Symptoms

The symptoms of depression are often subtle at first. They may occur suddenly or happen slowly over time. It can be hard to recognize that symptoms may be connected and that your child might have depression.

Physical symptoms

• Unexplained aches and pains, such as headaches or stomach pain
• Trouble sleeping, or sleeping too much
• Changes in eating habits that lead to weight gain or loss or not making expected weight gains
• Constant tiredness, lack of energy
• Body movements that seem slow, restless, or agitated

Mental or emotional symptoms

• Irritability or temper tantrums
• Difficulty thinking and making decisions
• Having low self-esteem, being self-critical, and/or feeling that others are unfairly critical
• Feelings of guilt and hopelessness
• Social withdrawal, such as lack of interest in friends
• Anxiety, such as worrying too much or fearing separation from a parent
• Thinking about death or feeling suicidal

It's important to watch for warning signs of suicide in your child or teen. These signs may change with age. Warning signs of suicide in children and teens may include preoccupation with death or suicide or a recent breakup of a relationship.

Depression can have symptoms that are similar to those caused by other conditions.

Less common symptoms

Severely depressed children may also have other symptoms, such as:

• Hearing voices that aren't there (hallucinations). This is more common in young children.
• Having false but firmly held beliefs (delusions). This is more common in teens.

Normal moodiness vs. depression

Telling the difference between normal moodiness and symptoms of depression can be hard. Occasional feelings of sadness or irritability are normal. They allow the child to process grief or cope with the challenges of life.

For example, grieving (bereavement) is a normal response to loss, such as the death of a family member or even the death a pet, loss of a friendship, or parents' divorce. After a severe loss, a child may remain sad for a longer period of time.

But when these emotions do not go away or begin to interfere with the young person's life, he or she may need treatment.

Bipolar disorder

Some children who are first diagnosed with depression are later diagnosed with bipolar disorder. Children or teens with bipolar disorder have extreme mood swings between depression and bouts of mania (very high energy, agitation, or irritability).

It can be hard to tell the difference between bipolar disorder and depression. It is common for children with bipolar disorder to first be diagnosed with only depression and later to be diagnosed with bipolar disorder after a first manic episode. Although depression is part of the condition, bipolar disorder requires different treatment than depression alone.

Like depression, bipolar disorder runs in families. So be sure to tell your doctor if your child has a family history of bipolar disorder. For more information on bipolar disorder, see the topic Bipolar Disorder in Children and Teens.