What is depression?

Depression is a mental health condition that affects people of all ages. Children with depression may feel:

• unhappy
• miserable
• irritable

Children with depression have different symptoms from young people or adults with depression, and they may not be able to express their feelings clearly. They might describe feeling 'grumpy' or 'down'. You may notice that they have lost interest in things they normally enjoy or have temper tantrums instead of a depressed mood. They may act out their feelings in their behaviour or play and complain of physical symptoms such as stomach aches or headaches. You may notice they are having difficulties with friends or that they are doing less well at school.

While it is common to feel unhappy sometimes, if these feelings interfere with your child's activities or social life, or if they go on for more than 2 weeks, they may have depression.

This article is about depression in children. Many aspects and risk factors of depression are not age specific. 'Children' generally refers to people aged 5 to 12 years. For information on depression in young people, visit the healthdirect page. You can also read more on depression in the general community.

How common is depression in children?

Symptoms of depression affect as many as 1 in 4 children. Depression is less common in children than it is in young people.

What are the symptoms of depression in children?

The signs of depression in children might change the way they feel, think or behave. There are also physical signs of depression. These symptoms are not always the same as symptoms in adults.

Children with depression may feel:

• cranky
• irritable
• angry
• sad
• anxious
• overwhelmed
• out of control

Children with depression may think:

• that they are a bad person
• their difficulties are their own fault
• that bad things will happen to them, and they may worry a lot
• that no one loves them

Children with depression may behave in unusual ways, such as:

• not wanting to do things they enjoy (such as see friends) or being less playful
• not wanting to be apart from a parent or carer (increased clinginess) or showing other regressed behaviour (acting younger than their age)
• being angry and impulsive, yelling, hitting, biting, lashing out and saying “I hate you” or damaging things (but remember, it's normal for children to have tantrums at times)
• doing less well in school than they normally do
• not feeling hungry, or eating too much
• finding it hard to concentrate

Children can also have physical signs of depression, such as:

• stomach aches
• headaches
• tiredness
• muscle pains
• changes in sleeping habits
• toileting difficulties, including bedwetting

Children can also have severe depression and suicidal thoughts or actions.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

What causes depression in children?

Depression can be caused by a wide range of factors. Every child has their own circumstances. Factors might come from their environment or may be inherited from their family.

Things that might affect babies' and toddlers' mental health include:

• traumatic events, such as a death in the family
• abuse
• parent or carer separation or divorce
• sickness or living with disability
• being born early (prematurely)
• homelessness
• a parent or carer experiencing a mental health condition — such as postnatal depression

Children experience many new changes that affect their mental health, such as:

• separation anxiety, especially in new situations
• new fears or phobias
• difficulties with relationships or bullying

Aboriginal and/or Torres Strait Islander children, and children who are refugees or asylum seekers, are also more likely to experience depression.

Children are more likely to experience depression if they live with conditions such as:

• autism spectrum disorder
• a learning disability or learning disabilities
• attention deficit hyperactivity disorder (ADHD)
• significant disability

Having someone in the family with a mental illness also makes depression more likely.

Children can also develop depression for no obvious reason. Even if the cause isn't clear, a child may still be experiencing depression.

When should I talk to a doctor?

You should speak to your child's doctor if:

• your child has signs of depression for 2 weeks or more
• their symptoms stop them from managing as well as usual at home or school
• you are worried that they may have depression

The sooner a child can get help, the sooner they can start to feel better.

Your child's doctor will be able to make an assessment and build a mental health treatment plan with you for your child. This is a plan that states the treatment goals and includes the services and resources available to you.

If your doctor thinks that other health professionals should be involved, they will be able to refer your child to other services such as a paediatrician, psychologist or psychiatrist.

If your child has been showing occasional signs of depression or is just feeling sad, they could reach out to a school teacher, counsellor, friend or family member for help.

FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

How is depression in children diagnosed?

For a health professional to diagnose depression in your child, they will ask questions about their feelings and behaviours. This may involve questionnaires to be filled out by carers and teachers.

It is important to understand the difference between a child who is frustrated and a child with depression. Feelings of anger, irritability and anxiety are common in the development and growth of your child. Your doctor can help you to understand what is typical for your child and what may need further support.

How can I help my child with depression?

If your child has depression, they may need your help to understand what they are feeling and to seek help. By building a trusting and open relationship with your child, you can help them find words to express their feelings and support them to build resilience. This will help them manage difficult situations and recover more easily.

If you're concerned that your child's symptoms may be a result of other relationship challenges in the family, consider family or couples therapy.

If you are concerned that your child is showing symptoms of depression, take them to their doctor. The doctor can assess their behaviour and feelings. They may also check for physical signs that might indicate depression. They will also rule out other problems such as:

• anaemia
• thyroid issues
• vitamin deficiencies

Whatever treatment your doctor recommends, your child will need your help to arrange their treatment. They will also need your emotional support, since they may be confused or worried about what is happening to them.

It may also help to discuss your child's situation with their teacher and any other adults they spend a lot of time with. Making other people aware of what's going on can help them be more sensitive to the situation and give your child extra support.

How can I talk to my child about depression?

