Fact Sheet: Preventing depression in children and young people

Tension with parents, bad marks at school, losing friends, divorce, unhappiness with themselves or their bodies, and first relationships: children and young people have a lot of difficult issues to cope with. They can sometimes feel sad, down or distressed. That is a normal and natural reaction. But up to 24 out of 100 (24%) of young people will have at least one episode of depression that needs treatment by the time they are 18.

But depression in children and young people can be prevented or at least detected early.

What is depression?

Depression is more than feeling blue, having a bad day or normal up and down. Depression is one of the most common mental illnesses, and it can become a serious illness. There are several different types of depression that can be recognised by different signs. People in any social or age group can be affected - from children to older people, and both women and men.

There are many possibilities for help for people who are depressed.

What are the signs of depression?

If someone has had at least two of the following for longer than two weeks, it might mean that they are depressed:

• Deep sadness
• Listlessness
• Loss of interest in the things they usually care about

Depressed people feel really low, listless and have lost interest in the world around them. Many feel worthless, feel guilty and see everything negatively. They brood on things, are easily irritated, have trouble concentrating and cannot sleep at night. Some feel anxious or have suicidal feelings. Depressed people often have little appetite and lose weight.

And people who are depressed often feel as though it will always be like this.

Which symptoms of depression occur and how strong and frequent they are vary from person to person, and are different in the various age groups, too. Pre-school children probably do not get depressed very often, and it can be hard to tell if they are. Pre-schoolers who are depressed cry a lot, do not have any interest in play and are very anxious. They try hard to be nice and obedient. In some children it can set back their development.

School-aged children who are depressed often lose interest in their leisure activities and can be hostile to others. They can have outbreaks of temper, get upset quickly over little things and have low self-esteem.

With teenagers it can be hard to tell the difference between "normal” mood swings and when the person is really depressed. Healthy young people are sometimes defiant, aggressive, uninterested, have low self-esteem or retreat into themselves - without being depressed. Weight changes, drug and alcohol use, extreme tiredness and thoughts of suicide can be a sign of depression in a teenager.

Is depression dangerous?

Depression is a serious illness. Depressed young people are more likely than others to abuse drugs or alcohol, fall behind at school or have behaviour problems. Some have thoughts of suicide and some try to end their lives.

Why do some people get depressed?

Depression often has more than one cause. Usually it comes from a mixture of biological factors, mental factors and the impact of events in a person's life. In children and young people, it is often caused by problems in the family, violence, problems at school and social isolation. Children and young people are at higher risk of developing depression include those who are showing signs of depressed mood and/or who have family members who are depressed or have another mental illness.

Depression can also be caused by physical illness or as an adverse effect of some medication. Young women can get depressed at a particular time in their menstrual cycle.

How can you help reduce the chances of children or young people getting depressed?

It is a very important life task for children and young people to learn how to cope with problems, life events, positive and negative life experiences as well as their own emotions.

There are several possibilities that can be tried to prevent depression in children and young people:

• Education about depression and/or
• Developing strategies and behaviours to help them cope in difficult situations

Psychologists, counsellors and other experts have developed programmes that aim to prevent depression in children and young people. In a series of sessions, the children or young people learn about how they can solve problems and conflicts, what they can do when they feel sad or how they can cope with stress.

It has been shown that psychological programs can lead to short-term improvement in the symptoms of depression in children and young people who are at high risk of depression. They can reduce the chances of them getting depressed for up to a year later. But whether these or other programmes can also help children and young people who are at no particular risk for depression is not known. Psychological programmes vary a lot, and there is still no clear answer on whether any type of programme is better.

As well as psychological and educational programmes, there are many other information sources, like the internet. More and more, young people look for information on the internet and get in touch with others by email or in chatrooms. Researchers are studying what influence this might have on the development or experience of depression.

As well as the internet, children with depression and their parents can go to counselling services run by churches or charities, paediatricians, psychiatrists or psychologists to learn more about depression. Many schools have counsellors.

Children and young people who are showing signs of depression need to have someone they can trust to talk to. They may need to be able to be open about their fears and be able to talk about themselves and their lives.

You can find out more about what family, friends or others can do here.

© IQWiG (Institute for Quality and Efficiency in Health Care)