Parenting and Youth Anxiety and Depression 

Sunny Patel, MD, MPH

Senior Medical Advisor 

July 19th, 2023 
Overview 

Defining Anxiety & Depression 

Signs & Symptoms Across Developmental Stages 

How to Support Your Child 
Disclaimer: For this presentation, “parenting” is used broadly to represent those 

who may fill those roles and “families” is also meant inclusively, referring to all 

individuals with responsibility for a young person (including parents, stepparents, 

guardians, foster families, grand families, kinship families, chosen families, older 

siblings, or other caregivers). 

Purpose: Caring for every child’s mental health is an important component of 

parenting, as positive mental health is essential to a child’s healthy development. 

Confident, well-informed parents make better parenting decisions, benefiting the 

family system. Today’s presentation will include information on anxiety and 

depression in children and youth and discuss how to get help should your family 

need. 
Overview 

Defining Anxiety & Depression 

Signs & Symptoms Across Developmental Stages 

How to Support Your Child 
 

 

Anxiety

How many children experience depression or anxiety? 

Persistent sadness or 

hopelessness (4 in 10 children) 

Depression (2 in 10 children) 

Anxiety (3 in 10 children) 

Serious suicidal thoughts (2 in 10 children) 

Source: National Survey on Drug Use and Health , Youth Risk Behavior Survey , National Comorbidity Survey Adolescent Supplement (NCS-A) 
 

 

 

Defining Depression and Anxiety 

Depression 

• Occasional sadness is a 

normal part of growing 

up. 

• If children are sad, 

irritable, or no longer 

enjoy things, and this 

occurs day after day, may 

be indicative of 

depression 

Anxiety 

• Fears and worries in 

children can be common 

and developmentally 

appropriate. 

• Fearful anticipation of 

further danger or 

problems accompanied 

by an intense unpleasant 

feeling or physical 

symptoms 
 

 

 

What causes anxiety and depression in children? 

We don’t always 

know what the cause 

of big feelings are, 

and they can seem to 

come out of nowhere. 

No single test to 

diagnose anxiety and 

depression 

Risk factors: 

• Genetics or Family history 

• Traumatic experiences 

• Stressful life events 

• Temperament 

• Certain medical conditions 

• Substance use 

Gene x Environment 

Interaction 
Overview 

Defining Anxiety & Depression 

Signs & Symptoms Across Developmental Stages 

How to Support Your Child 
 

 

 

 

 

 

 

 

Typical or Not? 

It can be difficult to understand mental 

health disorders in children because 

normal childhood development is a 

process that involves change. 

Behaviors may be signs of an underlying 

mental health concern or disorder if they: 

• are intense, 

• persist over long periods of time, 

• are inappropriate for the child’s age, 

or 

• interfere with the child’s life. 

How intense and how 

persistent are these 

behaviors? 

Is this age appropriate? 

Do these behaviors 

interfere with my child’s 

life? 

Is this age 

appropriate? 

How intense and how 

persistent are these 

behaviors? 

Do these behaviors 

interfere with my 

child’s life? 
 

 

 

 

 

Signs & Symptoms of Anxiety 

General signs and symptoms of potential distress: 

– Physical Symptoms:* Headaches, stomachaches, fatigue, changes in 

appetite or sleep patterns, persistent physical complaints. 

– Emotional Symptoms: Low self-esteem, low energy, mood swings. 

– Behavioral Symptoms: School avoidance, withdrawing from friends and 

family, risky behavior. 

*Some physical disorders can cause symptoms that are similar to those of mental health conditions; 

therefore, it is important to rule-out physical health conditions for more effective, appropriate care. 
 

Common signs and symptoms of Anxiety include: 

Early Childhood 

• Frequent crying 

• Excessive 

Clinginess 

• Sleep difficulties 

• Stomach aches 

• Headaches 

• School avoidance 

• Excessive worry 

School-Age 

• Perfectionism 

• Self-doubt 

• Difficulty separating 

from parents 

• Withdrawing from 

social engagements 

• School avoidance 

• Fear of harm 

• Preoccupation with 

“what if” 

Adolescence 

• Irritability 

• Concentration 

• Avoiding situations 

• School performance 

• Sleep issues 

• Increased sensitivity 

to criticism 

• Substance use 
 

 

 

 

Signs & Symptoms of Depression 

Depression can be difficult to recognize because it can manifest 

in different ways depending on the person's age. 