It is important that you make your child feel supported when talking to them about depression. Here are some tips for approaching the topic of depression with a child:

• Be patient with them. Being calm and encouraging can make a child more comfortable talking about their feelings. They don't have to talk to you then, but let them know you are there when they are ready.
• Let them know that it is OK to talk about their mental health.
• Listen to what they tell you and try not to judge if they say something that makes you uncomfortable. By validating their emotions, they will feel more comfortable sharing with you in the future.
• Ask them what they think they need from you — sometimes they don't know what they need, but let them know that you are there and you will work this out together.
• If you feel that they don't want to talk to you, you can suggest that they talk to someone else such as another trusted adult, a family member, a friend or a doctor.

If you notice that your child is showing signs of depression and you want to give them space to start a conversation with you, try asking them open-ended questions:

• How is school going?
• How are you feeling about (for example an upcoming event)?
• How are you getting along with (for example friends, siblings, schoolmates)?

If you are worried about suicide or self-harm, you can ask direct questions such as:

• Have you ever thought about death?
• Have you thought about hurting yourself?

Asking direct questions about suicide will not put ideas in your child's head. Being gentle and direct can help your child feel safe to share their thoughts, and it shows them that they can come to you for support. It is important to seek help from your child's doctor or another health professional as soon as possible so they can guide the next steps.

Remember that children talk and think about death very differently from adults. You cannot assume they mean the same thing an adult would, even if they say something like “I wish I was dead”. Young children often don't fully understand what death really means.

When a child says “I wish I was dead”, it usually reflects distress, frustration or wanting to get away from a difficult situation, rather than a true wish to die. Their words may also be shaped by a curiosity about death or things they have seen or heard. This does not always mean they have suicidal intent in the way an adult might.

If you find it confronting or difficult to have these conversations with your child, speak to your child's doctor about how they can help.

How is depression in children treated?

Your doctor can help you build a mental health treatment plan for your child if they have depression. The treatment plan is written up by your doctor and will help you access up to 10 sessions per year with a mental health professional, with the cost partly covered by Medicare. The plan may include different treatment strategies and tools.

Your doctor may recommend a referral to a:

• psychologist
• social worker
• psychiatrist
• paediatrician

If your child is diagnosed with depression, here are some tips to support them at home:

• Give your child a lot of positive attention, especially talking and listening to them about their concerns and feelings. Encourage positive time as a family, such as at mealtimes.
• Help your child to get the right amount of sleep each night.
• Talk to your child's school counsellor or teacher to find out how best to support your child at school.
• Work together with your child to set goals and solve problems.
• Encourage your child to do activities they usually enjoy.
• Support positive social opportunities and encourage friendships, connection and a sense of community.
• Reinforce things they feel proud of and encourage areas that build their self-esteem
• Provide your child with a healthy diet and enough physical activity.

Your doctor may also recommend leaflets or online resources for help and support. If your child is being bullied (at school or online) or not getting the support they need, it is important to focus on solving these problems as part of treating your child's depression.

Your doctor may also refer your child for psychological therapy. This could be:

• cognitive behavioural therapy (CBT)
• interpersonal therapy (IPT)
• family therapy
• individual therapy
• group social skills training

If your child's symptoms do not improve with therapy, or if they severely affect their quality of life, your doctor may refer you to a child psychiatrist. They can discuss medicines for depression (antidepressants).

Few medicines have been proven to be effective at treating depression in children. Any child who takes medicines for depression must be closely monitored by their doctor for their safety and side effects. Antidepressants are typically only considered for children older than 6 years.

What are the complications of depression in children?

Depression can lead to mental health and physical complications in children. When depression becomes very severe, your child can experience dark thoughts. These can sometimes lead to self-harm or suicide. If someone you care about has severe depression, learn the warning signs.

Children diagnosed with depression may have ongoing mental health difficulties that continue into adulthood. Treating depression and supporting their mental health early can prevent problems later in life.

Can depression in children be prevented?

Preventing depression in children focuses on improving their mental health and communication skills. Teaching children about how to regulate their emotions and become resilient, and role modelling this as parents, can help them when they feel sad or angry. Talking to your child about their feelings and experiences can improve their mental health and emotional communication skills.

Providing a child with a supportive and positive environment and appropriate boundaries can help prevent depression.

There are educational programs and resources available for parents and carers that provide support. Sometimes programs are provided at school to introduce children to the concept of mental health.

Resources and support

Supporting a child with depression can be difficult for parents and carers. There are resources available to help you as you help your child.

• Speak to Kids Helpline about depression by calling 1800 55 1800 or via webchat.
• Share your experiences on My Circle — a free social platform for people aged between 12 and 25 years, and supported by Kids Helpline counsellors.
• Find support for yourself while caring for a child with depression on ReachOut Australia's website for Parents and Carers.
• ReachOut also has many school resources for student wellbeing.
• Beyond Blue also has support on parenting and mental health.
• Headspace has resources and example questions for how to talk to your child about their mental health.
• Learn about mental health and raising children with Beyond Blue.

If you are worried about depression in a child aged 5 years or younger, call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available from 7am to midnight (AET), 7 days a week (including public holidays).

If you are experiencing depression related to your sexuality or gender identity (LGBTQI+), QLife provides a counselling and referral service for LGBTQI+ people. You can call them on 1800 184 527.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Information for Aboriginal and/or Torres Strait Islander peoples

For more information on mental health and wellbeing for Aboriginal and/or Torres Strait Islander peoples, visit the Black Dog Institute.

Beyond Blue has information on how depression affects Aboriginal and/or Torres Strait Islander peoples.

Languages other than English

• Embrace Multicultural Mental Health has services and information available.
• This Way Up has translated resources on mental health topics.
• The Transcultural Mental Health Centre has translated mental health resources in over 40 languages.