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National Institute of Mental Health
Schizophrenia

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National Institute of Mental Health (NIMH)

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What is schizophrenia?

Schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality, which can be distressing for them and for their family and friends. The symptoms of schizophrenia can make it difficult to participate in usual, everyday activities, but effective treatments are available. Many people who receive treatment can engage in school or work, achieve independence, and enjoy personal relationships.

What are the signs and symptoms of schizophrenia?

What are the risk factors for schizophrenia?

How is schizophrenia treated?

How can I find help for schizophrenia?

How can I find a clinical trial for schizophrenia?

Where can I learn more about schizophrenia?

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Learn about schizophrenia, including onset & symptoms, risk factors, treatments and therapies, how to help a loved one, & resources for more information.

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The Schizophrenia Oral History Project

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Addressing Mental Health in School Crisis Prevention and Response

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Addressing Mental Health in School Crisis Prevention and Response

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A wide variety of resources for educators.

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"We initially chose IRIS because of the past experiences and their credible research-based, high-quality modules that align with specific areas of growth and need to support a state-directed corrective action plan in our region."

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"We initially chose IRIS because of the past experiences and their credible research-based, high-quality modules that align with specific areas of growth and need to support a state-directed corrective action plan in our region."

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Information on various topics

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Child Mind Institute | Transforming Children’s Lives.

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The Child Mind Institute is an independent nonprofit dedicated to transforming the lives of children struggling with mental health and learning disorders.

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Image Source: https://www.ocduk.org/ocd/the-language-of-ocd/

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Most children and parents will have some distress or upset - so how do I know when a child or family needs additional help?

Ask your patients (and their parents) about reactions and coping.

Listen for ongoing or severe traumatic stress symptoms.

Consider a referral for a more thorough evaluation with a mental health professional if:

Traumatic stress reactions are severe or prolonged (more than a month).

Traumatic stress reactions interfere with recovery or with returning to normal activities.

Consider: Is the child participating in daily activities to the extent possible given their medical condition? Are stress reactions interfering with treatment adherence? Are new fears or worries troubling the child or parent?

Steps for making a referral Effective mental health treatment for traumatic stress Online resources - help in finding a mental health professional Distinguishing between types of mental health professionals
Therapist Resource Guide: There are many ongoing stressors that children and families endure after diagnosis of an illness or an injury. This guide focuses specifically on medical traumatic stress and responses that children and families may have.

Steps for making a referral

Mention concerns you have identified.
Say something like: "I'm concerned that (you are / your child is) having these upsetting thoughts and feelings. It might be useful to talk with a specialist who can help your family more."

Involve child and family in making a plan.
Ask for their ideas about what is needed now
Say something like: "What issues or difficulties are impacting you / your family the most right now? What would help make things better?"

Ask for permission to offer advice. Present advice as range of possibilities; be sure to incorporate patient/family ideas

Say something like: "I have some suggestions that have helped other patients in the past in situations similar to yours. May I share them with you?"

Range of possibilities might include: patient education materials / websites; speaking with social worker, local clergy, school counselor; seeking out support group, referral to therapist / community mental health center.

Ask about their readiness to act on this now or in the future.
Say something like: "Is this (suggested plan) something you would be willing to do when you leave today, or if you need it next week...month?"

Ask about barriers to potential plans / referrals, and strategies to overcome barriers.
Say something like: "What kinds of things would interfere with following-up on this plan we just discussed? How can we work through this so you end up getting the help you need.?"

Involve the child and parent in setting the agenda*:*Adapted from Wissow et al. (2008)

Keep the door open.

If your patient or their parents are not quite ready to act on a suggested referral now, arrange to follow up to see how your patient is doing.

You might say: "I'd like to talk with you again in a few weeks to see how things are going."

Promote continuity of care.
If your care for this patient is ending, ask permission to communicate your concerns about traumatic stress reactions or risk factors to the child's primary care provider, or to other providers who will continue to take care of this patient.

