Depression in Children and Adolescents
Depression is a mental health condition characterised by persistent sadness, hopelessness, and a loss of interest or pleasure in activities that were previously enjoyed. It can influence the way a child thinks, feels, and behaves, and may also lead to physical symptoms such as fatigue, appetite changes, or disturbances in sleep.
Predisposing Factors
Depression in children and adolescents can develop due to a combination of genetic, biological, environmental, and psychological influences.
Genetic Factors
- A family history of mood disorders — such as depression or bipolar disorder — increases vulnerability.
Biological Factors
- Neurochemical imbalances, including low levels of serotonin or dopamine, may contribute to mood symptoms.
Environmental Factors
- Exposure to stressful events, trauma, abuse, neglect, parental separation, or family conflict can increase risk.
Temperamental Factors
- Children who experience emotional dysregulation or temperament-related difficulties may be more predisposed.
Psychosocial Factors
- Peer rejection, bullying, academic pressure, and family conflict can contribute to emotional distress.
Medical Factors
- Chronic illness, neurological conditions, or hormonal changes may worsen or trigger mood-related symptoms.
Symptoms
Depression in children and adolescents may look different from adult depression and can sometimes be difficult to recognise, particularly in younger children. Symptoms may include:
- irritability or anger rather than sadness (more common in younger children)
- low energy or fatigue
- changes in sleep patterns (difficulty sleeping or oversleeping)
- changes in appetite (increased or reduced eating)
- difficulty concentrating or decline in academic performance
- feelings of guilt or worthlessness
- physical complaints such as headaches or stomach aches without a clear medical cause
- withdrawal from friends, family, and social activities
- thoughts of self-harm or suicidal ideation in severe cases (more common in adolescents)
Diagnosis
Diagnosis of depression in children and adolescents involves a comprehensive clinical assessment, which may include:
- observation of behaviour, mood, emotional regulation, and interaction with peers and adults
- review of developmental history and previous emotional or psychological difficulties
- medical evaluation to rule out contributing conditions (such as thyroid disorders, nutritional deficiencies, or neurological causes)
Treatment
Treatment approaches are tailored to the child’s age, symptoms, and level of functional difficulty.
Cognitive Behavioural Therapy (CBT)
Often considered a first-line treatment for depression and anxiety in children and adolescents.
Interpersonal Therapy (IPT)
Focuses on improving social relationships and interpersonal functioning to support mood recovery.
Family Therapy
Helpful when family dynamics or stressors play a role in emotional difficulties.
Play Therapy
Particularly useful for younger children, providing a developmentally appropriate way to express and process emotions.
Medication
Medication may be recommended alongside therapy in cases where:
- symptoms are severe, or
- significant impairment persists despite psychological treatment
Antidepressants are prescribed and monitored by a qualified clinician.
Lifestyle and Supportive Interventions
- Establishing a regular daily routine
- Social skills support for difficulties in peer interactions
- Parental guidance to help caregivers support emotional and behavioural needs
- School-based support, including reasonable classroom adjustments (e.g., extended time for assignments)
