Depression is the most prevalent psychiatric disorder globally. Depression is a leading cause of medical, psychological and socioeconomic burden for societies. According to an estimate by the World Health Organization, the burden of depression will become the leading cause of disability worldwide.

Depression can occur at any time throughout the lifespan.

Researchers investigate depression from diverse perspectives, raising different research questions. The Neurodevelopment theory of depression places emphasis on precursors of depression that occur at the earliest stages of an individuals life (Galecki P., Talarowska M Neuropsychopharmacological, Biological Psychiatry. 2018:80:267-272).

It is unlikely that a single marker of depression will be established, and diagnosis of depression is based on clinical symptoms. However, research for biomarkers may be a valuable tool for differentiation of subtypes on a spectrum of depression.

1. Sounding the Alarm

The rise in youth suicide and other forms of self harm has made recognition of signs of depression in youth critical. Many of my young clients have had friends and school acquaintances die by suicide. Although parental recognization and contact with mental health providers has increased since COVID 19, seeking help for the child often lags as symptoms of despair worsen over several years prior to being brought for treatment.

Kids depression often goes unnoticed and they suffer in silence. Kids often minimize their feelings, or conceal them so as not to bring attention to themselves and their unhappiness. Significant others in their orbit may overlook subtle changes in mood and behavior assuming it is not a significant behavioral change, especially if the child denies feeling anxious or depressed.

2. Parent/Child Communication

When a child is depressed, they may detach from family members, they become withdrawn, often isolate in their room, lose motivation, eat less, lose interest in peer relationships and social activities. They may want to share but have difficulty expressing their needs to parents and other significant adults.

Communication barriers occur for several reasons:

1. Kids often protect their parents. They don’t want to add to parent stress, or burden them with responsibility for their depression so they hide it.

2. Parents don’ t listen- kids report if they try to share their feelings and don’t get a helpful response they stope trying.

3. Parents want to fix the problem for the child and miss the message at the heart of the problem

4. Parents mistake symptoms of depression believing the child is going through a phase that is temporary.

5. Parents don’t allocate time to check in with their child often enough to observe mood and behavioral changes from week to week.

3. Healthy Parent Child Relationships

Every child has unique needs. What all children have in common include the need to spend time with parents doing activities they enjoy. Healthy parenting behaviors are protective and guard against a child’s unmet needs that externally exhibit in disobedience, defiance, anger, and aggression, or internally in anxiety, depression, and withdraw. Being present, listening, kindness, warmth, smiles, showing interest in child’s life, comforting physical touch, minimizing conflict while maximizing caring all contribute to a child’s positive self concept. Children develop positive social skills. Parents who are flexible, encourage independence while setting clear boundaries and realistic expectations, avoid harsh criticism, teach children to be self reliant.

4. Signs

Kids signs of mood changes are often difficult to spot. Some kids withdraw from family and social contacts, others appear sad, and shut down. Some lose interest in activities they loved, slack off or skip school with resulting grade decline. In class kids may experience loss of focus and concentration, inattention, boredom, resulting disinterest in learning. Others kids act out in anger, are irritable, exhibit frequent crying spells, and sleep disturbances. A change in appetite and weight gain or loss as well as sleeping too much can occur. Kids may express feelings of worthlessness, helplessness, guilt, hopelessness and not wanting to live.

5. Spotting Depression

The best way to know if your child is depressed is to ask. Build a trusting relationship with your child so the child will want to confide in you. Parents let the child know their feelings are important to share and encourage a child to express feelings with words and conversations. Parents help children by sharing their own feelings about daily life experiences, or feelings of depression.

6. Supporting Treatment

Sometimes talking and supporting your child is just what is needed. Encouraging your child to seek trusted friends, other family members, school counselors to talk with is very helpful. Involving the pediatrician when a child does not respond to support or symptoms worsen is appropriate.