Facilitating collaboration between pediatric health care and mental health providers: The American Academy of Pediatrics Task Force on Mental Health has developed tools to facilitate collaboration between pediatric health care providers and mental health professionals, including a Physician Referral and Feedback Form template

Effective mental health treatment for traumatic stress

There are very good and helpful treatments for children who continue to have traumatic stress symptoms.
What treatment approaches are effective?
Evidence-based treatments include cognitive-behavioral treatment approaches, and in particular Trauma-Focused Cognitive Behavior Therapy (TF-CBT).

Click here for a fact sheet about effective treatments for youth trauma from the National Child Traumatic Stress Network.

A recent article includes informative summaries of effective mental health treatments for child traumatic stress symptoms, and guidance for health care professionals:
Cohen, J, Kelleher, K, Mannarino, A.. Identifying, treating, and referring traumatized children: The role of pediatric providers. Archives of Pediatric and Adolescent Medicine 2008;162(5):447-452 How can I help parents find effective treatment for their child?
When helping parents find a counselor or therapist to help their child with traumatic stress symptoms, you might suggest that they ask prospective therapists questions such as:

Do you have experience working with children after trauma?

What is your approach to working with this type of problem?

What is your success rate?

How do you work with parents?

The National Child Traumatic Stress Network offers useful tips and information about finding a mental health professional to help children and their families after trauma.

Online resources - help in finding a mental health professional

The National Child Traumatic Stress Network (NCTSN) has trauma-trained, child mental health professionals and community-based treatment centers in 35 states in the US. For information about or referral to a NCTSN center near you, please go to the NCTSN Organizational Members site.
American Psychological Association - Psychologist Locator National Association of Social Workers - Find a Licensed Social Worker American Academy of Child and Adolescent Psychiatrists - Psychiatrist Finder Anxiety Disorders Association of America - Find a Therapist Sidran Institute Help Desk - Locate Trauma Resources ISTSS Clinician Directory - Find a Clinician, Counselor or Mental Health Professional
Distinguishing between types of mental health professionals

Psychologists are professionals who have earned a doctoral degree (Ph.D. or Psy.D.) after 4-6 years of graduate-level training in human behavior and development, psychological testing and evaluation, and psychotherapy. Psychologists are licensed by the state in which they practice.

Psychiatrists are physicians (M.D. or D.O.) who have completed medical school, plus additional advanced training in the evaluation and treatment of psychiatric disorders and emotional and behavioral problems. Psychiatrists are licensed by the state in which they practice. As medical doctors, psychiatrists can prescribe and monitor medications.

Clinical Social Workers are professionals who have earned a master's degree (M.S.W.) after 2-3 years of graduate training. Clinical Social Workers are licensed by the state in which they practice (LCSW or similar credential - varies by state).

Marriage and Family Therapists are professionals who have completed a master's degree (M.A. or M.S.) after 2-3 years of graduate training. Some Marriage and Family Therapists have completed a required amount of clinical hours and passed a state-administered examination to become licensed marriage and family therapist (LMFT).

Licensed Professional Counselors (LPC) & Licensed Mental Health Counselors (LMHC) are mental health professionals who have earned a master's degree (M.A. or M.S.) after 2-3 years of graduate training and have obtained a required amount of clinical experience and passed a state-administered licensing examination.

For more information on the training and credentialing of mental health professionals, see Mayo Clinic: Mental health providers.

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When and How to Refer for Mental Health Care

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Pediatric providers can follow specific steps to determine if and how to refer a child and familiy for further mental health services after a medically traumatic event. Providers can also become familiar with current evidence-based treatments and online resources for mental health services for traumatic stress.

