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If you're a parent or caregiver, it's easy to miss the symptoms of depression in children and teenagers.

The illness can start in a way you don't even notice at first. It may come on slowly. Also, symptoms may get better and then worse over time. And depressed children of any age often don't find it easy to tell others how they're feeling.

If you're a teenager and you think you or a friend might be depressed, see Teenagers and depression.

The symptoms of depression in children are often different from those in adults.¹ Children often don't say they feel sad. Instead they may be grumpy and stop enjoying activities they used to like. Teenagers can be moody and young children often cry, but it doesn't always mean they're depressed.

These are the symptoms you might notice if your child is depressed.²

• Being sad or irritable most of the day, nearly every day. Your child might get angry at the smallest thing.
• Losing interest in all or most activities they used to find fun. Your child may not want to play with friends or join in games any more.
• Eating too little or too much. Your child might gain weight, lose weight or not put on weight as children should.
• Sleeping too little or too much. Your child might have problems getting to sleep, wake in the night or need more sleep than usual.
• Feeli ng restless or sluggish. Your child might not be able to sit still. Or your child might think, speak or move more slowly.
• Being tired and having no energy. Your child may find even the smallest task needs a lot of effort.
• Blaming themselves for things that go wrong. Feeling worthless or guilty for no reason is common.
• Not being able to concentrate or make decisions. Your child's grades at school may suddenly drop.
• Trying to harm or even kill themselves. Your child may have gloomy thoughts that can even lead to trying suicide.

Children don't need to have all of these symptoms to be depressed. But if your child has the first two symptoms and at least two others for at least two weeks, they could have major depression. Talk to your doctor. There are treatments that can help.

Symptoms of depression can differ between children (ages 5 to 11 years) and teenagers (ages 12 to 18 years).

• Children may have more physical symptoms than teenagers. They may say they have headaches and stomach pains.
• Teenagers are more likely than children to say they have a low mood.
• And teenagers are more likely to think about suicide and to blame themselves.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.