Signs of Depression in Children During COVID-19

Sad tween girl in quarantine, looking out her bedroom window

 Justin Paget / Getty Images

Many parents worry about the toll that isolating at home during the COVID-19 pandemic is having on their children. Sadly, the truth is that while staying home, social distancing, masking, canceling activities, and limiting in-person school is vital to saving lives and stopping the spread of COVID-19, these changes to daily life are also profoundly emotionally challenging for many kids (and adults).

What to Know

While we are absolutely physically safer when following pandemic safety precautions, living in crisis and in quarantine is understandably hard to cope with. For this reason, researchers, doctors, and parents are concerned about the impact living in quarantine is having on kids' sense of well-being, as well as the increased risk this poses for childhood depression, now and later in life.

A number of studies done during the first year of the pandemic have confirmed that an unfortunate, natural byproduct of living in quarantine for many kids is feeling scared, lonely, anxious, clingy, depressed, and even suicidal.

Below, we examine the signs of childhood depression, how the condition may present differently during the pandemic, and how to help your child cope and/or prevent depression (and other mental health conditions) from taking hold.

Communal Causes

The coronavirus pandemic has claimed hundreds of thousands of lives in the United States alone, as well as sickening millions more. Moreover, it's disrupted all of our day-to-day lives, shuttering schools and businesses and devastating many swaths of the economy.

What gets less attention is the profound impact this worldwide crisis is having on the mental health of children, particularly by causing a surge in childhood depression. However, many doctors, researchers, educators, parents, and government officials are now urging a greater focus on the well-being of children, particularly around deciding when and if to reopen schools.

Weighing the relative risks of opening schools is complicated, but many child health experts and researchers advocate for a return to classrooms (as much as possible) to provide much-needed structure, normalcy, support, and hope to our country's youth—as well as to preserve academic learning.

As they study the signs of depression in children isolated at home, researchers have found that prolonged quarantining poses mental health risks for children—and that this impact may be felt after as few as 10 days. In China, studies have shown that upwards of 35% of kids in quarantine show signs of negative mental health consequences.

Childhood depression was already on the rise before this global crisis, with as many as 8% to 10% of teens and 3% of children affected, according to the American Academy of Pediatrics (AAP). Researchers believe that not only are these rates increasing now, but that living through this experience is likely to increase the prevalence of depression later in life.

Studies show that experiencing trauma during childhood is a key predictor of developing mental illness in adulthood. The AAP also notes that around 75% of adolescents with depression are misdiagnosed, which underscores the urgency for parents to understand and watch for the signs of this condition.

Signs and Symptoms of Childhood Depression

Depression often asserts itself differently in young children and adolescents than it does in adults. Yes, the tell-tale depressed or sad mood, lack of energy and enthusiasm for activities and life in general, dysphoria (emotional discomfort), and fatigue may be present, but children may also experience this condition in unique, and often, hidden ways that lead to under-diagnosis.

Children, and especially teens, may keep their feelings to themselves, further complicating diagnosis and appropriate treatment. Note that depression (and other related and comorbid mental health conditions like anxiety) often looks different in different kids as well, with each one having their own, individualized set of signs and symptoms, which may also change over time.

Signs and symptoms of depression in children may include:

  • Anger and/or aggression
  • Apathy for or refusal to participate in school, often accompanied by a decline in performance
  • Behavioral changes
  • Complaining of stomach pain, headache, or general malaise
  • Decrease in physical activity
  • Decrease or increase in appetite, which may be accompanied by weight gain or loss
  • Defiance or hostility, which studies show may be a child's way of expressing worry or distress
  • Difficulty with concentration and/or executive function
  • Difficulty with sleep, including trouble falling and staying asleep, sleeping too much, and/or not sleeping enough
  • Feeling burned out
  • Feeling sad or hopeless
  • Feelings of grief
  • Feelings of guilt
  • Indecisiveness
  • Low self-esteem and/or self-doubt
  • Reduced interest in activities or hobbies they used to enjoy
  • Running away from home or threatening or planning to do so
  • Social withdrawal from friends and/or family
  • Suicidal ideation, talking about death or dying, self-harm, and/or giving away possessions

If your child is having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

Again, children with depression are unlikely to exhibit all of the possible signs or symptoms in the above list—and may also present in their own way. So, be on the lookout for any subtle changes unique to your child that may indicate they are struggling.