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created by Angie Walden

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While summer offers preschool and elementary school children a welcome break and chances to navigate new friendships and activities, it can trigger anxiety in children upset by unstructured time, changes in routine and friend groups, and transitions involving new faces and places. Separation anxiety, social anxiety, and specific phobias are instantly recognizable: a sobbing child clings to a parent, refusing to set foot inside day care; a socially anxious child worries about attending a birthday party because "nobody will play with me;" or a child is so terrified by insects that simple summer fun like a nature stroll, digging in the dirt, or a picnic in the park is impossible.

Common symptoms of anxiety in children

Thumping heart, rapid breathing, sweating, tense muscles, nausea, and dread are familiar symptoms of anxiety that accompany a " fight, flight, or freeze " reaction triggered by real or imagined threats, like a snarling dog or new social experience. Anxious children may be clingy, startle easily, cry or have tantrums, sleep poorly, and have headaches or stomachaches.

But anxiety is not all bad. "It can motivate us, or help us avoid danger," says Dr. Mona Potter, medical director of McLean Anxiety Mastery Program and McLean Child and Adolescent Outpatient Services. "The problem is when anxiety gets out of hand and makes decisions for us that are no longer helpful - maybe even paralyzing." By that point, normal anxiety may have become an anxiety disorder.

What types of anxiety are common in children?

Separation anxiety: Very anxious and upset when parted from parents and caregivers; refusal to attend camp, sleepovers, or play dates; worry that bad things will happen to self or loved ones while separated.

Social anxiety: Strong fear of social situations; very anxious and self-conscious around others; worry about being judged or humiliated.

Specific phobia: Severe, irrational fear set off by a situation or thing, such as thunderstorms, worry about vomiting, or insects.

What makes some children more vulnerable to anxiety?

Anxiety may set deep roots due to a blend of

biological factors, such as genes and brain wiring

psychological factors, such as temperament and coping strategies

environmental factors, such as anxious parenting or troubling early childhood experiences and environment.

Sometimes, anxiety is a side effect of medicine. Ask your doctor about this possibility.

Treating anxiety in children

Occasional anxiety is normal. But talk to your pediatrician if anxiety causes your child to limit activities, worry often, or avoid camp or day care. A severe anxiety disorder can delay or derail child development.

Depending on developmental stage and level and type of anxiety, treatment may involve changes you and your child work toward yourselves. Or you might work with child mental health professionals, such as a psychiatrist, psychologist, or social worker. These experts can help parents and children learn to apply cognitive behavioral therapy (CBT), a highly effective treatment that addresses anxious thoughts and behaviors. "For example, we might encourage children to practice 'detective-thinking' to catch, check, and change anxious thoughts," says Dr. Potter. "We also encourage them to approach, rather than avoid, anxiety-provoking triggers."

Mindfulness techniques and antianxiety or antidepressant medicines also may be discussed. Often a combination of approaches works best.

Ways parents can help children learn to manage anxiety

Personalize and externalize: Ask your child to give anxiety a name. Your child can draw pictures of anxiety, too. Then, help your child acknowledge anxiety when it rears up: 'Is that spiky-toothed, purple Bobo telling you no one wants to play with you?' Labeling and distancing anxiety can help your child learn to be the boss of it.

Preview anxiety-provoking situations. Consider meeting camp counselors or touring new places ahead of time.

Model confidence: Children are emotional Geiger counters. They register anxiety radiating from parents. Try to be mindful of what you model through words and body language. Work on tempering overanxious reactions when appropriate.

Narrate their world: "Children are coding the world. Particularly through early childhood their brains are just sponges, taking everything in," says Dr. Potter. "We can help them with the narrative they're constructing: 'Is the world a safe place or a dangerous place where I have to be on guard all the time?'"

Allow distress: Avoiding distressing situations invites anxiety to ease temporarily, only to pop up elsewhere. Rational explanations won't work, either. The whirring emotional center of the brain known as the limbic system requires time and tools to calm down enough to let the thinking (cognitive) center of the brain come back online. Instead, try distress tolerance tools: one child might splash her face with cold water, another might charge up and down stairs to blow off anxious energy, or tense and relax her muscles, or distract herself by looking around to find every color in the rainbow.