– In children and youth, irritability can be a sign of depression, while 

sadness is more common in adults. 

– The biggest thing to look for in children and youth is a change in their 

typical behavior. 
 

 

 

 

 

 

 

Common signs and symptoms of depression include: 

Early Childhood 

• Changes in appetite and 

sleep patterns 

• Lack of interest in 

activities 

• Absence of joyfulness 

• Physical complaints 

• Difficulty concentrating 

• Lower energy 

• Irritability 

School-Age 

• Moodiness/Irritability 

• Acting out/Oppositionality 

• Hopelessness 

• Excessive guilt 

• Decreased energy 

• Heightened sensitivity to 

criticism 

• Feelings of worthlessness. 

• Thoughts of self harm and 

suicide (more common in 

older children) 

Adolescence 

• Irritability 

• Substance use 

• Lack of interest in personal 

grooming or appearance 

• Self-loathing 

• Social withdrawal/ 

Isolation 

• Poor school performance 

• Feelings of emptiness 

• Sleep disturbance 

• Sudden weight changes 

• Self-harm and thoughts of 

suicide 
Significant Overlap of Symptoms Between Anxiety and Depression 

• Irritability 

(tantrums, 

defiance) 

• Concentration and 

memory difficulties 

• Sleep problems 

• Excessive guilt 

and preoccupation 

with errors 

• Tiredness, low 

energy 

• Changes in 

thinking 

• Thoughts of self 

harm or suicide 

Depression

Anxiety 
Overview 

Defining Anxiety & Depression 

Signs & Symptoms Across Developmental Stages 

How to Support Your Child 
 

 

Screening for Anxiety & Depression 

NEW US Preventive Services Task Force 

(USPSTF) recommendations: 

1. Anxiety screening for children and youth ages 8-18. 

2.Depression screening for children and youth ages 12-18. 
 

 

How to Support Your Child with Anxiety 

Parents have an important and essential role in helping 

children deal with anxiety disorders. 

– Validate their feelings. 

– Help children manage their symptoms. 

– Set realistic expectations. 

– Talk through worries. 

– Model healthy ways of handling anxiety. 
 

 

 

 

 

How to Support Your Child with Depression 

Depression can cause isolation and loneliness. One of 

the most important things you can do to build trust with 

your child is to focus on their feelings. 

– Listen carefully & provide emotional support. 

– Encourage a healthy lifestyle. 

– Help your child feel connected. 

– Know that change is possible. 
Treatment Options 

- Meet with pediatrician or behavioral 

health provider 

- Education on symptoms and treatment of 

depression and anxiety in children and 

youth 

- “Talk Therapy” (psychotherapy) - Cognitive Behavioral Therapy (CBT) or Interpersonal Therapy (IPT) are first line 

choices 

- Medications 
Overview 

Defining Anxiety & Depression 

Signs & Symptoms Across Developmental Stages 

How to Support Your Child 
How to Get Help 
NEW SAMHSA RESOURCE: FindSupport.gov 

Find Health Care or Support 

www.findsupport.gov 22 

 

 

 

 

Resources for Parents & Caregivers about Children’s 

Mental Health 

ACF’s Behavioral Health Webpage includes federal 

resources for parents and caregivers, teens and young 

adults, tribes. 

https://www.acf.hhs.gov/behavioral-health 

ACF’s Office of Early Childhood Development Behavioral 

Health Webpage includes resources for parents and 

caregivers with young children. 

https://www.acf.hhs.gov/ecd/initiatives/behavioralhealth 

SAMHSA’s Resource Page for Parents and Caregivers 

includes a list of mental health resources, including the 

recording and slides from ACF-SAMHSA training for 

parents and caregivers. 

https://www.samhsa.gov/families/parent-caregiverresources 
 

 

 

Thank You 

SAMHSA’s mission is to reduce the impact of substance use 

and mental illness on America’s communities. 

www.samhsa.gov

And we encourage you to visit SAMHSA Store for mental health and substance use resources

https://store.samhsa.gov/

And 

https://www.samhsa.gov/find-help/national-helpline

And 

https://findtreatment.samhsa.gov/ 

1-877-SAMHSA-7 (1-877-726-4727) ● 1-800-487-4889 (TDD)