Also, be extra aware of your child's mental health if they have experienced a loss due to the pandemic, as the death (or prolonged illness) of a loved one or acquaintance puts them at increased risk of depression. Likewise, pay close attention if your family is experiencing other forms of trauma, such as food insecurity, job loss, relocation, or divorce.

Children with special needs, pre-existing mental health conditions, those living in historically underserved communities, those that are economically underprivileged, or those being quarantined due to infection or fear of infection are more likely to become depressed.

Exacerbating Factors

One difficulty of detecting depression in children during quarantine is that simply experiencing the pandemic puts people in situations that mimic, encourage, or facilitate the signs or symptoms of depression, such as being out of school, social isolation, feeling stigma for getting sick, and withdrawal from activities. Plus, the devastating effects of the crisis put everyone in a continuously stressful situation.

Many kids have had their lives uprooted, their social lives severely restricted, and their physical activity decreased. Some children are coping with the illness or loss of a loved one and/or the fear of getting sick. Their parents may be out of work and/or they may be at risk of being evicted. And due to health orders, most kids are under some form of social isolation and miss seeing friends.

It makes sense that many kids, to varying degrees, are suffering, lonely, and feeling depressed—the challenge is teasing out unhealthy from healthy coping, but even this is difficult. It may be tempting or comforting to assume that since the root or exacerbating cause of many children's depression is the pandemic that that means there's nothing to worry about, but sadly, that's not the case.

On the one hand, many people can relate to and understand the causes of depression during the pandemic, and in some ways, the mental health impacts of the pandemic are communally shared. But that doesn't mean that those who are actually depressed don't need help to feel better—and it's unlikely that the condition will simply go away even when the disaster does.

What the Research Says

It's important to recognize that while society at large is experiencing trauma due to the pandemic, we still need to intervene with the kids that are struggling more than normal. Plus, we may need to come to grips with the fact that a large percentage of kids may need support—and while it's normal to struggle under these conditions, it doesn't mean we don't need to intervene.

Researchers, by and large, are alarmed by the increased rates of mental health effects kids are experiencing during the pandemic. In fact, study after study has found widespread emotional distress among children, teens, and adults.

According to a 2020 comprehensive review, "High rates of anxiety, depression, and post-traumatic symptoms were identified among children."

Studies have found that older children and teens, as well as girls, are showing more signs of depression during quarantine than younger kids and boys.

Scientists worry that the full scope of the trauma is not limited to the depression and other mental health disorders present now, but that the aftermath of the experience of living in a pandemic may cause susceptibility to these psychiatric conditions in the future.

Prevention and Coping

With so many kids at risk of depression (and other mental health conditions) due to witnessing widespread COVID-19 outbreaks and living under pandemic restrictions, it's important for parents and caregivers to do what they can to prevent its development in their children.

Acknowledge Feelings of Loss

Kids have missed out on a lot due to the pandemic. For many kids, just about every part of their lives has been restricted, from seeing friends and playing sports to going to school or taking a trip to the park. So many special events have been canceled, too, including proms, sports tournaments, graduations, birthday parties, family reunions, vacations, holiday gatherings, and even just simple outings with grandparents.

It might seem counterintuitive, but talking about grief for loved ones lost (or just the sheer numbers of people dying) and about what they've missed out on—including coming up with modified replacements and/or dreaming about what they'll be able to do in the future—can help your child process and feel better about what they've lost. Simply sharing their sadness allows them to feel seen, valued, and less alone.

Nurture Resiliency and Calm

Most kids are, by nature, resilient, adaptable, and stronger than we imagine. However, we need to nurture their coping skills to boost these traits, especially during times of crisis, as there is only so much each kid can take.

