Depression - Youth

Learn about depression, signs to look for, how your doctor determines if your child has depression and treatment
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Found in: Mental Health Conditions
Date: September 2022

About depression - youth

Often kids get sad, or upset or grumpy, and that is normal. This is not what we mean when we talk about depression here.

Depression is an illness that can affect how children and adolescents feel and behave for weeks or months at a time. This will affect how they function in their day-to-day lives.

Depression can range from mild to severe. It can look different in children and young people than in adults. While the familiar adult symptoms may still be there – low mood, changes in sleeping and eating, loss of energy and motivation, trouble concentrating, and so on – their most obvious symptoms may be irritability, rebellious behaviour or frequent physical pain.  

Depression can start at any age (from childhood through to old age). It is less common among younger children, with the rate increasing around mid-adolescence. Sometimes, it is the body’s way of communicating that something in the person’s life is harmful (e.g. too much school or work pressure, isolation from community, loneliness or family harm).   

Children and young people with depression often have other problems. Common co-occurring difficulties include anxiety disorders, substance use disorders, attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder, deliberate self-harm and suicide attempts.

The risk of suicide in people with depression is significant. It is important that if you or someone in your care is having any suicidal thoughts, you seek help immediately through a helpline or dial 111.

If you’re concerned you or your child may be depressed, a number of New Zealand websites have useful self-tests you can do, and there are sites just for children and young people. These are listed below.

Remember, depression is a serious illness, and you do need to see your doctor, a counsellor or a therapist if you suspect you, or a loved one, may be suffering from it. With the right support and treatment, it is very possible to recover from depression and live a fulfilling life.  

Myths about depression

Depression is a sign of a weak character 

NOT TRUE The fact is that depression can strike anyone. While some particular personality types are more likely to develop depression, the vast majority of people who develop the condition have been previously healthy and not had major difficulties. 

People with depression can just “snap out of it” or just choose to “pull their socks up”

NOT TRUE One of the most disabling symptoms of depression is the fact that it saps the will and makes doing anything an enormous effort. Depression is an extremely unpleasant experience, and most people with this condition would (and do) do anything to get well. Children and young people will not “grow out of it” without support, and it is not just a phase.

What causes depression?

While the exact cause of depression is not known, depression is believed to result from the interaction of neurobiological, genetic and environmental factors.

Factors that make young people and children vulnerable to depression include:

  • Having a sensitive or anxious temperament 
  • Having a parent who suffers from depression, or a family history of depression (genetic predisposition)
  • Traumatic life events, like the loss of a loved one, experiences of abuse and neglect, or living in chronically stressful environments 
  • Stressful life events, like the break-up of parents, pressures at school, learning difficulties, being bullied, relationship break-ups, or problems with friends
  • Social isolation, i.e., having no friends or family that they feel connected to
  • Having chronic and severe medical conditions 
  • Imbalance of hormones
  • Certain medications can cause depression in some people


Signs to look out for (symptoms)

Symptoms of depression usually develop over days or weeks, though the child or young person may have a period of anxiety or mild depression that lasts for weeks or months beforehand. 

Depression in children and young people can look different from depression in adults. Children and young people may tend to be more irritable and rebellious than sad. Young children, especially, may not be able to express in words how they are feeling because of their age. They may be more inclined to emotional outbursts and expressions of physical illness such as frequent headaches or stomach-aches.

Signs to look for in a young person or child include:

  • Irritable mood. This may be the main mood change, especially in younger children. This may show itself through aggressive and/or defiant behaviour. 
  • Persistent low, sad or depressed mood. The young person may be miserable and unable to cope with daily activities. This may be expressed though negative thinking, for example, self-critical comments or complaining. 
  • Loss of interest and pleasure in usual activities. This is a reduced ability for enjoyment. Children and young people may refuse to engage or appear disinterested in previously enjoyed activities. This may include loss of interest in sex in adolescents.
  • Change in sleeping patterns. Most commonly, reduced sleep, with difficulty getting to sleep, disturbed sleep, and/or waking early and being unable to go back to sleep. Sometimes there can be an increase in sleep. 
  • Change in appetite. Most often people do not feel like eating. Some people have increased appetite, often without pleasure in eating. This is often seen in those who also sleep more.
  • Decreased energy, tiredness and fatigue. These feelings may be so severe that even the smallest task seems too difficult to finish.
  • Physical slowing or agitation often comes with severe depression. The young person may sit in one place for periods and move, respond and talk very slowly; or they may be unable to sit still, but pace and wring their hands.
  • Thoughts of worthlessness or guilt. As a result of feeling bad about themselves, children and young people may withdraw from doing things and from contact with others.
  • Thoughts of hopelessness and death. The young person may feel there is no hope in life, wish they were dead or have thoughts of suicide.
  • Difficulty in thinking clearly and concentrating. They may not be able to read a book or watch television. This can also show itself through declining performance at school. They may also have great difficulty making even simple everyday decisions.
  • Loss of contact with reality. In very severe cases, depression can result in symptoms of psychosis. 

