Depression in children and teenagers

A child or teenager can be depressed if they feel ill and have lost their appetite even for what they usually think they are doing. Seek help early if you think a child or teen has a depression. Most people get better already after a few weeks with the right treatment.

This text is aimed at you who are an adult and know a child or teen who you think may have suffered from depression. You as a child can read more at  Våga tell,  and you as a teenager can read more at umo.se about feeling bad .

Common symptoms of depression in children and teenagers

Feeling sad, pondering life or doubting yourself is common, regardless of age. When something difficult or difficult happens, it is common to react with sadness, disappointment or disappointment. After a while it usually goes by itself, sometimes with the support of those closest.

Symptoms for more than two weeks

If the child or teenager continues to feel ill every day for more than two weeks, it can be a depression. Depression can either come on suddenly or develop over a long period of time.

A person who has previously been active and outgoing may not want to be with his friends as before. They can constantly seem depressed, angry, angry or annoyed. Nothing is fun, not even what the person has previously done to do. Often, those who are depressed end up with any activities or interests they have had in their spare time.

Low self-esteem

Self-esteem is often low in people with depression. This can be seen by the fact that the child or teenager has very negative and critical thoughts about himself.

It is also common for the child or teenager to withdraw and isolate themselves or become in conflict with the environment. In addition, they usually have at least three of these symptoms:

  • She has trouble sleeping, sleeps too little or very much.

  • They have changed appetite, eat too little or too much.

  • They have physical problems, such as stomach pain or headaches.

  • She is tired and energy-free in a way that cannot be rested.

  • She has trouble concentrating and thinking.

  • She thinks about death and not wanting to live.

Different symptoms depending on age

There is a big difference in how depression is felt in a smaller child and in a teenager. Smaller children who become depressed can sometimes stop or go back in their development. For example, the child may stop playing or stop doing things they have learned. They can also respond by crying, screaming or bumping anyone who tries to comfort.

For a child who goes to school, especially in high school or high school, depression can make them unable to concentrate, think and be engaged. Then it becomes difficult to keep up with the lessons and do homework.

To interpret the symptoms as an adult

It can be difficult to understand and interpret the symptoms as an adult. It is common to think that a teenager is angry or annoyed, while the teenager himself feels sad.

For you as an adult, it may feel like nothing helps to get the child in a better mood. The child or teenager may have difficulty understanding why they feel so sad or angry. It is common for them to think no one understands.

Sometimes the problems can be noticed earlier in the preschool or school than at home. If you plan to talk to a teacher at school, it may be good to tell your child so they do not feel left out. Ask the child what they want.

Thoughts on death

It is common for even young people to have suicidal thoughts . Thinking about death is common, even in younger children. For example, one might think that it would not be so bad to die because life feels so difficult.

It can be a sign of depression if a child or teen starts talking about themselves as dead or longing for death. It is important to take it seriously, although in most cases it does not mean that the person will try to take their life. It is important that you show the child that everything can be talked about, even if it may feel difficult or upset or worried.

Here you can read more about talking about suicidal thoughts with someone who is feeling bad.

Different degrees of depression

The most common form of depression is called “real depression” and is divided into three levels of difficulty:

  • Mild or mild depression
  • Moderate or moderate depression
  • Severe or deep depression

The various degrees describe how much the person can handle in everyday life.

Easy depression – everyday life can be handled

In the case of mild or mild depression, the child or teenager works in everyday life, despite feeling ill. She can cope with going to school or socializing with friends, though it requires effort. The person often seems angry, tired, irritated or angry.

Moderate depression – everyday life is difficult

In a moderate or moderate depression, it is difficult to cope with everyday life. The person can still go to school, but the absence is usually high and it is difficult to cope with tests and homework. This causes school work to suffer. They often have problems with sleep, and sleep either too much or too little. Some turn around the clock, and wake up at night.

Since the person often does not seem sad or depressed, but more angry, tired, irritated or angry, it can be difficult to understand that they are depressed.

Severe depression affects life very much

If the depression is severe it affects life very much. Then the child or teenager is often unable to go to school anymore, and seems to have lost interest in everything. She cannot take care of her hygiene and often isolates herself from family and friends.

Having suicidal thoughts or plans to take one’s life can also be included in the symptoms, but that does not mean that everyone with severe depression has suicidal thoughts.

Another sign of a severe depression is that the person is exposed to dangerous games or is not afraid of them, for example being careless in traffic. It may seem that life is no longer important.

Depression can be recurring. Then the symptoms come back repeatedly.

Depression can also be mild, but last for a long time. It’s called dysthymia.