Brainstorm with your child what helps them relieve stress and feel calmer, and share what strategies help you. Coping includes both dealing with difficult emotions as well as distraction. Ideas for distraction may include:

  • Physical activity
  • Playing board games
  • Watching TV or movies
  • Social media
  • Reading books
  • Cooking
  • Art projects
  • Playing with a pet
  • Talking with friends

In fact, studies show that media use is very helpful for kids in distress. Dealing with feelings head-on is often accomplished by talking things through, but also may include making goals, to-do lists, schedules, and future plans.

Stick to Routines

It's well established that most kids do best when given structure, boundaries, and rules. While it's challenging to keep these routines and the feeling of a normal daily schedule when under quarantine, it can be beneficial to do so.

So, even if your child is doing virtual school, have them get up, eat breakfast, get dressed, and sit at a desk for class. Have set times for meals, physical activity, and recreation.

Additionally, stick to bedtimes, set limits on screen time, and continue to have your child do the activities, chores, and social plans that they used to do—you just may need to accommodate them to a life centered at home.

That said, you'll also want to be flexible and adjust your routine to what works best for your child. Aim for each day to follow a rhythm that cues transitions throughout the day.

According to researchers of a 2020 systematic review of pandemic studies on children, "Routines, social interactions, and friendships are among the most important factors responsible for children’s normal psychological development."

Get Them Out of Their Rooms

While it's important for kids to have their privacy and time to themselves, especially as they enter adolescence, it's not healthy for your child to spend all their time in their bedroom. Ideally, have them come out of their rooms to do school, play games, watch movies, and eat meals together. Go on family outings, when possible (while adhering to social distancing and other safety rules), to get them outside, too.

If your child is wedded to their room, consider stopping by frequently to check on them and/or bring the game, TV show, or snack to them and hang out together in their room. Essentially, make sure they feel noticed and that their needs are being cared for. Let them know you want to spend time with them and that life during the pandemic, while limited, can also be about family connectedness and fun.

Find Compromise

Only you can decide what feels right for your family in terms of the stringency with which you follow recommended guidelines on coronavirus protective measures. While it's essential to follow all the required protocols in your area, you'll also want to find compromises and solutions that address your child's social and emotional needs where you can. For example:

  • If your child misses sports, what modifications can be made for them to safely participate?
  • If your child is craving get-togethers with friends, find a safe way to do so.
  • If independent learning isn't working, can they do school in a pod?
  • Is there a friend of your child's that can be included in your family's bubble?
  • Can your child meet up with friends outside with masks on?
  • Can you be more flexible on screen time?

Aim to strike a balance of limiting possible coronavirus exposure (keeping in mind your family members' personal health risks and jobs) with providing enough interpersonal and outside-of-the-home interactions to protect your child's mental health. Sometimes, just seeing a friend for a walk around the block—or on a Zoom call—may work wonders for your child's spirits.

Prioritize Grace Over Grades

Over 90% of students worldwide have been impacted by pandemic-related school closures. Unfortunately, few kids are thriving academically or emotionally with this change. It may help to share this information with your kids, so they know that they aren't alone in struggling with distance learning. Maybe shift their perspective to making the most of what school can offer now, rather than what it can't.

Are the demands of online school and independent learning not working for your child? Talk to their teachers and school administrators about solutions and any supports that may be available. Advocate for your child and prioritize their well-being, learning, stress reduction, and participation over grades.

A Rand Corporation study found that one in five students aren't even going to class—and that 80% of teachers report burnout, too. So, being overwhelmed and underperforming is all too common.

Provide whatever help you can to your child, but also give them—and yourself—a break, something many teachers agree with as around 40% have opted against giving letter grades during the pandemic.

If the demands of school are too much, find out which assignments to prioritize and what they can skip. Honor what your child needs in order to learn and trust our instincts about how much is too much and what is best for your child.

