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Childhood depression: recognising the signs and supporting your child

Sultan AlmuhasinMedical review: Tatmeen team11 min read
طفل يجلس على سرير قرب نافذة ممطرة، وعلى الجدار المضاء ظلان لشخص بالغ وطفل يمد يده نحوه.
Article contents
  1. What can depression look like in a child?
  2. When does a change need assessment?
  3. How can you start the conversation?
  4. What if your child talks about death or self-harm?
  5. Who can you turn to, and what happens during assessment?
  6. Is something at home causing it?
  7. How can you help at home while arranging care?
  8. How is depression in children treated?
  9. Frequently Asked Questions
  10. Sources and references
  11. Writer and reviewer

You may first notice something small. Your child no longer wants to play with friends they used to look forward to seeing, or they seem irritable and tired much of the time. You may feel torn between worrying about them and wondering whether you are reading too much into the change. You do not need to be certain of a diagnosis before asking for help. Start with what you notice and listen to what your child says.

In Saudi Arabia, call an ambulance on 997 if your child is at risk of harming themselves or others now. Stay close1 if it is safe to do so. Seek emergency help2 if they have an intention or plan to end their life5, or if you cannot keep them or others safe.

What can depression look like in a child?

Depression does not always look like crying. A child may seem sad, easily upset or angry, or unable to enjoy things they used to love. Notice changes from what is usual for your child, especially when they keep happening and affect daily life:

  • They withdraw from play or friends, or lose interest in activities they used to look forward to.
  • They sleep or eat more or less than usual, have less energy or find it difficult to concentrate.
  • Their participation at school or their homework is affected, and familiar tasks seem harder to manage.
  • They often blame themselves, or talk about feeling worthless or hopeless.

Your child may also complain of headaches or stomach aches3. Take these complaints seriously; do not assume the pain is psychological without a medical assessment. A child who withdraws or loses motivation may be misunderstood as lazy or disruptive4.

These signs alone are not enough to diagnose depression. Some may be related to anxiety, stress or another health problem, and a child can have more than one difficulty at the same time.

When does a change need assessment?

Sadness after something upsetting does not, by itself, mean depression. Ask yourself: How long has my child seemed different? Is this happening most days? How has it affected their relationships, sleep, school and life at home?

Arrange an assessment if the changes last for weeks5, cause clear distress or interfere with daily life. If your child is deteriorating quickly, or is eating or drinking so little that their health is being affected, seek urgent medical assessment6 without delay. An understandable reason for sadness does not remove the need for help when its impact becomes substantial.

How can you start the conversation?

Choose a quiet time and somewhere your child can talk without other people overhearing. Begin with what you have noticed, without giving it a diagnosis: "I've noticed you don't seem to enjoy playing as much as before. Would you like to tell me about your day?" Then give them time to answer.

They may say "I don't know", or express their feelings through anger. You could say: "You don't have to know why right now. I'd like to understand what's making your days difficult." Listen to what they say without rushing to correct them or compare them with someone else. "I'm here with you, and we'll get help if we need it" leaves more room for a conversation than "You've got nothing to be upset about."

If your child does not want to talk, let them know you are available7 and ask whether they would prefer to speak with a safe adult they trust or a professional. You can seek an assessment even if they have not told you everything. Choose words that fit your child's age and understanding17.

What if your child talks about death or self-harm?

Take what they say seriously, even if they say it in anger or it sounds like a passing remark. Ask calmly, using words they understand: "Have you thought about hurting yourself?" and "Have you thought about ending your life?" Asking directly about suicide8 does not increase suicidal thoughts. It helps open a conversation and gives you a way to seek support.

If your child says they want to die or has thoughts of harming themselves or others, stay with them if it is safe, or ask a safe adult to stay with them. Contact their doctor or a mental health professional immediately for a safety assessment. If you cannot obtain this assessment promptly, take them to an emergency department for urgent medical assessment if you can transport them safely, or call 997 if safe transport is not possible5. Do not rely on a promise9 that they will not do anything as a substitute for assessment15.

If there is a current danger to your child or others, an intention or plan to end their life, or you cannot keep them or others safe, call 997 or take them to an emergency department if you can transport them safely. Do not wait for a suicide attempt1 to happen.

If a suicide attempt, overdose or serious self-inflicted injury happened recently and your child has not had a medical assessment of the event, call 997 or take them to an emergency department if you can transport them safely. If you suspect a harmful dose of medicine11 or exposure to a harmful substance, call an ambulance10 without waiting for symptoms or confirmation of intent, even if it appears accidental. If the event has already been medically assessed, follow the care and safety plan16 with the professional; current danger or a new or continuing urgent medical need still requires emergency help.

While you seek help, secure medicines and items1 your child could use to hurt themselves if you can do so safely. Do not get into a confrontation that puts anyone in danger. After assessment, ask for a clear safety plan7: who your child can contact, who will stay close by, and what to do if the thoughts return or become more intense.

Who can you turn to, and what happens during assessment?

You can start with a paediatrician or family doctor, who can assess your child's health, consider possible explanations and arrange a referral to a professional experienced in children's mental health when needed. In Saudi Arabia, the Ministry of Health provides medical consultations around the clock through 937. You can ask about the appropriate next step in accessing care. Immediate danger needs an ambulance or emergency department.

If your child has not started school yet, discuss any concerning change in their communication, play or development with a paediatrician. Assessment needs to take their stage of development into account.

Prepare brief notes about when the changes began, your child's sleep, eating, school and relationships, any difficult events and any medicines they take. If your child has said anything about harming themselves, tell the professional clearly what they said. A teacher's observations about concentration or withdrawal may help, without sharing details with people who do not need them.