Common with other problems along with depression

It is common for children and teenagers who have depression also have other problems. Physically injuring oneself by, for example, scratching or cutting oneself is a common way of trying to relieve severe depression or strong feelings of anxiety. Eating disorders are also common.

It is important to try to help your child or teen find other ways to deal with difficult feelings. Read more about what you can do as a relative of someone who injures himself, or someone who has an eating disorder.

There is also a risk that teens who feel ill begin to drink alcohol or use other drugs to cope with their difficult feelings. Therefore, it is important not to wait too long to seek help.

When and where should you seek care?

Seek help early if you suspect a child or teen has depression. It is especially important to seek treatment early if your child has had a depression before and is experiencing symptoms again.

In most county councils and regions there are receptions that have a special mission to take responsibility for the mental health of children and young people. It’s called first-line psychiatry. It can be at a health center or pediatric clinic and is often called a call center.

The first line refers further if needed

Contact a child care center, eg if a child is under six.

For children over the age of six, you should primarily contact the student health center, the care center or a reception that belongs to the first line psychiatry. They refer to specialized reception, bup, if needed.

Children who attend school can contact pupil health themselves. The school nurse then hears from the guardian afterwards, so that together you can figure out what needs to be done.

A teenager can also contact Bup, pupil health or  a youth reception .

Seek medical care directly if thoughts or plans for suicide

If a child or teenager has thoughts or plans for suicide, seek medical care immediately. 

Tell the child or teen that you intend to seek care for them.

Investigations and investigations

When a child or teen is suspected of having a depression, it needs to be assessed and investigated before they can receive treatment.

Regardless of whether you have sought care through student health, the care center or any other reception in the first line of psychiatry, an assessment is made as to where you are best assisted. Either the investigation and treatment can be given within the first line of reception, or you will receive a referral to Bup , child and adolescent psychiatry , which is more specialized.

Depending on the child’s age, parents may be included in the visits. Sometimes several calls are needed for the investigator to find out if it is a depression or some other problem.

Physical examination to exclude illness

Some physical illnesses may have the same or similar symptoms as depression. Another cause may be iron deficiency or that the child or teen has, for example, too much or too little thyroid hormone.

Therefore, it is important that the child or teen can also do a physical examination. After the investigation, a diagnosis is made. Usually, it is a doctor who makes the diagnosis.

Treatment for depression in children and teenagers

Depression can be treated in different ways. Which treatment is used depends on the type of depression and how severe it is, and what suits the child or teenager best.

When you are notified of the diagnosis, the investigator together with a psychologist or other therapist suggests which type of treatment is best.

Both you and the child have the right to be involved in deciding on the care and treatment. Make sure you understand the information, ask questions if you don’t understand. You can also ask to have the information written down or translated to read it peacefully.

Treatment for mild – moderate depression

For mild to moderate depression, both the child or the teenager and the parents need to be informed about what depression is, and knowledge of what one can do yourself to begin to feel better.

It is important to have regular habits when it comes to daily rhythm, food, sleep and physical activity. The following advice is the most important to follow:

  • Staying in daylight. Daylight is important for feeling good. Therefore, it is good to be outdoors, preferably in the middle of the day when it is brightest.
  • Eat nutritious food at regular times. Eating good, healthy food is important for all functions of the body, and also affects mental health.
  • Move. There are many studies showing that physical activity helps with depression. When you move, substances are formed in the body that give calm and make you feel better. Children and teenagers also tend to sleep better if they are allowed to move.
  • Relax and get enough sleep. Sleep is important and therefore it is good to help the child or teen so that they can sleep enough. Children and teenagers who are often up late and, for example, playing or surfing the net may need help to go down laps in the evening in order to fall asleep.

If the child or teen does not feel better after about eight weeks with this treatment, further treatment is needed.

Treatment for severe depression

Treatment for severe depression consists of either psychotherapy or other psychological treatment and partly antidepressant drugs.

If the child or teen has a severe depression, they can sometimes also have other problems such as self-harm or eating disorder . Sometimes depression needs to be treated before the other can be treated, sometimes everything needs to be treated simultaneously in different ways. It’s different for different people.

Psychotherapy for depression in children and teenagers

For many children and teenagers it helps to talk about difficult feelings or to work something hard together with someone for whom they feel confident. Psychotherapy can have a good effect in depression. As a parent, you can sometimes be part of the treatment. It is very important that you, as a parent, learn what to do to make the child feel better.

The most common treatment used is any variant of cognitive therapy, KBT, interpersonal therapy, IPT, or a combination of different therapy forms.

Read more about psychotherapy and other psychological treatment .

