In normal times, I don’t see many kids or teens with depression coming to my office for help. It’s much more common for me to meet children who are struggling with anxiety, or who have been impacted by a recent trauma. I figured that the coronavirus pandemic would bring more of the same: lots of kids feeling super anxious about the virus, or who were experiencing the pandemic and quarantine as a traumatic event.
At first, this was true: I did see lots of anxious kids in March, April, and May. But things have changed recently. Suddenly, it seems like almost every child I meet has symptoms that warrant a diagnosis of depression. Given these new struggles, I thought it would be helpful to talk about childhood depression today: what causes it, how to spot it, and how to know when to get help.
What Causes Depression in Children and Teens?
When you imagine depression, you might picture it as the result of bad things happening in a child’s life: for example, a divorce, a serious illness, or bullying at school. Kids who experience these kinds of events can absolutely feel depressed, but for many kids, depression happens without a clear cause.
Sometimes, it isn’t negative experiences, but a lack of positive ones that leads to depression. Many psychologists believe that depression happens when we lose our ability to socialize with others, and participate in activities that are fun or rewarding. A child who is feeling isolated may begin to feel depressed, and this can set off a vicious cycle: kids who feel depressed lose interest in activities they used to enjoy, which leads to more social isolation. This can make it really hard to beat depression, and symptoms tend to get worse over time.
For other children, genetics and biology might play a part in depression. Scientists have identified at least one gene that may be linked to depression, and people who have an immediate family member with depression are up to 3 times more likely to experience depression themselves. An imbalance of chemicals in the brain, such as serotonin, might also contribute to depression for some kids.
How Quarantine Increases Depression Risks for Kids
As the pandemic wears on, many children seem to be developing depression symptoms who didn’t struggle with depression before. Even if a child doesn’t know anyone who has fallen ill, they may still notice changes in mood. Kids and teens who haven’t been directly affected by the coronavirus are still finding themselves feeling down, crying more easily and often, and losing interest in the activities that used to excite them.
When you think about depression as coming from a lack of positive experiences, rather than an excess of negative experiences, this starts to make a lot of sense. Most children have remained physically safe and unharmed during quarantine, but they’ve lost many of the activities that add joy to life. Social distancing is critically important, but it has some side effects that increase the odds of depression for kids and teens. For example:
Many clubs, classes, and extracurriculars have been canceled or postponed.
Online school is very structured, and kids miss out on the casual chats with friends in the halls, cafeteria, etc. that help to build friendships.
Most children are going on fewer face-to-face hangouts and playdates with friends, and may have limited options for outings.
Kids who have recently moved or changed schools have very few ways to meet new people.
Which Kids Are Most Affected by Pandemic Depression?
Quarantine may be especially hard on preteen and teen-aged kids, because being away from other young adults makes it harder to develop and grow. Friends play an increasingly important role during the preteen and teen years. Older children are expanding their horizons, becoming more independent, and developing their own identity, and they need their peers to accomplish these tasks.
Children of any age who already struggled with social anxiety or feeling isolated may also be at increased risk of depression. Kids who had a strong social network before the pandemic tend to be faring better right now, because it’s fairly easy for kids to maintain close friendships online. On the other hand, kids who were already lonely feel even more so right now, and they have few opportunities to meet new people or turn acquaintances into closer friends.
Signs of Depression in Children and Teens
Let’s be honest: a lot of us are feeling a little down right now, and that’s normal and okay. It can be hard to differentiate between everyday quarantine malaise and symptoms of depression that might require extra support. This can be especially true when we’re dealing with kids. Here are a few signs and symptoms of depression to keep eye out for if you are concerned about your child:
Ongoing, prolonged feelings of sadness and hopelessness
Pulling away from friends and activities that used to be fun
Sleeping too much or too little
Being irritable or extremely sensitive to criticism or rejection
Fatigue, low energy, or low motivation
Headaches, stomach aches, or other physical symptoms that don’t have a medical cause
Decrease in self-esteem
Thoughts about death or a wish to be dead
When (And How) to Get Emergency Help
Most children and teens who are depressed do not have thoughts about suicide. However, it’s important for parents who suspect their child may be depressed to be on the lookout for warning signs that could indicate a child is thinking about or seriously considering suicide:
Isolating from family and friends
Writing, drawing, or talking about death in a preoccupied way
A sudden, major shift in personality
Increasingly aggressive or risky behavior
Giving away important belongings
Threatening suicide
Any time a child threatens suicide, it has to be taken extremely seriously. Parents who worry their child could be at risk of seriously hurting themselves should head to the nearest emergency room, where a child can get help right away.
If your child is struggling with suicidal thoughts, there are resources to help. Parents or children can call the Suicide Prevention Lifeline for help at 1-800-273-8255. Teens can also text “home” to 741-741 to contact the Crisis Help Line, where they’ll be put in touch with a crisis counselor who is trained to work with young people. Both these services are free, and available 24/7.
Help for Kids and Teens With Depression During Quarantine
Social support systems are our best weapon to fight depression, especially during quarantine. You can help your child by encouraging her to find new ways to stay in touch with friends. I find that online socializing feels less awkward and more “real” when there is some structure to it: for example, playing a game, cooking a recipe, or even watching a movie together. Small groups or one-on-one Zoom hangouts also tend to feel more natural and less intimidating than large group calls.
Any activities that are new, different, or give a sense of accomplishment can help. You can gently encourage your child to accompany you on grocery store runs, walks, or other outings for a change of scenery. Kids with depression may be incredibly reluctant to get out of the house, but the more they do it, the easier it will become.
If you’re noticing big changes in your child’s mood, counseling can help get your child back on the right track. Cognitive behavioral therapy can help young people notice the overly negative thought patterns that fuel depression and keep them feeling down. It can also help them to learn coping skills to deal with intense sadness, and discover activities they can enjoy even in the midst of the pandemic.
Online therapy for kids is available in many communities, and some counselors have begun offering online social groups for kids, like my Dungeons and Dragons gaming group for girls. If you’d like to learn more about the group or my approach working with kids online, you can contact me here.
