Depression in Children: Signs Parents Mistake for Tantrums and Laziness

Can Children Have Depression?

Yes. Depression does not occur only in adults: it is diagnosed in school-age children and teenagers and, less often, in younger children. According to WHO estimates, depression and anxiety disorders are among the most common mental health problems in adolescence. Yet in children it often goes unnoticed, because it looks different than in adults and is easily mistaken for personality, age, or poor upbringing.

In ICD-10 and DSM-5, the criteria for depression in children are broadly the same as for adults, but with an important caveat: in children and teenagers, the mood may be irritable rather than depressed. For a diagnosis, symptoms must be present for most of the day, nearly every day, for at least two weeks and interfere with schoolwork, social life, and family life. As in adults, the causes combine heredity, temperament, stress, trauma, and the child’s environment.

Signs of Depression in a Child That Are Mistaken for Tantrums

A child cannot always say “I feel sad” or “I don’t want to live.” More often they show their state through behavior, and adults see it as disobedience. In addition, children have less experience and fewer words to understand what is happening to them, and they often consider themselves “bad.” Below are signs that should raise concern, especially if there are several of them and they last for weeks.

Irritability and Outbursts of Anger

The child has started getting angry often, snapping back, crying over small things, and reacting strongly to any request. Parents say, “they’ve become impossible.” In fact, irritability is one of the main ways depression shows up in children. Punishment in this situation usually only increases alienation and makes things worse.

“Laziness” and Falling Grades

The child stops doing homework, complains that they cannot remember anything, and their grades drop sharply. This is often seen as laziness. In depression, energy, concentration, and motivation decline, and studying becomes objectively hard for the child. Reproaches do not help here; they only deepen feelings of guilt and worthlessness.

Loss of Interest in Former Activities

The child quits clubs and sports, stops playing with friends, and nothing brings joy, even things they used to love. Teenagers may lie in their room with their phone all day long. This is not simply “outgrowing a hobby” if they are giving up almost everything and feel bored and empty.

Physical Complaints

Frequent stomachaches, headaches, nausea, and fatigue, especially in the morning before school. The pediatrician finds no cause, and the child is suspected of pretending. But in children, emotional distress is often expressed precisely through the body, and such complaints should be taken seriously.

How Depression Differs From Normal Adolescence

Adolescence really does come with mood swings, a drive for independence from parents, conflicts, and heightened sensitivity to peers’ opinions. These are normal stages of growing up. An ordinary teenager may feel sad or angry, but they still have friends and interests, the ability to enjoy things and make plans, and their bad mood does not last for weeks without a break.

In depression, the changes are deeper and longer-lasting. The teenager loses interest in almost everything and pulls away from friends; sleep changes (too much or too little), as does appetite; and they begin to say things about being worthless, hopeless, or “what’s the point of it all.” Self-harm, risky behavior, and use of alcohol and other substances are also warning signs. If in doubt, it is better to see a specialist; erring on the side of caution is safer.

What Parents Should Do if They Suspect Depression

Start with a conversation, not an interrogation. Choose a calm time when you are not in a hurry and talk about what you notice without judgment: “I can see you’ve been sad lately and get tired a lot.” Listen more than you talk, do not dismiss their feelings (“that’s nothing, other people have bigger problems”), and do not rush to give advice. It is important for the child to feel that their state is being taken seriously.

If the child tells you about thoughts of death or self-harm, stay calm, thank them for trusting you, and do not let the conversation end there: a specialist consultation is needed as soon as possible. Asking directly about suicidal thoughts does not push a child toward them; on the contrary, it gives them a chance to talk about their pain. At the same time, take care of the daily routine, sleep, meals, and time together without lecturing.

• Notice changes in behavior, sleep, appetite, and schoolwork, and write them down
• Speak calmly and without judgment; listen more than you advise
• Do not punish the signs of depression: irritability, poor grades, fatigue
• Keep a daily routine, walks together, and simple family rituals
• Restrict access to medications and dangerous objects if there are warning signs
• See a child psychiatrist or psychotherapist without waiting for it to pass on its own
• Talk to the teacher or school psychologist to reduce the workload

How Depression Is Treated in Children and Teenagers

Treatment begins with a thorough assessment by a child psychiatrist or psychotherapist: a conversation with the child and parents, information from school, and ruling out physical causes such as thyroid problems or anemia. For mild depression, psychotherapy, family support, and adjusting the workload are often enough. International guidelines, including NICE, name cognitive behavioral therapy, interpersonal therapy, and family therapy as the main methods.

For moderate and severe depression, if psychotherapy does not help, a child psychiatrist may consider medication. In children and teenagers, only certain medications from the antidepressant group are used, under close monitoring, especially in the first weeks. The decision is made together with the parents, and starting or stopping medication on your own is unacceptable. At Psychiatry Online, parents can get an online consultation with a psychiatrist to assess the situation and understand what kind of help their child needs.

How to Support Your Child During Treatment

Recovery from depression is gradual, with good days and bad days. It is important for the child to feel accepted on bad days too, and valued not only for grades and achievements. Praise effort, not just results; help them return to enjoyable activities in small steps; and do not demand immediate change. Doing things together, such as walks, cooking, or games, often brings you closer than conversations do.

Parents need support too. A child’s depression brings anxiety, guilt, and confusion. It is important not to blame yourself but to act: take part in family sessions with the psychotherapist, learn about the illness, and look after your own wellbeing. In Kazakhstan, there is the 150 helpline for children and young people, which both the child and the parent can call for advice.

When to see a doctor

• For more than two weeks, the child has been sad, irritable, or indifferent to everything
• They have stopped seeing friends, given up hobbies, and spend whole days lying in their room
• Their grades have dropped sharply, and they refuse to go to school for no clear reason
• They often complain of stomachaches and headaches, and the pediatrician finds no cause
• Their sleep and appetite have changed noticeably, and they are constantly tired and sluggish
• The child talks about being unwanted, hopeless, or not wanting to live
• You have noticed signs of self-harm or use of alcohol and other substances

Questions and answers

Reviewed by

Pavel Kornilov, MDPsychiatrist

Depression, anxiety disorders, OCD, bipolar disorder; online medication selection and adjustment.