Practice exposure: Gradual exposure helps rewire an anxious brain and shows a child he can survive anxious moments. Let's say your child is anxious about talking in public, ducking his head and squirming if addressed. Pick a pleasant, slow-paced restaurant for a fun weekly date. Then coach your child to take charge of ordering foods he likes in small steps. At first, he might whisper the order to you and you'll relay it to the waitress. Next, he might order just his drink or dessert, and finally a full meal as distress tolerance and confidence grows.

A few helpful resources
Anxiety and Depression Association of America CDC Key Findings: Children's Mental Health Report (2018)Key Findings: U.S. Children Diagnosed with Anxiety and Depression (2018)
You and Your Anxious Child, Anne Marie Albano, PhD, with Leslie Pepper (Avery: 2013)

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Anxiety in children - Harvard Health Blog

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While summer offers preschool and elementary school children a welcome break and chances to navigate new friendships and activities, it can trigger anxiety in children upset by unstructured time, changes in routine and friend groups, and transitions involving new faces and places.

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Signs and symptoms of childhood depression

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Rates of childhood depression have been rising in the last several years. Yet, information and awareness about childhood depression has not caught on at the same rate. Millions of people across the world wonder and doubt if children can get depressed. Many well-intentioned adults still believe that children 'can't get depressed. They are so young- what do they have to be depressed about? When we were that age, we were just happy'. Alongside misunderstanding is stigma and the idea that mental illness is a taboo subject.
What we now know:

Childhood depression is a real, distinct clinical entity.

It is a serious health condition, which if left untreated, increases risk of future, prolonged and more severe depressive episodes. Untreated depression in childhood and adolescence can pose risk of suicide.

Depression often has biological, psychological and social underpinnings. An individualized treatment plan that explores and addresses each of these aspects, works best.

Effective treatment options for childhood and teen depression have been widely tested, proven and established, through several scientific studies over the years.

Childhood depression can be hidden and therefore, easily missed. Timely recognition and treatment can be life-changing and life-saving.

The barriers surrounding mental health stigma are beginning to give way due to powerful social movements and discussions that address realities of mental health.

Who is Affected by Depression in Childhood or Teenage?
Depression can affect anyone. However, children or teens who have immediate family members with a history of depression or other mood disorders (such as bipolar disorder) are more likely to suffer from depression, often due to a genetic predisposition. Predisposition implies greater likelihood; it does not mean that the child or teen will necessarily experience depression.

Children with chronic or severe medical conditions are at a greater risk of suffering from depression.
Common Signs of Depression in Childhood or Adolescence
Depression in childhood/adolescence can manifest somewhat differently than it does in adults. Irritability and/or anger are more common signs of depression in children and teens.

When depressed, younger children are more likely to have physical or bodily symptoms, such as aches or pains, restlessness, distress during separation from parents, as they may not have the emotional attunement and/or expressive abilities to talk about their emotions.

Other signs of depression in children and teens, can be:

Loss of interest in usual fun activities

Withdrawal from social or usual pleasurable activities

Difficulties with concentration

Running away from home or talking about running away from home

Talking about death or dying, giving away (or talking about giving away) favorite possessions, writing goodbye letters

Sleep increase (or decrease)

Appetite/weight changes (more likely an increase, in depressed teens)

Occasionally, new or recent onset agitation or aggression

Comments indicating hopelessness or low self-worth

Not all of the above-mentioned symptoms have to be present for a diagnosis of depression. Symptoms usually occur on most days, for at least 2 weeks, in order to meet criteria for depression. When seeing a professional to explore a diagnosis, you can utilize online health resources to prepare meaningful questions to ask a doctor in order to facilitate productive conversation for treatment.
Ruling Out Medical Conditions First
Psychiatric disorders are diagnosis of exclusion, which means that only if the symptoms are unexplained by medical conditions, or effect of substances or other non-psychiatric causes, would the cause of symptoms be deemed to be due to a primary psychiatric disorder.