How the doctor determines if your child has depression (diagnosis)

There are pen-and-paper tests for depression. However, usually a diagnosis is made by the doctor or clinical psychologist based on whether the child or young person has some or all of the typical symptoms, and the length of time they have had them.

For this reason, it’s important that your doctor spends time with you and your child to get a full understanding of the difficulties they have had.  

While depression could be responsible for the symptoms listed above, the same picture can be seen with the depressed phase of bipolar affective disorder and also in some medical conditions. This is why it’s important your doctor excludes these conditions.

Note: Over the age of 16, young people are treated as adults in terms of consent for assessment and treatment. Below this age, caregivers (usually parents, but sometimes organisations such as Oranga Tamariki, when children are in care) have legal responsibility, and responsibility for consenting to any treatments the child may receive. 

Treatment options

Depression can be effectively treated, and people will usually recover from it. The earlier effective treatment is started, the better the chance of recovery.  

If you think a child or young person in your life is depressed, look for the signs and talk to them. Your support is important.

As a parent or caregiver, you can advocate for the child or young person; help them navigate services; be with them at appointments, if they are comfortable with this; and encourage them to persevere with treatment or make changes where needed. 

Treatment of depression can involve a number of aspects, each of which can be tailored to a child’s individual need. A combination of medication and therapy may be helpful, particularly for those experiencing severe symptoms.

Talking therapies

Talking therapies, adapted to the developmental level of the child or young person, are effective in the treatment of depression. A therapist can identify any underlying causes of depression, help the child or young person recognise and respond to early signs that they are entering a depressive episode, and help them learn new ways of thinking and behaving that will support their wellbeing.

Therapies identified as effective in research and treatment guidelines include: 

  • Cognitive behaviour therapy (CBT) 
  • Interpersonal therapy (IPT) 
  • Attachment-based family therapy (as appropriate to the developmental level of the child).

Your doctor will explain what is available locally and may offer some guidance around which type of talking treatment is most suitable for your child or teenager (based on their developmental level and the severity of their depression). It’s also important to listen to the child or teenager’s own opinion and allow them to choose an option they feel drawn to. 

Although CBT is the most common style of talking therapy in these cases, it is not the only option. If your child or teenager feels it isn’t right for them, encourage them to try a new therapist or style of therapy. With perseverance, they will be able to find the right fit for them – but it can be hard to keep trying new things, especially while depressed, so your support is crucial.  

Remember, if you are experiencing depression and are at school you can talk to:

  • your school guidance counsellor
  • your doctor, and talk about a referral to Child and Adolescent Mental Health Services (CAMHS)
  • your Hauora Youth mental health worker. Some areas in New Zealand have services for Māori, Pasifika and Asian youth – ask your school counsellor.


Antidepressant medication, in particular fluoxetine, has also been shown to be effective in treating depressive symptoms. Doctors are usually very careful when prescribing for young people. Finding the right medication can be a matter of trial and error – there is no way to predict which medication will be effective and tolerated (have fewer troublesome side effects) by any one person.

If your child is prescribed medication, they and you are entitled to know:

  • the names of the medicines
  • what symptoms they are supposed to treat
  • how long it will be before they take effect
  • how long you will have to take them for and what their side effects (short and long-term) are
  • what the process of stopping taking them could look like.

If medication is prescribed, it is important the child/young person is closely monitored by a health professional, particularly at the beginning of treatment. It is also really important to take the medication as prescribed and to tell the doctor or health professional if your child stops taking the medication – a sudden stop can make the person taking it feel worse.

If your child is considering stopping medication, talk to your doctor and work together with them to find some compromise that will ensure continuing wellness but address the child or young person’s concerns about the treatment.

Other strategies to support recovery

Complementary therapies

The term complementary therapy is generally used to indicate therapies and treatments that differ from conventional western medicine and that may be used to complement and support it. 

Certain complementary therapies may enhance your life and help you to maintain wellbeing. In general, mindfulness, hypnotherapy, yoga, exercise, relaxation, massage, mirimiri and aromatherapy have all been shown to have some effect in alleviating mental distress.

When considering giving your child any supplement, herbal or medicinal preparation, you should consult your doctor to make sure it's safe and will not harm their health, for example, by interacting with any other medications.

Physical health

Take care of your child’s general health by making sure they eat well, get enough sleep and exercise. This is really important to help them through depression.

Identifying your own needs

As a parent or caregiver, it is important to care for your own mental health and seek support where you need it. Seeing a loved one experience depression can be hugely distressing. Looking after your own health, finding peer support and, in some cases, seeking therapy for yourself will help you manage this challenge better, for both your own wellbeing and that of the child or young person.   

Thanks to Natasha de Faria, clinical psychologist, for reviewing this content. Date last reviewed: September, 2022

Thanks also to Sutherland Self-Help Trust for making the 2022 updates possible.