Patient Education

Depression in children and teens PRINT BACK

Causes of depression

Doctors do not fully understand the causes of depression. It is believed that some people inherit a tendency to have an imbalance in the brain chemicals that control mood. Major losses or disappointments can bring on this imbalance, leading to clinical depression.

Doctors do know that depression is not a sign of personal weakness or something that can be willed or wished away. Children and teens with clinical depression cannot simply “snap out of it.” It’s important to remember that depression is no one’s “fault.”

Risk factors

Although doctors do not know which children and teens will develop depression, they do know that some are at greater risk. For example, the rate of depression is higher in children of parents with bipolar disorder or major depression, and in children who have been in the hospital for chronic illness.

Also, once a young person has an episode of major depression, he or she is at greater risk of having another episode within the next five years. Other factors that increase the risk for depression in children and teens are:

  • A parent or other family member with depression
  • Family history of drug and alcohol addiction
  • Academic or behavior problems at school
  • Social problems at school including bullying
  • Loss or separation from a parent or caregiver
  • Having a hard time with friends
  • Family conflict and/or lack of positive feelings or emotions expressed in the family
  • Having a negative outlook.

Signs and Symptoms 

Signs and symptoms of child and teen depression vary and may be different from those seen in adults. In children and teens, early symptoms can be hard to notice, or may be due to other causes. Signs and symptoms of depression in children and teens that cannot be otherwise explained include:

  • Missed school or poor school performance
  • Changes in eating and sleeping habits
  • Withdrawal from friends and activities once enjoyed
  • Persistent sadness, hopelessness or irritability
  • Indecision, lack of focus, constant worrying, restless mood or forgetfulness
  • Guilt or low self-esteem
  • Frequent physical complaints, such as headaches and stomachaches, without apparent physical cause
  • Lack of enthusiasm, low energy or motivation
  • Drug and/or alcohol abuse
  • Thoughts of death or suicide
  • Attempts at self-injury
  • Play that involves persistently sad themes
  • Giving away previously-cherished belongings.

Young people who are depressed have a greater risk of suicide than other young people. This is another important reason for seeking professional help if depression is suspected.


The most common treatments for depression are:

  • Psychotherapy. This involves talking with a mental health professional (therapist) about ways to better cope with changes in your life. Research has shown that it is effective for depression and that most people see progress in a timely manner.
  • Antidepressant medication. Medicine can help correct an imbalance in the brain chemicals that control a person’s mood. Most medicine can be used safely but should be prescribed by a doctor who knows about the drug and how it might affect other medicine you may be taking. Be sure to tell all of your doctors about all of your medical conditions and all of the medication that you’re taking. Most people will see signs of relief within four to six weeks.
  • A combination of the two treatments. This approach combines “talk therapy” with antidepressant medication and can be more effective for some people than either medicine or psychotherapy alone.

Parents and adults can help

If you think that a child or teen is depressed, you should:

  • Have the child seen by a doctor or therapist who specializes in child or adolescent mental health, or the child’s doctor, for an evaluation.
  • Get as much information as you can about depression.
  • Learn more about available care and resources from a doctor or mental health professional.
  • Talk to other families who can offer advice and support.
  • Find and join support groups, such as those offered by Mental Health America (formerly the National Mental Health Association) at or 1-800-969- 6642.

Getting help

If you think that a child or teen may be depressed, call your health care provider or your program’s toll-free number.

Get help for the child or teen right away if here or she is thinking of hurting him or her self or others.


This artcile is information only. It is not meant to give medical advice. It should not be used to replace a visit with a provider. Blue Shield of California does not endorse other resources that may be mentioned here.