Antidepressant drugs for children and teenagers

There are several different types of anti-depressants, so-called antidepressants. Drugs are mainly relevant in severe depression.

Not all antidepressants are approved for the treatment of children and adolescents. You can discuss which drug is appropriate with the responsible physician. If you have thoughts and thoughts about antidepressants, it is good to discuss them with your treating physician.

When the child or teenager has started treatment with antidepressants, it is very important not to stop the treatment without first contacting the doctor.

Read more about medicines for children and teenagers during depression .

What can I do as a relative?

It can feel heavy and hard to be worried about a child or teen who is feeling bad. You can feel powerless, and like nothing you do helps. It can feel difficult if the child cannot or does not want to talk about how they are doing.

As a parent or other relative of a child or teen with depression, you can both become angry and feel guilty. Talk to another adult if you feel that way.

It is important that you take care of yourself so that you are able to support the person who is feeling ill.

Important to talk to the child

It’s good to think about how you treat your child when you talk to each other. Listen and let the child tell in their own words. Show that you respect the child’s experiences. Do not accuse the child or teenager of anything they have done or known. Try to be calm even if they get angry.

It is also good to take time when the child wants to talk. It is not always precisely when you ask yourself and think you have time. A moment on the bedside in the evening can often work well.

Try to make it easy for the child to tell. Ask open and easy questions, and take the time to listen to the answers. For example, an open question might be “How are you thinking?”  and  “Can you tell me more?” .

Try to listen without giving good advice. Also try to endure it sometimes getting quiet. Getting time to think and formulate at your own pace has a value in itself.

Sometimes it is easier to talk while doing something together, such as driving a car or walking.

Talk about suicidal thoughts

If the child or teen says something about not wanting to live, you should not change the topic, but instead ask how they think. Talking about these thoughts and feelings does not mean that the thoughts of suicide will be stronger, or that those who think about suicide will really try to take their life.

Instead, this conversation may be just what the person needs. Putting words to their problem can be the beginning of solving it. Read more about helping someone who has suicidal thoughts.

Your support means a lot

A person who has depression may need to gather strength and courage, and it may feel difficult to receive help. That you as a relative are there and provide support can mean a lot. You may need to seek help several times before you find something that works.

If you have previously received help, but do not feel that it felt right, try again.

It means a lot that you as a relative or parent are there for the person who is feeling bad. Listening, showing that you care and offering to help is important for them to feel better.

You may need to stay home

For a period of time you may need to be at home with the child, even with a teenager who is feeling very ill. In the event of a severe depression, a child or a teen should not be alone at home.

If you need to stay at home with a child who is between 12 and 16, in connection with a depression, a medical certificate is needed. You can also be at home with a teenager who is over 16, but then a special medical certificate is needed. Talk to the attending physician if you need a certificate.

If the person who is ill does not want help

If the person does not want to receive treatment yourself, be prepared for it to take time. Ask for help from others and decide for yourself or with someone in the care what is your limit for what you can do.

This also applies to persons under the age of 18. It can be a very difficult and difficult situation for you. Try to respect the person’s wishes. What you can do is keep talking about how they are doing. Bring up the question of help again and again, in a demanding way. 

If you are afraid that the person will be injured, for example by injuring or starving, or to talk about taking their life, it may be relevant to receive care against their will. There are various laws governing this. You can read more about forced care here.

You may need help and support

You may need help, support and relief to cope yourself. Ask relatives or friends to help with practicality. It can be a great help to get help with practical things like cooking, cleaning or picking up or leaving siblings.

You can talk to friends, others in the same situation or seek professional support. For example, you can contact a patient and close associate for information, or contact others who have similar experiences. You do not need to be a member to contact an association. More information about being related can also be found on  the NKA – National Competence Center website .

As a parent, you have the right to receive support calls through care. By seeking help, you can get answers to your questions and reduce concerns.

It is very important that you get help if you have depression or any other diagnosis yourself. Otherwise, it will be difficult to help your child. Feel free to ask your child’s therapist how you can seek help yourself.

Support from the social services

If it is very difficult for you as a relative, you can also seek support from the social service. There may be conversation groups or other support for you as a relative. There may also be support for the child or teen, or for the whole family.

Contact your municipality to find out what kind of support you have for relatives where you live.

Include the whole family

It is good if you in the family can talk openly about the depression, so that everyone knows what is happening.

Ask the person with the depression how they want the others in the family to get information. Ask the therapist for advice on how to do it best.

As a sibling to someone who has a depression, it is easy to feel forgotten. Siblings can also be worried about getting sick themselves. Therefore, it is important that siblings also receive information and sometimes participate in support discussions with the whole family.

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