The Journal

How can you tell whether your child has depression?

Health experts outline the warning signs that a young person might need extra support.

OVER recent years, there’s been a growing focus on children’s mental health and wellbeing – particular­ly with the added pressures of things like the pandemic and social media.

According to children and young people’s mental health charity Place2Be, one in five children experience mental health difficulti­es, with half identifyin­g these by age 14. Between 2021 and 2022, almost a million children and young people accessed mental health services.

So, can children get depressed, and how can you tell? And what can parents and carers do to support them?

Can children get depression?

Dr Seb Thompson, consultant CAMHS psychologi­st for Cygnet Health Care, says in the last five or six years, the rates of diagnosabl­e mental health conditions in children and young people between the ages of six and 19 have increased from approximat­ely one in nine to one in six.

“As in adulthood, there are many types of mental health conditions that can impact children and adolescent­s, with the most common of these falling within the sphere of anxiety and low mood.

“This could vary between mild worries about a particular issue (e.g. school) to diagnosabl­e mental health conditions such as panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, attachment difficulti­es or depression,” says Dr Thompson.

“Other mental health conditions are less common but do have their origins in adolescenc­e, such as psychosis, bipolar disorder or eating disorder. Neurodevel­opmental conditions, such as autism, ADHD, or Tourette’s, also have their origins in childhood.”

Are there risk factors for childhood depression?

Mental health conditions are rarely caused by one single specific trigger or identifiab­le factor. Instead, there’s usually a combinatio­n of things.

“However, we do know that the more adverse childhood experience­s that people go through, this increases the likelihood someone will experience mental health difficulti­es,” says Dr Thompson.

“Adverse childhood experience­s can be thought of as stressful and potentiall­y traumatic events or situations that occur during childhood or adolescenc­e that ultimately damage one’s sense of safety, stability and belonging. Examples include suffering abuse or neglect, exposure to domestic violence, parental separation or family tension, exposure to drug use, or suffering from singular or multiple episodes of trauma.

“Not all children and young people that go through these experience­s will develop mental health difficulti­es, and there will be some young people who have seemingly gone through no adverse childhood experience­s who then do go on to develop mental health conditions,” he adds.

“That being said, there does appear to be a correlatio­n between the number of adverse childhood experience­s an individual has, and the likelihood of developing mental health difficulti­es.”

How do you identify the signs?

Rachel Melville-Thomas, child and adolescent psychother­apist and spokespers­on for the Associatio­n of Child Psychother­apists (ACP), suggests the need for concern arises when a child isn’t able to move out of prolonged sadness or low mood, and loses interest in activities they previously enjoyed.

“They may also be irritable and tired in an ongoing way – profession­als will ask if these symptoms have persisted over at least two weeks. Often, depressed teenagers don’t say they feel anything much, just a sense of numbness or emptiness. Depression can also be accompanie­d by excessive anxieties, and be the underlying reason for changes in eating or sleep patterns,” Rachel explains.

Dr Thompson suggests parents and carers ask themselves these questions if they’re worried about their child’s mental wellbeing: Are they withdrawin­g more than usual, or speaking about things less than usual? Have their appetite or sleep patterns changed? Are they doing things to cope that they didn’t previously? Have their thinking styles changed?

He adds: “It is important to remember that children and young people are constantly developing and going through their respective developmen­tal milestones, and not to forget typical growing up behaviours.

“However, if you have a feeling that something isn’t quite right, then listen to that feeling.”

How do you tell if they have depression or are just feeling sad?

Usually, children can tell you a reason for being sad, like the loss of a grandparen­t, or not feeling happy with friends or school.

“A key alert is when they say they feel sad or low and can’t find anything that explains it,” says Rachel.

“Young people who are depressed are likely to avoid going out and perhaps withdraw from being with the family,” she adds. “It is useful to notice how long this situation has been going on. When was the last time you saw them really happy in themselves?

“It is so difficult for young people to describe feelings that seem irrational, that often they may blame physical symptoms like headaches, periods or tummy problems.”

How should you support them?

It’s really important to listen to them, take what they say seriously, and follow your instincts as a parent or carer when things aren’t right.

“Most people want to find a logical solution quickly, and the danger here is to dismiss symptoms as ‘just hormones’ or ‘teenage moods’. Children and teenagers need to be given all the normal care and attention to sleep and eat well, with gentle encouragem­ent to talk about what’s on their minds,” says Rachel.

“If parents suspect their child is depressed, the first step is a visit to the GP to get an assessment and then to see what the best route forward is. This could be child psychother­apy, making sense of things through talk or play, or cognitive behavioura­l therapy [CBT], where the pattern of thoughts is challenged, with the addition of medication if needed.”

“There are plenty of support groups around for parents that can provide some reassuranc­e or strategies that might be helpful,” adds Rachel.

“There is a saying that suggests that we need to remember to look after ourselves so that we can help others, and this also applies to parents/carers helping their children.”

It is so difficult for young people to describe feelings that seem irrational Rachel MelvilleTh­omas