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Depression (PDQ®)

Depression in Children

Most children cope well with cancer. A small number of children may have:

  • Depression.
  • Anxiety.
  • Trouble sleeping.
  • Problems getting along with family or friends.
  • Problems staying on treatment.

These problems can affect the child's cancer treatment and enjoyment of life. Children with severe late effects from cancer treatment may be more likely to have symptoms of depression. A mental health specialist can help children with depression.

Assessment for depression includes looking at the child's symptoms, behavior, and health history.

As in adults, normal sadness in children is not depression. Depression lasts longer and has specific symptoms. The doctor may assess the child for depression if a behavior problem goes on for a long time. To assess for depression, the doctor will need the following information about the child:

  • Home life with family.
  • How the child faces illness and treatment.
  • Age and stage of development.
  • Past illnesses and how the child responded to them.
  • Sense of self-worth.
  • Behavior, as seen by the parents, teachers, or others.

The doctor will talk with the child and may use a set of questions or a checklist that helps to diagnose depression in children.

A diagnosis of depression depends on the symptoms and how long they have lasted.

Children who are depressed have an unhappy mood and at least 4 of the following symptoms every day for 2 weeks or longer:

  • Appetite changes.
  • Not sleeping or sleeping too much.
  • Being unable to relax and be still (such as pacing, fidgeting, and pulling at clothing).
  • Frequent crying.
  • Loss of interest or pleasure in usual activities.
  • Lack of emotion in children younger than 6 years.
  • Feeling very tired or having little energy.
  • Feelings of worthlessness, blame, or guilt.
  • Unable to think or pay attention and frequent daydreaming.
  • Refusing to go to school.
  • Trouble learning and getting along with others.
  • Aggressive behavior.
  • Anger towards self, parents, and teachers.
  • Frequent thoughts of death or suicide.

Treatment may be therapy or medicine.

Talk therapy is the main treatment for depression in children.

Individual and group talk therapy are the main treatments for depression in children. This may include play therapy for younger children. Therapy will help the child cope with feelings of depression and also understand the cancer and its treatment.

Medicines for depression may be used with care.

The doctor may prescribe antidepressants for children with severe depression and anxiety. Children taking antidepressants must be watched closely. SSRIs (selective serotonin reuptake inhibitors) are a type of antidepressant that usually have few side effects. However, in some children, teenagers, and young adults, SSRIs make depression worse or cause thoughts of suicide. The Food and Drug Administration has warned that patients younger than age 25 who are taking SSRIs should be watched closely for signs that the depression is getting worse and for suicidal thinking or behavior. This is especially important during the first 4 to 8 weeks of treatment.

See the section on Depression and Suicide in the PDQ summary on Pediatric Supportive Care for more information.

  • Updated: December 3, 2014