Signs and Symptoms of Depression in Children

Raising Depression-Free Children : A Parent's Guide to Prevention and Early Intervention
By Kathleen Panula Hockey

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Diagnosing children with clinical depression can be a difficult task for physicians and mental health professionals. Part of the process is to gather information from parents, teachers, and if possible, friends.

Below is a list of signs and symptoms of depression in children. It is a composite of many lists found in many childhood depression books. The list is divided into four categories: physical, emotional, cognitive (thinking style), and behavioral. Childhood depression may be experienced in one area or several.

Physical:

• significant weight loss or weight gain
• appetite changes: eating too much or too little food
• physical complaints: stomachaches, headaches, and so on
• sleeping too little, too much, or not well; frequent nightmares
• tired all the time; loss of energy; exhaustion

Emotional:

• depressed, sad, or tearful mood
• moodiness; mood swings; easily angered
• anxious, nervous, fearful; worries a lot
• feels guilty a lot; hates self
• feels helpless to change negative situations
• feels hopeless about the future
• seems overly sensitive to criticism or correction

Cognitive:

• thoughts of running away
• suicidal thoughts; thoughts of death or death-related themes
• self-defeating or self-hating thoughts
• helpless and hopeless thoughts
• mostly negative thoughts about most situations (pessimism)
• many thoughts that create excessive or irrational guilt

Behavioral:

• slipping grades
• loss of playfulness or zest for life
• easily discouraged or frustrated
• increased whininess or aggressiveness
• loss of interest in usual pleasurable activities or hobbies
• social isolation; withdrawal
• difficulty concentrating; can't make choices
• can't finish projects
• lets life happen rather than helping to shape its direction
• overactivity; restlessness
• quiet, monotone, one-word answers to questions
• developmentally “going backward,” such as soiling pants at age six
• self-injurious behaviors, such as head-banging and cutting oneself
• talking, writing, singing, or drawing about death or suicide
• habitually listening to music with death- or suicide-related themes
• habitually reading books, reading comics, or playing videos with death- or suicide-related themes

Exhibiting a few of these does not necessarily mean your child has clinical depression. She may be experiencing normal sadness, other medical problems, a situational problem, or something else that indicates a different diagnosis or no diagnosis at all. That is why, if you have concerns, you should not attempt to diagnose your child yourself but instead get a more thorough assessment by a qualified professional. If your child is talking about death or suicide, it is vital that you seek professional help immediately.

As stated before, a good place to start the process of assessment is with your child's primary care physician. A physician can evaluate for any medical problems that might be causing depressive symptoms. (Page 14 of chapter 1 discusses several medical conditions that mimic depressive symptoms.) In addition, a primary care physician usually has a list of psychologists, psychiatrists, or licensed master's-degree-level therapists and can often facilitate a referral if needed.

If a thorough assessment by a physician and/or clinician rules out clinical depression, it is not time to relax and go on with life as usual. Depression prevention is needed. From a prevention viewpoint, these signs and symptoms are also target areas for preventive interventions.

© 2003 Hazelden Publishing

About the Author

Kathleen P. Hockey is a clinician, author, and recognized speaker in the area of childhood depression and prevention. She received her MSW from the University of Michigan in 1984 and is a member of the National Association of Social Workers and the Academy of Certified Social Workers. In 1993, Ms. Hockey obtained her Diplomate in Clinical Social Work. For the last twenty years, Ms. Hockey has treated children and families in both psychiatric inpatient and outpatient settings as well as in community service agencies. She is currently practicing brief, strategic and cognitive therapies with children, teens, adults, and families at her private practice in Richland, Washington.