When we think about childhood, many of us picture carefree days filled with play, curiosity, and joy. But for some children, this period of life can feel sad, confusing, and overwhelming. Depression is not just an “adult problem.” Children and teens experience it too — and often, it goes unnoticed. In fact, nearly two million young people in the United States live with depression, yet many never receive proper treatment.
The good news is that depression in children is treatable, and early recognition makes a tremendous difference. This blog post will walk you through what depression looks like in children, what causes it, how it’s diagnosed, and what you can do as a parent or caregiver to support a child who is struggling.
What Is Childhood Depression?
All kids go through ups and downs. A tough test at school, a disagreement with friends, or even just a bad day can leave them feeling irritable or sad. Usually, those feelings fade and return to their usual selves. Depression is different.
When sadness, irritability, or hopelessness lasts for two weeks or longer and begins to interfere with sleep, appetite, friendships, and activities, it may signal clinical depression. Children may stop enjoying the hobbies, sports, or games they once loved. In the most severe cases, depression can even trigger suicidal thoughts.
If depression is suspected in a child or teen, it’s important to consult a healthcare provider. While depression is serious, it is also very treatable with the proper support.
How Common Is Childhood Depression?
Research shows that about 3% of children ages 3 to 17 live with depression. Among teenagers, the rates are much higher — about 1 in 5 have experienced major depression. And these statistics likely underestimate the true numbers, since many children never receive a formal diagnosis.
For children managing chronic health conditions such as diabetes, asthma, epilepsy, or ongoing pain, the risk of depression is even greater.
Symptoms of Depression in Children
Depression in children doesn’t always look like depression in adults. Signs vary depending on the child’s age and developmental stage, and they can be subtle. Common symptoms include:
- Persistent sadness or irritability
- Withdrawal from favorite activities
- Fatigue or low energy
- Self-criticism, negative self-talk, or feelings of worthlessness
- Noticeable changes in appetite
- Difficulty falling asleep, staying asleep, or sleeping too much
These symptoms may appear alone or in combination. What matters most is how long they last and whether they interfere with your child’s daily life.
What Causes Depression in Children?
Experts agree there isn’t a single cause. Instead, depression usually develops from a combination of genetic, biological, and environmental factors. Some of the most common contributors include:
- Family history of depression
- Chronic illness or physical injury
- Stressful life events such as divorce, moving, or losing a loved one
- Bullying or exposure to trauma
- Substance use
Risk Factors to Consider
Some children are more vulnerable to depression than others. Risk factors are anything that increases the likelihood that a child or teen will experience depression. Some of the more common risk factors include:
- Having a parent or close relative with depression
- Past history of anxiety, ADHD, or conduct problems
- Adverse childhood experiences (ACEs)
- Being female
- Conflict at home
- Bullying at school
- Puberty-related changes
- Chronic health conditions
- Struggles with friendships
- Substance use
Understanding these risk factors can help parents and caregivers stay alert to early warning signs.
Complications of Untreated Depression
Without proper support, childhood depression can have lasting consequences. Kids may struggle in school, develop anxiety disorders, or turn to drugs and alcohol. The most concerning risk is suicide.
Persistent feelings of sadness, hopelessness, and worthlessness that, if left untreated, may lead to suicidal thoughts or behaviors. Because children often struggle to express their emotions verbally, signs of suicidal risk—such as withdrawal from friends and activities, changes in sleep or eating patterns, sudden irritability, or giving away belongings—can be overlooked. Factors such as bullying, family conflict, trauma, or a family history of mental illness can further increase the risk. Early recognition, compassionate communication, and prompt professional intervention are essential to protect children experiencing depression and prevent tragedies related to suicide.
Although it is difficult to pinpoint an exact prevalence of suicide among children who have depression:
- A study summarizing many studies of preadolescent children (roughly under age 12) in community samples found a lifetime prevalence of 15.1% for suicidal ideation, 2.6% for suicide attempts, and 0.79 per 1 million children for completed suicide. Depression was one of the strongest correlates of suicidal thoughts and behaviors in that group. PMC+1
- In a study of 9- to 10-year-olds, about 1.3% reported having made a suicide attempt. PubMed
- Among adolescents, the risk is higher. For example, in youths with Major Depressive Disorder (MDD), about 38%-50% report recurrent suicidal ideation. PMC
How Is Depression Diagnosed in Children?
If depression is suspected in a child, the first step is to speak with their pediatrician. Doctors often begin by ruling out physical conditions such as thyroid problems, anemia, concussion, or chronic illnesses that can mimic depressive symptoms.
If no medical explanation is found, the pediatrician may refer the child to a child psychologist, psychiatrist, or therapist for further evaluation. Diagnosis typically involves conversations with both the parents and the child, surveys or questionnaires, and sometimes feedback from teachers or caregivers.
Treatment Options
Treatment usually involves a combination of therapy and, in some cases, medication.
Talk Therapy
Cognitive Behavioral Therapy (CBT) is especially effective for children. It helps them identify negative thought patterns and replace them with healthier perspectives. CBT also teaches coping skills and relaxation techniques to reduce anxiety and stress.
Medication
For some children, antidepressants can be helpful. The most commonly prescribed are selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac®), paroxetine (Paxil®), and sertraline (Zoloft®). These medications increase serotonin levels in the brain, which can improve mood and well-being.
Dr. Schuetze-Pizarro is a professor in the Department of Psychology at SUNY Buffalo State. She coordinates the Child Advocacy Studies (CAST) certificate program, a multidisciplinary program designed for undergraduate students interested in careers in which they may need to advocate for children. She teaches courses on child development, research methods, and child maltreatment. Her research focuses on the effects of perinatal and environmental risk factors on children’s socioemotional, physiological, and behavioral development. She has published extensively on the development of children with histories of prenatal exposure to substances including cocaine, marijuana, alcohol, and cigarettes, and related risk factors including child maltreatment, exposure to violence, and socioeconomic adversity. Her primary area of interest is examining the role of multiple risk factors in predicting individual differences in developmental trajectories in high-risk populations.
Key Buffalo Providers & Programs
- Oishei Children’s Hospital Children’s Psychiatry Clinic: Comprehensive diagnostics and therapy (individual, family, group) for ages 0-21, plus specialty clinics.
- Child & Family Services (CFS): Offers counseling, support, and Children and Family Treatment and Support Services (CFTSS) for Medicaid-eligible youth.
- Mental Health Advocates of WNY (MHAWNY): Provides support groups (including teen chats), legal aid for mental health consumers, and programs like “Just Tell One” for youth.
- Erie County Mental Health: Manages Erie Path app for caregiver support and links to local providers.
- NAMI Buffalo & WNY: Offers support, education, and connects families to resources like Children’s Single Point of Access (SPOA) for coordinated care and intensive services.
- BryLin Hospital: Offers inpatient care for acute crises in children and adolescents (ages 5-17).
- Buffalo Pediatric Associates: Integrates mental health specialists within pediatric care for early intervention.