Before arriving to the diagnosis of depression, a child or teen who is suspected to be depressed, must undergo a comprehensive medical evaluation to rule out any underlying medical condition which could be manifesting as or resulting in depression. For example, hypothyroidism (depressive symptoms, weight gain, low energy, cognitive difficulties, constipation). Even conditions such as undiagnosed anemia can mimic depression, due to accompanying fatigue/low energy. Vitamin D deficiency, common in cold climates, increases risk of depressive symptoms and fatigue. The good news is that these conditions have effective treatments, and treatment of the underlying medical condition in a timely manner should resolve depressive symptoms.
Ruling Out Other Psychiatric Conditions
Rule out undiagnosed/untreated ADHD (attention Deficit Hyperactivity Disorder), anxiety disorders or other psychiatric conditions, which when left untreated, can result in depressive symptoms due to the impairment in functioning from ADHD or anxiety disorder itself.
Treatment
Why Treat?

Depression is associated with visible brain changes seen on functional brain MRI studies of depressed individuals. Treatment, for example, psychotherapy has been shown to confer long term benefit and neural changes in the brain.
How Do I know My Child Needs Treatment?
In addition to an overall assessment, your child's pediatrician may administer rating scales and other forms of assessment to determine the degree of depression and may refer you to a psychiatrist or a psychotherapist.

We know a child/teen needs treatment for depression when their school, social, and/or home functioning is significantly affected by depressive symptoms, on a frequent basis.

If your child/teen is feeling suicidal and/or having thoughts/urges to hurt themselves, call 911 or take your child/teen to the nearest ER.
What Kind of Treatment?
For mild to moderate depression, CBT (Cognitive Behavioral Therapy) is the typical first-line treatment of choice for children and teens. There can be exceptions to this, depending on the specific clinical condition, age and circumstance of the child. For children younger than 10, other modalities of psychotherapy such as play therapy, psychodynamic psychotherapy, and behavior therapy may be utilized.

For moderate to severe depression, evidence-based guidelines recommend a combination of CBT and antidepressant medications (typically SSRI medications, also known as Selective Serotonin Re-Uptake Inhibitors).
SSRI Use for Depression in Children

SSRIs and other antidepressants have a black box warning from FDA about risk of increase in suicidal thoughts and behavior with use, particularly in the early phase of treatment. Studies did not show completed suicides.

After this warning came out in 2004, antidepressant prescription rates dropped, and suicide rates climbed up.

Close monitoring during dose initiation, titration and dose changes helps to reduce this risk

Antidepressant medication use in children and adolescents is preceded by a weighing of benefits and risks of use versus risks of untreated depression.

Fluoxetine and Escitalopram are FDA approved for treatment of depression in children and teens.

Studies involving paroxetine (another SSRI) have shown a higher profile of side effects with its use in children, and therefore, may not be recommended for children and teens.

Studies show a higher likelihood of an individual responding to an SSRI that an immediate family member benefitted from (however, this is a likelihood, not necessary that it will happen in each situation)

If depressive symptoms are secondary to other conditions, such as untreated ADHD or anxiety disorders, adequate treatment of those disorders is essential and will usually resolve the depressive symptoms. However, in certain situations, specific antidepressant medications and/or psychotherapy targeted towards depression may be needed in addition. One might note that if trials of two or more antidepressants are not effective, or if a child/teen is sensitive to medications in general, there are additional avenues that can be explored. One plausible route for consideration is genetic testing that combines personal genetic data with medication information to achieve the desired remedy.

