Depression and Anxiety Disorder in Children and Adolescents
Authors: Mary Margaret Gleason, Lindsay A. Thompson
Journal: JAMA Pediatrics (2022)

Depression and Anxiety Disorder in Children and AdolescentsDepression and anxiety are common in children and indicate a problem with mood or anxiety processing.Everyone has moods and fears.Some people have intense moods or feelings that interfere with their lives in their family, with peers, at school, and in play.Importantly, both depression and anxiety disorders can be treated.Depression is mostly a problem of moods.Sadness or irritability are the core symptoms, and thinking, sleeping, eating, and energy are also affected.Anxiety disorders are difficulties with worries or fears that make it hard for a child to participate in their day-to-day life.Extreme fears can focus on specific types of situations, such as social situations or being away from parents, or can be generalized about almost anything.Anxiety can also include panic attacks with rapid heartbeat or trouble breathing.Depression and anxiety can cause difficulties with sleeping, thinking, or managing frustration.It is common for anxiety or depression to first be noticed with disruptive behaviors such as trouble with rules, talking back, or tantrums.Depression and anxiety disorders can develop in children at any age, from preschool through adolescence.A combination of life experiences, inherited genes, and other factors influence who develops anxiety or depression and when.While depression and anxiety are more likely to develop in stressful situations or run in families, both can develop any time and in anyone.During the COVID-19 pandemic, rates of anxiety and depression have doubled, with depression rising to 1 in 4 children and youth and problematic anxiety to 1 in 5. Importantly, rates are rising during the pandemic.Suicidal symptoms can develop with depression and, less commonly, with anxiety disorders.In 2019, almost 25% of girls and more than 10% of boys seriously considered suicide.Symptoms are especially common among lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ+) youth and Black youth.If you are worried your child is thinking about self-harm, contact a health care professional immediately.Parents, teachers, and pediatric primary care clinicians can monitor for signs of depression and anxiety including school difficulties, changes in sleep or eating, getting along with friends or family, withdrawing from activities, and using screening questionnaires for depression or anxiety in health care visits.Depression and anxiety are treatable with therapy that teaches specific skills, medications, or both.Specific treatment plans de-pend on age, severity of symptoms, ability to access therapy, and family preferences.Families can take care of your own mental health, talk about feelings starting at an early age; teach and model healthy coping strategies; keep your child safe from weapons, abuse, and preventable incidents; and talk to your child's health care professional.Some family and community health strategies to prevent depressionandanxietyincludeparentsaccessingtheirownmentalhealthcare; teaching families skills for effective communication and managing feelings;introducinganti-bullyingandantidiscriminationactivities;supporting families to access basic needs like food and safe housing; and preventing exposure to extreme stresses like abuse and disasters.