You’ve probably heard a lot in the past few years about how American youth are increasingly struggling with their mental health and well-being. While the pandemic may have contributed to the crisis, rates of youth being diagnosed with anxiety and depression was already on the rise.^1,2

As a parent, it’s natural to be concerned about your child’s mental and emotional well-being. And these worries come with good reason. About 4.4% of children ages 3 to 17 experience depression, according to the Centers for Disease Control and Prevention.¹ In fact, the number of children with depression rose 27% between 2016 and 2020.³

It’s normal for kids to get sad sometimes.³ But how do you know if your child is dealing with depression? And what should you do if you suspect there’s a problem? Let’s take a closer look at depression in children, and what steps to take if your child needs help.

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What are the symptoms of childhood depression?

If your child feels sad, hopeless or irritable often, it could be a sign of depression.

Depression occurs when a low mood lasts for weeks and affects everyday functioning or a child’s development, says Michael Strober, PhD. He is a professor of psychiatry at the UCLA School of Medicine. Parents should be concerned if your child’s low mood persists.

Keep an eye out for changes in your child’s mood or behavior. Physical changes can also be depression red flags. Here are the two most common symptoms, according to the American Academy of Pediatrics (AAP):⁵

• Your child seems sadder and more sensitive than usual. They are also in a low mood for most of the day.
• Your child no longer enjoys activities they used to love.

Other signals of childhood depression included on the AAP's list include:⁵

• Spending less time with friends
• Mentioning feeling sad, of little value or guilty about things
• A change in eating habits (or losing/gaining weight)
• Feeling less energized or motivated than usual
• Difficulty paying attention or making choices
• Sleeping less or more than usual
• Struggling or failing at school
• Talking less and making less eye contact than usual
• Spending more time using media (such as video games and social media)

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What other clues could mean my child is depressed?

Pay attention to the length of time your child has had symptoms, says Nekeshia Hammond, PsyD. She is a psychologist in Brandon, Florida. Has it been going on for more than two weeks, for example? “That’s a sign that this is more than just having a bad day or having a bad week,” she says.

Remember that some kids may not have the words to describe their emotions. That’s often the case with younger children. So, you may have to do a little digging. Talking with your child is important. It may help to ask specific questions of a younger child. For example:

• How do you like your teachers?
• What did you do during your playdate today? How did you like that?
• How do you like the other kids in your class?
• How is your homework?
• Did something happen today that made you sad?

“It really is harder for them to express their emotions,” Hammond says. “But they can tell you factual things. Because the younger crowd is very concrete, it’s more about the examples that you give.”

Other children may be reluctant to ask parents for help, even if they realize something is wrong. Often in the early stages of a mental health concern, children become aware that something is wrong, but they don’t know what it is.⁶

Children may also not know why they feel the way they do. They might not understand what “mental well-being” is. Or what the signs and symptoms of mental health problems might be. When they feel this way, they may be reluctant to ask parents and caregivers for help.⁵

Reasons for this may include:⁶

• They worry they will burden their already stressed-out parents.
• They worry their parents/caregivers will “freak out” or overreact.
• They do not trust their parents/caregivers to be able to help them.

So instead, a child may seek validation and care from others they trust.

Sometimes starting a good conversation with the children in your life can be tough. Need some tips? Download these conversation starter cards to help check in and move beyond one-word answers.

I think my child might be depressed. What do I do next?

The biggest thing is to reach out to a mental health professional early, Hammond says. “All the research shows that the earlier the intervention, the better.” You can start with the following steps:

Step 1: Make an appointment with your pediatrician. Your child’s doctor should be your first stop. Some medical problems have symptoms that are similar to depression, says Hammond. These include low blood sugar, anemia or thyroid issues. Your pediatrician can rule those out. Trauma and attention deficit hyperactivity disorder (ADHD) can also cause similar symptoms as some mental health conditions.⁴

Step 2: Get a thorough mental health assessment. Once you’ve addressed any medical issues, Hammond suggests setting up psychological testing. The goal of this testing is to figure out whether your child is struggling with their mental health. An evaluation will more clearly define the problem. Your pediatrician can send you to a specialist to carry out the tests.

“Unfortunately, I’ve seen, over and over again, the pediatrician and the psychological testing steps get skipped,” Hammond says. “Take the time to really clarify what is happening with your child, so they can get the best treatment.”

Importantly, if you think your child is in immediate danger, call 911 or go to the closest emergency room. You can also call the 988 Suicide & Crisis Lifeline (previously known as the National Suicide Prevention Lifeline) at 988 or 1-800-273-TALK (1-800-273-8255). Or, text 988 or chat at 988lifeline.org. The lifeline provides 24/7 free and confidential support.

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My child has been diagnosed with depression. What do I do next?

See a mental health professional who has strong experience treating depression in kids, says Strober. Your pediatrician can send you to the right person. Then work with that specialist to come up with a plan. The professional could be a child psychologist, therapist, psychiatrist or other specialist.⁴

For example, with a preschooler, play therapy may be an option. With play therapy, a mental health professional plays with your child to help them learn coping and social skills.

Talk therapy may be suggested for an older child. That’s because they can better describe their feelings in words. This kind of therapy can help children change negative thoughts and learn ways to handle their feelings.⁴

Your child’s plan may need more than one professional. For example, you might need to see a child psychiatrist. This is a type of medical doctor who can let you know whether your child needs medication. Learn more about different types of mental health professionals.

What more can I do to help between appointments?

Following healthy habits can help your child handle symptoms of depression. For starters, make sure they eat healthy meals, get lots of exercise and get enough sleep. And offer them plenty of emotional support:

• Reassure your child that they can come to you when they need to talk.
• Let them know that you support and love them no matter what.
• Spend time doing activities that bring them joy. That could be going to a playground, playing a board game at home or even taking a walk outside.

Bottom line: Getting your child help if they are depressed is vital. Recognizing the symptoms early can make all the difference for both your child and your family.

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If you or someone you know is in crisis— seek safety and get help right away. If you or someone you know is in immediate danger, call 911 or go to the closest emergency room.

To reach a trained crisis counselor, call the 988 Suicide & Crisis Lifeline (previously known as the National Suicide Prevention Lifeline) at 988 or 1-800-273-TALK (1-800-273-8255). You may also text 988 or chat at 988lifeline.org. The lifeline provides 24/7 free and confidential support.

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