Your child's pediatrician/psychiatrist, therapist, together with you, may also explore for any bullying, trauma, and will try to understand your child/teen's inner life and look further for any school, social, family or other stressors that may be contributing to, or exacerbating/perpetuating the depressive condition. If family stressors are significantly contributing to your child's depression, your doctor may recommend family therapy in addition. With your permission, the doctor/therapist may coordinate with your child's school to share recommendations to optimize your child's school functioning and emotional well-being at school.
Overcoming Mental Health Stigma
In 1999 the United States Surgeon General labeled stigma as quite possibly the biggest barrier to mental health care. Stigma manifests as misguided stereotypes and negative attitudes or beliefs towards those with mental illness. Research shows that stigma and embarrassment were the top reasons why people with mental illness did not engage in medication adherence, such as self-care, therapy and medication compliance. As of late, there has been an increase in available resources and tools to overcome stigma for children and teens, as well as their caregivers. Allies such as Bring Change to Mind, an organization focused on encouraging dialogue about mental health, as well as raising awareness through education, offers high-school and college programs that foster a culture of peer support within schools.
A Word About Substance Use and Depression
Sadly, substance use among teens is becoming rampant across the country, even in reputed school districts, and thus, needs to be addressed when exploring and treating depression.

Marijuana use is particularly common among teens. Marijuana is considered to be a 'gateway drug' and can lead to 'amotivational syndrome'. This syndrome manifests as low motivation to do things, and in conjunction with marijuana related 'munchies' can mimic a primary depressive disorder. In many cases, a teen may be 'self-medicating' for untreated or undiagnosed depressive or anxiety symptoms through substance use. Use or withdrawal from other substances can cause depressive, mood symptoms as well.

Proper and timely treatment can be very effective in resolving depressive symptoms and in reducing risk of relapse. Please consult your child's pediatrician or health care provider if you suspect your child/teen may be suffering from a medical or a psychiatric condition.

Note: This article is for informational purposes only and is not intended to provide medical or psychiatric advice or recommendations, or diagnostic or treatment opinion. This is not a complete review or description of this subject. If you suspect a medical or psychiatric condition, please consult a health care provider. All decisions regarding an individual's care must be made in consultation with your healthcare provider, considering the individuals' unique condition. If you or someone you know is struggling, please contact the 24x7, confidential National Hotline at 1-800-273-8255 or use the crisis text line by texting HOME to 741741 in the US, or go to http://www.suicide.org/international-suicide-hotlines.html for the suicide hotline number for your country.
About the author:
Richa Bhatia, MD, FAPA is a Child, Adolescent and Adult psychiatrist, dual Board certified in Child, Adolescent and General Psychiatry. She is the author of 2 books: 'Demystifying Psychiatric Conditions and Treatments' and '65 Answers about Psychiatric Conditions'. Previously, she served as a faculty member in the departments of psychiatry at Harvard Medical School and Geisel School of Medicine at Dartmouth. She serves as an Associate Editor for Current Psychiatry, Section Editor for Current Opinion in Psychiatry and is on the editorial board of several other psychiatry journals. She is an expert contributor for Psychology Today and Thrive Global. Some of her interests are childhood depressive and anxiety disorders, the interface between medical and psychiatric conditions, differential diagnosis, compassion and bullying prevention. She is an active member of the Child and Adolescent Psychiatry Section of the World Psychiatric Association (WPA), the American Psychiatric Association and the Anxiety and Depression Association of America.

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Rates of childhood depression have been rising in the last several years. Yet, information and awareness about childhood depression has not caught on at the same rate. Millions of people across the world wonder and doubt if children can get depressed.

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It's normal for kids to feel sad, act grouchy, or be in a bad mood at times. But when a sad or bad mood lasts for weeks or longer, and when there are other changes in a child's behavior, it might be depression.

Therapy can help children who are going through sadness or depression. And there are things parents can do, too. Getting the right care can prevent things from getting worse and help a child feel better.

If sadness has lasted for weeks or longer, talk about it with your child's doctor.

How Can I Tell if My Child Is Depressed?

