Pediatric Depression

What are the signs and symptoms of depression in children?

Symptoms of depression can differ from child to child. Depression is often mistaken for typical emotional and psychological changes in childhood and because of this, many children go undiagnosed and untreated. It’s common for younger children with a depressed mood to be irritable and act out or frequently display angry behavior. Many children may also display sadness or low mood like depressed adults.

Children may also have physical symptoms such as frequent headaches, stomachaches, body pains or digestive issues. If your child is experiencing physical symptoms, visit your pediatrician to rule out physical problems or conditions and request to have your child screened for depression.

Other symptoms of depression in children can include:

• Unusual grouchiness or anger
• Withdrawing from friends and family
• Becoming more isolated
• Having a negative view of themselves, life or the future
• Changes in sleep
• Changes in appetite
• Crying more
• Difficulty with focus and concentration
• Fatigue and low energy
• Thoughts of suicide or death

What tests are used to diagnose depression in teens and kids?

At Children's Hospital Colorado, we diagnose depression through a clinical interview with a specially trained mental health professional.

A children’s mental health specialist at our Pediatric Mental Health Institute performs a multi-part intake process to ensure a fast and accurate diagnosis. This helps families begin targeted treatment to meet their specific needs. This intake process includes:

• A clinical interview with parents and children
• A standardized Behavior Assessment for Children (BASC-3)
• Questionnaires

When diagnosing this condition, we focus on the symptoms of depression and how they impact your child's daily life. While there are no lab tests or imaging procedures to diagnose depression, our caregivers use tools such as intake questionnaires combined with personal information from the clinical interview, which are very helpful in diagnosing depression in children. Within those intake assessment sessions, therapists may also identify other conditions that contribute to depression such as attention-deficit/hyperactivity disorder (ADHD), anxiety or other mental health conditions.

What can I expect from the intake process at Children’s Colorado?

When you contact us regarding therapy services or to describe your child’s symptoms, we’ll ask you some initial screening questions. A diagnosis requires time to get to know your child and their symptoms, and to build an individualized treatment plan.

We’ll ask you to complete an online intake packet and then schedule an intake interview with you and your child. We can do this interview in person or via telehealth online. We’ll then schedule a follow-up visit for one week after the initial intake interview. At this follow-up visit, we provide families with assessment results, diagnoses and treatment recommendations.

How do we treat depression in teens and children?

Treatment type and length varies based on many factors including the causes of a child’s depression.

Evidence-based treatment for children with depression starts with therapy. For some children, adding medication to therapy can help. Cognitive behavioral therapy (CBT) is the treatment of choice for depression and is the foundational approach to treatment at Children’s Colorado. For many children experiencing depression, once a week outpatient therapy can help a child recover from depression within three to six months. More severe cases may require a brief hospitalization.

We also utilize dialectical behavior therapy (DBT), which is an evidence-based treatment that has been shown to be very effective for children and teens experiencing problems with impulsivity, coping with strong emotions, dealing with stress and interpersonal conflict.  This therapy is also very helpful for youth who experience suicidal thoughts or who have engaged in self-injury. Also, acceptance and commitment therapy (ACT) has been shown to be particularly effective for treating both anxiety and depression. Both treatments are based in mindful awareness, which has been shown to reduce anxiety, depression and pain symptoms.

In addition to therapy, families can create routines to support their child’s recovery from depression. These include:

• Getting physical activity every day
• Eating nutritious meals regularly
• Staying engaged in school and family life
• Maintaining a regular sleep schedule
• Keeping up with friends and doing fun activities

Why choose Children’s Colorado for treatment of depression in kids?

Experts in our Pediatric Mental Health Institute are trained and experienced in treating childhood depression. When you receive care here, you can be certain that you and your child are receiving evidence-based treatment that ensures the best possible outcomes.

We provide high quality evaluations that are grounded in the most up-to-date research. Research into depression treatment continues to validate CBT as the most effective treatment with the highest recovery rates. Our providers have years of experience providing children with CBT and have seen its benefits.

In addition to traditional CBT, our providers are the foremost experts in the region in DBT and ACT, which have proven to help children with depression.

Moreover, all our staff are experienced with and sensitive to the needs of children who may be nervous or scared. We include resources like experts from our Ponzio Art Therapy Program and child life specialists to help kids and teens process difficult experiences and feelings. We have toys, art materials, snacks and other soothing items to help put kids at ease.

Anxiety and Depression Association of America

Anxiety and Depression in Children (Centers for Disease Control and Prevention)

"Put Your Feelings Here: A Creative DBT Journal for Teens with Intense Emotions" by Lisa M Schab