Assessment includes talking with you and your child and understanding their medical and developmental history5 and circumstances. An adolescent may be offered part of the appointment on their own. Ask the professional how they will protect your teenager's privacy while sharing with you the information needed for their safety. Any questionnaire used is one part of assessment6, not a diagnosis on its own.

Is something at home causing it?

There is no single cause that explains depression in every child. Individual vulnerability, family and health factors3, and stresses such as loss, bullying or abuse may interact. Having a risk factor does not mean a child will develop depression, and it cannot establish the cause of one child's distress. Symptoms do not prove that a parent has failed. The priority is to understand what your child needs and what can change to support them.

If a conversation reveals bullying or abuse, addressing that danger is part of helping. Do not return your child to the care of someone who is harming them or ask them to confront that person. To report violence against a child within or outside the family in Saudi Arabia, you can call 1919 at any time of day or night18. If there is an immediate security threat, call the police on 99919.

How can you help at home while arranging care?

Offer support in steps your child can manage. As far as possible, keep regular sleep and meal times, and offer a simple activity they can choose, such as a short walk together or time to play. Your child may not enjoy an activity as much as they used to. Stay close without expecting them to look happy.

Break difficult tasks into smaller steps. You might start with part of a homework task instead of getting into a dispute over finishing all of it. If the difficulties are affecting attendance or schoolwork, coordinate with the school and the treating professional, involving your child in a way that fits their age.

You could begin a conversation with the teacher by saying: "We've noticed they get tired quickly and find it hard to start homework. We're arranging an assessment. It would help to understand what you're noticing in class and what could be adjusted for now." Agree on a person who will check in with your child and the specific information you will share. Their classmates and the whole school staff do not need to know their personal details.

Ask your child what felt easier or harder, and share important changes with their treating professional6 at follow-up. These steps support professional care12; they do not replace treatment.

How is depression in children treated?

Treatments can help, and the choice depends on your child's age6, development, level of distress and needs. Psychological therapy may help them learn ways to handle thoughts, feelings and everyday difficulties, with family involvement as needed. Ask the therapist how the approach fits your child's age, what your role will be between sessions and how you will review progress together.

Whether medicine has a role should be discussed with a child and adolescent psychiatrist6 after assessment, weighing the benefits and risks for your child's age and circumstances. The evidence for medication in younger children13 is more limited, so medicine recommendations for adolescents cannot simply be applied to them.

If an antidepressant is prescribed, agree with the doctor on follow-up and when to contact them. Some children and adolescents may experience new or increased suicidal thoughts14, particularly when treatment starts or the dose changes. Watch for any deterioration or concerning change and contact the doctor immediately. Seek emergency help if there is immediate danger. Do not change the dose or stop the medicine on your own.

Before the appointment ends, make sure you know the next step, when follow-up will happen and who to contact if things get worse. Ask too: What changes should we watch for in sleep, play and school? When should we review the plan if it is not helping? This keeps your child's everyday life part of the conversation, alongside their symptoms. You can stay close to your child without having to diagnose or treat them yourself.

Frequently Asked Questions

What are the signs of depression in a child?

Depression does not always look like crying. A child may seem sad, easily upset or angry, or unable to enjoy things they used to love. They may withdraw from play or friends, sleep or eat more or less than usual, have less energy, struggle at school or often blame themselves. They may also complain of headaches or stomach aches. These signs alone are not enough to diagnose depression, so notice changes from what is usual for your child.

When should my child be assessed for depression?

Arrange an assessment if the changes last for weeks, cause clear distress or interfere with daily life. An understandable reason for sadness does not remove the need for help when its impact becomes substantial. If your child is deteriorating quickly, or is eating or drinking so little that their health is being affected, seek urgent medical assessment without delay. You can start with a paediatrician or family doctor.

Does asking my child about suicide make suicidal thoughts more likely?

No. Asking directly about suicide does not increase suicidal thoughts; it helps you open a conversation and seek support. Take what they say seriously, and ask calmly: "Have you thought about hurting yourself?" and "Have you thought about ending your life?"

If there is a current danger to your child or others, an intention or plan to end their life, or you cannot keep them or others safe, call 997 or take them to an emergency department if you can transport them safely. Do not wait for a suicide attempt to happen. Stay close if it is safe. While you seek help, secure medicines and items your child could use to hurt themselves if you can do so safely, and avoid a confrontation that puts anyone in danger.

Is my child's depression my fault?

There is no single cause that explains depression in every child. Individual vulnerability, family and health factors, and stresses such as loss, bullying or abuse may interact. Having a risk factor does not mean a child will develop depression, and symptoms do not prove that a parent has failed. The priority is to understand what your child needs and what can change to support them.

How is depression in children treated?

The choice of treatment depends on your child's age, development, level of distress and needs. Psychological therapy may help them handle thoughts and feelings, with family involvement as needed. Whether medicine has a role should be discussed with a child and adolescent psychiatrist after assessment. If an antidepressant is prescribed, agree with the doctor on follow-up and when to contact them. Watch for any deterioration, concerning change, or new or increased suicidal thoughts, particularly when treatment starts or the dose changes, and contact the doctor immediately. Seek emergency help if there is immediate danger, and do not change the dose or stop the medicine on your own.

Writing and article review

Sultan AlmuhasinWritten bySultan Almuhasin

Content writer and researcher at Tatmeen, working on Arabic and English articles across mental health and everyday life topics, including relationships, stress, work, habits, and family.

Tatmeen teamMedical reviewTatmeen team

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