If a child is depressed, parents may notice some of these signs:

Sad or bad mood. A child may seem sad, lonely, unhappy, or grouchy. It can last weeks or months. A child may cry more easily. They may have more tantrums than before.

Being self-critical. Kids going through depression may complain a lot. They may say self-critical things like, "I can't do anything right." "I don't have any friends." "I can't do this." "It's too hard for me."

Lack of energy and effort. Depression can drain a child's energy. They might put less effort into school than before. Even doing little tasks can feel like too much effort. Kids may seem tired, give up easily, or not try.

Not enjoying things. Kids don't have as much fun with friends or enjoy playing like before. They may not feel like doing things they used to enjoy.

Sleep and eating changes. Kids may not sleep well or seem tired even if they get enough sleep. Some may not feel like eating. Others may overeat.

Aches and pains. Some children may have stomach aches or other pains. Some miss school days because of not feeling well, even though they aren't sick.

What Causes Child Depression?

Different things can lead to depression. There is no single cause. Some children have genes that make them more sensitive to depression. They may have other family members who have been depressed.

Some children go through stressful things. Some have faced loss, trauma, or hardships. Some go through serious health conditions. These things can lead to sadness or grief - and sometimes to depression.

Having extra support during and after hard times helps protect children from depression or lessen the effects. But even when they have good support, some children get depressed. Therapy can help them heal, feel better, and get back to enjoying things.

Is Your Child Depressed?

How can parents know what's typical moodiness and when there is a problem? Learn the signs of depression and ways to help your child feel better.

What Is the Therapy for Child Depression?

The therapy for child depression is cognitive behavioral therapy (CBT). Therapists help kids feel welcome and supported. They have kids talk about what they think and feel. They may use stories, play, lessons, or workbooks. These tools can help children feel at ease and get the most from CBT. When possible, a child's therapy includes their parent.

If a child has gone through a loss, trauma, or other difficult events, the therapy will include things that help a child heal from that, too. And if a parent is dealing with their own loss or depression, the child's therapist can help them get the care and support they need.

What Should I Do if I Think My Child Is Depressed?

If you think your child is depressed:

Talk with your child about sadness and depression. Kids might not know why they are so sad and why things seem so hard. Let them know you see that they're going through a hard time and that you're there to help. Listen, comfort, offer your support, and show love.

Set up a visit with your child's doctor. Let your child's doctor know if sad or bad moods seem to go on for a few weeks. By itself, this doesn't always mean a child is depressed. Tell your child's doctor if you have also noticed changes in your child's sleep, eating, energy, or effort. Tell them if your child is dealing with a loss, a big stress, or hardship.

The doctor will do a physical exam. A full exam lets the doctor check for health issues that could cause your child's symptoms. They can also check for depression. Your child's doctor may refer you to a child therapist. The doctor's office might have a child therapist on staff.

Set up a visit with a child therapist. A child therapist (mental health doctor) will spend time talking with you and your child. They will do an in-depth check for depression by asking questions and listening. The therapist can explain how therapy can help your child.

Take your child to therapy visits. The therapist may suggest a few visits, or more. Therapy can take time, but you will see progress along the way.

Be patient and kind. When your child acts moody or difficult, try to stay patient. Talk with your child's therapist about the best ways to respond when your child acts this way. Often, it helps to connect with your child in a calm way, then guide them to better behavior. Instead of feeling bad, this lets kids feel proud of doing better. It lets them see that you're proud of them, too.

Enjoy time together. Spend time with your child doing things you both can enjoy. Go for a walk, play a game, cook, read stories, make a craft, watch a funny movie. Spend time outdoors if you can. These things gently encourage positive moods. They help you and your child feel close.

Date reviewed: September 2021

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Childhood Depression: What Parents Need to Know (for Parents)

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When a sad or bad mood lasts for weeks or longer and there are other changes in a child's behavior, it might be depression. Learn the signs of depression and what parents can do to help their child.

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