Media Entertainment

Parents rightly worry about letting their kids go hog wild on streaming videos and gaming. But while it's important to keep an eye on screen time and not let your child go overboard, it's also key to give them social and entertainment outlets. In fact, studies show that media entertainment is an effective antidote to boredom, irritability, loneliness, hopelessness, and other signs of depression.

Get Them Moving (and Sleeping)

Another key component to healthy mental health for kids is getting enough exercise, fresh air, and sleep. Following a healthy diet is key, too.

Day after day of being stuck at home can wear on even the most mentally tough child, so aim to get them moving and get them outside as much as you can. Usually, the more physically active they are, the better sleep they will get.

Studies have found that more regular physical exercise is associated with less incidence of depression and anxiety. Unfortunately, researchers are observing a stark decrease in the physical activity kids are getting, with one study documenting that the percentage of kids exercising an average of an hour or more daily has dropped from over 50% to under 15% during the pandemic.

Options for outings and physical activity are limited now that many kid-friendly activities, parks, and businesses are closed or have limited hours. Additionally, many kids are doing school remotely, so they may rarely even leave the house. Remedy this situation by getting your kids to run, bike, or scooter around the block, go on neighborhood walks, and/or go to local parks at off hours to safely play.

Spend Quality Time Together

Keep your child engaged and excited about their day-to-day family life by making a point to spend quality time with them. Some ideas to inspire you:

  • Talk to them about their favorite topics
  • Teach them to cook their favorite foods
  • Start a family book club
  • Create new family traditions (like charades night, evening stargazing, games of inside tag, weekly taco night)
  • Switch off selecting TV shows or a series of films to watch together

While you're together, make a point to really talk to them. Ask questions about what's on their mind, how they're feeling and coping, if they've talked to any of their friends, what they miss about the "before times," and what they look forward to doing after the pandemic is over. Sharing your own feelings and modeling positive coping measures can help your child feel comfortable sharing, as well.

Limit News to Age-Appropriate Information

It's important for kids to understand what it means that we are living in a pandemic and how to avoid getting sick, but you also don't want to overload your child with scary, doomsday information, particularly if they are very young.

Uncertainty about the pandemic, the family's livelihood, and the future can be understandably jarring to a kid's sense of well-being.

Hearing daily death and infection counts is hard for adults to handle, let alone kids who may then feel scared that they or their loved ones will get sick.

Aim to keep information factual but as neutral as possible. Look for age-appropriate ways to explain what is happening—ask their teachers if you need help on this front. Monitor your kids' internet usage to be sure they're not obsessively reading about the pandemic as what starts out as keeping informed can quickly turn into an unhealthy fixation.

Note that researchers have found that fear of asking about the pandemic can also cause distress in children. So, be sure to let kids know what's going on, but highlight the positives as well, such as the good news that effective vaccines are now available.

Get Them Help

If your child is struggling and/or showing signs or symptoms of depression (or any other mental health condition) get them help as soon as possible—early intervention can reduce the severity of the condition.

There are lots of resources out there, including your child's pediatrician, teachers, school principal, school psychologist, and counselors. Talking with family members and friends can help, too.

Look for mental health services that will help our child develop healthy coping mechanisms during the current crisis.

Additionally, public health experts, school administrators, doctors, researchers, and government leaders are increasingly warning about spikes in child suicidal ideation and suicide attempts, often with parents not realizing how much their child had been suffering. So, treat seriously any talk or actions of self-harm, which is often an impulsive act in a moment of despair.

Let your child know that their health and safety (including mental health) is your number one concern. And most importantly, that they are not alone. Remind them that the whole world is struggling through this crisis together, but that you are there to support and love them, always.

A Word From Verywell

With so much out of our control and so many unknowns about the mental health cost of living in a pandemic, it's hard to fathom how to best protect your child from becoming depressed. However, often, the best thing you can do is to simply be present and attuned to your child's needs and moods, as even just paying closer attention can help.

That said, just like any mental health condition, you can't fully inoculate your child from becoming depressed—and it's no one's fault if they do develop the condition. Instead of either of you feeling guilty, focus on providing kind, compassionate support and getting them whatever help they need.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

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