How can you tell if your child has depression?

To mark Mental Health Week (May 13-19), health experts outline the warning signs that a young person might need extra support.

Children’s mental health difficulties have reportedly been on the rise (Alamy/PA)

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.

“Like 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 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 and although they are not mental health conditions, young people with these conditions often tend to have a higher proportion of additional mental health needs.”

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 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 can parents and carers spot 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,” Melville-Thomas explains.

Thompson suggests parents and carers ask themself 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? Has 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 can you tell the difference between depression or 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 Melville-Thomas.

“Young people who are depressed are likely to avoid going out and perhaps withdraw from being with the family,” he 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, but these don’t seem to go away as expected.”

What should you do to 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 Melville-Thomas.

“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.”

Sometimes, parents may also need some support, as they might feel alone with what’s going on.

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