This blog was originally posted in 2020. Some information may be out of date. For the latest updates on vaccines, testing, screening, visitor policy and post-COVID support, visit EEHealth.org/coronavirus.

The COVID-19 pandemic is taking a mental health toll on many of us, including children — from adolescents to preschool age.

Before the pandemic, roughly 3% of children aged 3-17 years experienced depression. Now, social distancing, cancelled activities, and other coronavirus stressors are triggering depression in children who hadn’t shown any signs of it previously.

This environment is unnatural for children, and the social and emotional isolation can make any of us more vulnerable to depression. Depressed children have a higher risk of suicide — a leading cause of death for children aged 10 to 17.

Depression can be easy to miss. It doesn’t look the same in children as it does in adults. A depressed child may have physical symptoms like aches and pains or fatigue. They may have difficulty concentrating. They may be argumentative, irritable or angry.

Some depressed children keep their feelings hidden and don’t even seem sad. Younger children may not even understand their own sadness so they can’t express it.

How can you tell if your child is slipping into depression, or just having normal feelings and mood swings that come with growing up?

Being able to identify the early symptoms of depression can help prevent severe depressive illness from setting in. Look for these signs of depression in children:

• Any changes in eating or sleeping habits
• Isolating, emotional or social withdrawal
• Unusual irritability, moodiness
• Sadness, hopelessness, low energy
• Lack of interest in usual activities
• Acting out behaviors, anger, rage, agitation
• Neglecting their personal appearance
• Lack of response to praise
• Harsh self-assessment like “I’m no good”
• Alcohol and drug use, other risky activities
• Statements of “I am a burden”
• Questioning the purpose of their life

Depression is more than just feeling sad or having bad days. An important red flag is persistence and severity of depression symptoms. If several of these symptoms last for at least two weeks and don’t improve, let your child’s doctor know.

In children, depression and anxiety often go together. Signs of anxiety in children may include:

• Constant worrying, negative thoughts
• Feelings of apprehension or dread
• Feeling tense, jumpy, restless, irritable
• Sweating, dizziness, tremors
• Pounding or racing heart, shortness of breath
• Headaches, fatigue and insomnia
• Difficulty concentrating
• Clinginess
• Upset stomach, frequent urination or diarrhea

You know your child better than anyone else. If anything seems off, seek help. Depression is serious but it’s treatable — and it won’t go away on its own so you’ll need to seek help.

Your child’s doctor can help refer you to a mental health professional. Treatment for depression may include individual or group talk therapy/counseling, play therapy, support programs, medications or a combination of these approaches.

Some steps parents can take to guard against depression include:

1. Frequently check in with your child to see how he/she is feeling.
2. Acknowledge the reality of the pandemic but reassure your child that it’s temporary and won’t go on forever.
3. Help your child stay active and engaged in activities (e.g., practicing mindfulness)
4. If your child needs to quarantine, encourage social connection, such as a FaceTime or Zoom calls with friends.
5. Make goals or plans for the future, such as a new skill they can learn or future activity.
6. Help your child understand that they aren’t alone and that life will get better.
7. Encourage your child to list and reflect each day on things they are grateful for.
8. Emphasize that you are there for them. Listen without judgment or trying to “fix” them.
9. Be a good role model and take care of your own mental well-being (e.g., practice self-care).
10. Treat any talk of self-harm or suicide seriously. Call 911 or go to the emergency room if your child cannot be kept safe in the home.

When a child is struggling, connection and communication is crucial. Don’t be afraid to talk to your child about sadness. They need to know that they’re not alone. Talking about it can help validate their feelings and teach them how to recognize and express them in healthy ways.

If you’re concerned about your child, his/her primary care physician can help you with next steps and/or refer you to a behavioral health therapist.

Both in-person and virtual counseling is available, and can help teens struggling with depression, particularly during a crisis like the COVID-19 pandemic. Get support from Linden Oaks Behavioral Health or call the 24-hour Help Line at 630-305-5027.