations with your doctor, especially at the beginning. The doctor must check whether the medication is working, and whether there are any side effects.
Unfortunately, a depression does not pass just like that. Instead, you gradually start to feel better. At some point, you will notice that you have more energy and that you are able to do more things for longer at a time. You will gradually feel happier slightly more often, and you will have fewer periods in which you feel sad. You will probably also think less about the things that you feel you are no good at.
If you have been thinking about suicide, these thoughts will occur rarely or cease altogether. Finally, you will mostly feel happy and only sad once in a while – just like everyone else who is not suffering from this disorder.
Advice for children and adolescents who suffer from depression
You might not have the energy or strength to do things for very long at a time, but you can then do them for a shorter period of time. Be honest with the people around you. Tell them when you are getting tired and need a break or need to stop.
For example, if it is difficult for you to manage a full day at school, you and your parents and teachers may agree on a shorter school day for you for a period. Give yourself breaks during the day to relax.
Getting some exercise and fresh air every day often helps lift your mood a little, even if you do not really feel that you want to or have the energy for it. You will also get strength from eating your daily meals (neither smaller or bigger portions), even if perhaps you do not feel much like eating or you would prefer to eat junk food.
Tell your parents when you are really struggling so that you can spend some time together. Perhaps you could have a chat or find something you can do together to distract you from your sad thoughts for a while. If you are feeling sad, it is generally worse if you are alone with this feeling of sadness.
If you cannot confide in your parents, try to find close relationships to confide in. This may, for example, be a grandparent or another adult in your family that you feel comfortable with. It may also be your school teacher or an educator.
Also tell your parents if you have thoughts or plans about suicide. Your parents or other persons close to you will help you through the tough periods so that nothing happens to you.
It is a good idea to keep in touch with your friends – perhaps with your closest friend. Even if you may be too tired for a visit, you can still write to each other.
Tell your closest friends that you suffer from depression or get help to tell them. Tell them that you are not able to do the things you usually do right now, or that you do not feel like doing much of what you usually do. Your parents might be able to help you.
It is also best if your parents let your teacher and your class know so that they can be considerate towards you, and you will not have to pretend to feel better than you do.
Advice for relatives
You play a key role in helping your child with depression. Your child needs:
- you to listen
- be present
- help make everyday life easier.
Because you know your child, you can contribute significantly to understanding what might be burdening him or her. Therefore, you also know what can provide relief and give positive experiences.
Your child needs to be aware – and reassured – that, despite his or her own low self-esteem and self-reproach, he or she is loved and valued. You can keep your child’s hopes up, and, for example, remind him or her that depression is a disorder that will pass, or remind him or her of the progress being made.
When talking to your child, it is important that you do not try to disprove or correct his or her perception or experience. Instead, you must listen with care and understanding and, when relevant, present your alternative and more positive outlook.
It is also important to ask about and listen to your child’s thoughts of suicide, if any. Here, you should express empathy for his or her pain, while also assuring him or her of your help and protection.
As parents of a child with depression, you also have an important task in helping him or her – as far as at all possible – maintain a normal daily rhythm and normal eating patterns, and motivating him or her to participate in activities and to get exercise and fresh air.
Generally speaking, as a family, you need to try to limit the amount of criticism, angry outbursts and conflict, as children and adolescents with depression are particularly negatively affected by this. When making demands on your child or correcting him or her, make sure that you speak in a neutral or encouraging tone of voice.
As parents of a child or adolescent with depression, it is easy to become over-involved. It is important to strike a balance between respecting your child’s boundaries and offering help and support.
Children and adolescents with depression often have difficulty maintaining contact with their friends and networks. Here you can be a great help, for example by:
- helping your child arrange short visits
- keeping the network informed (by agreement with your child)
- supporting that friends continue to send greetings to your child – even if, for a period of time, he or she does not have the energy to answer messages or receive visits.
- Remember that depression is a disorder and not anyone’s fault
- Remember that most cases of depression respond well to treatment
- Learn about depression, and support your child during his or her treatment
- Listen to your child and show empathy, but do not try to argue or convince him or her
- Accept that your child is sad
- Avoid criticism and reproach
- Lower your expectations of your child
- Help your child to maintain a normal daily rhythm and eating patterns
- Support contact between your child and your child’s network
- Be open – agree with your child what others are allowed to know about his or her depression
- Seek support, and give yourself breaks
- Accept that you cannot solve all the problems yourself, and focus on the areas where you can make a difference
- Be patient – also with yourself.
Text on this page updated December 2021 (version 1.03).
Author: Katie Powell, psychologist specialising in psychiatry, Centre for Child and Adolescent Psychiatry, Aarhus University Hospital – Psychiatry.
Most recently revised by: Merete Juul Sørensen, Senior Consultant at Centre for Child and Adolescent Psychiatry, Aarhus University Hospital – Psychiatry.