Things You Learn in Therapy
Things You Learn in Therapy
Ep 148: Depression In Kids, Decoded
Sharing another one of my favorite episodes from Kids These Days...
Depression in kids doesn’t always look like sadness. Often it shows up as irritability, anger, “I don’t care,” and a slow fade from hobbies, friends, and motivation. In this candid, practical conversation, Dr. Beth Tremell walks through the clearest signs of youth depression, how they differ from adult patterns, and the simple phrases parents can use to open a safe, direct conversation—without making things worse.
We unpack real-world red flags like drastic sleep shifts, appetite changes, chronic fatigue, harsh self-talk, and school or friendship struggles. You’ll hear calm, evidence-aligned ways to ask about suicidal thoughts—questions like “Do you want to die or stop hurting?”—and why bringing this up reduces isolation rather than creating risk. Dr. Beth shares how to respond when a child says “maybe I should just die,” how to stay steady in the moment, and what details matter for getting the right level of help.
Support is both emotional and practical: being physically present to counter the “island” of depression, setting gentle routines, and connecting with professionals. We outline when to call the pediatrician, how to find a therapist, and why school-based services—counselors, social workers, school psychologists—can be vital when community waitlists are long. Throughout, you’ll get clear, compassionate guidance for gauging severity by impact on grades, friendships, and daily life, plus small steps that build momentum back.
If you’re a parent, caregiver, or educator trying to tell the difference between a rough week and something deeper, this conversation gives you language, structure, and next steps. Listen, share with someone who needs it, and subscribe for more practical mental health guidance. If there’s a topic you want us to cover next, reach out and let us know.
This podcast is meant to be a resource for the general public, as well as fellow therapists/psychologists. It is NOT meant to replace the meaningful work of individual or family therapy. Please seek professional help in your area if you are struggling. #breakthestigma #makewordsmatter #thingsyoulearnintherapy #thingsyoulearnintherapypodcast
If you or someone you know is struggling with mental health concerns, please contact 988 or seek a treatment provider in your area.
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Feel free to share your thoughts at www.makewordsmatterforgood.com or email me at Beth@makewordsmatterforgood.com
www.bethtrammell.com
All right, friends, welcome back. I'm your host, Dr. Beth Tremell. This is Kids These Days. Need us to make words matter for good. I am a licensed psychologist and an associate professor of psychology at IU East in Richmond, Indiana. Go Red Wolves. I'm also the director of the Master's Mental Health Counseling Program. And I am uh talking today about depression in children and what we can expect from depression in children. You know, I recently posted an episode with my friend Sierra Dater, and we were talking about the recent report about depression in young girls specifically. And I know we talked about a few of these symptoms, but I wanted to cover kind of depression in a little more depth than what we could expect to see. And if you're someone who is interested in depression in adults and what we could expect for depression in adults, I recorded an episode just like this, but specifically for adults, on my other podcast, Things You Learn in Therapy. I'll link it at the bottom. And so today we're going to talk just about kids and adolescents. What does depression look like in our kids and adolescents? And so the first thing to remember is that depression for our kids and adolescents may not look the same as it does in us. And so this is our first thing to kind of realize is that it may look different. So that which we know or we think we know about depression in adults may be very different than how our kids experience depression, how our teens experience depression. And most notably, our uh kids and teens may actually look less like depression for what we think it is, right? We think sadness and crying and those sorts of sort of like low blah kind of moods. And for kids, what you might see is anger, irritability, withdrawal. I hate you, I hate my life. Maybe I should just die. Maybe nobody cares about me anyway. I am nothing but a worthless piece of fill in the blank, right? Now, some teens will say that, some kids will say that, and it doesn't necessarily automatically mean depression. But if I hear that from a child and I I also see a few other things that live in kind of the depressed category, I start to think, hmm, this friend may really be struggling with depression. So that's the first thing to realize that it doesn't look like depression in adults. Some things may look similar, but our kids may experience it in a much different way than what we would expect. So the first thing to realize is that yes, depression is rooted in depressed mood, meaning they seem sort of low or sad or slow or inattentive or like they don't care about anything. And they certainly, you know, don't care about things that matter to us, right? Depression does live in that lower mood category. And so that's the first thing to realize that if you have a child who is withdrawn or low or kind of seems sad, um, it may be one piece to kind of look out for. If they say they don't care about things and nothing matters and they kind of quit doing things that they used to like a lot, and they just say, I don't care anymore, I don't want to do that anymore, or nothing matters, those kinds of things, that may be their version of uh loss of interest, depressed mood with loss of interest. If they're having changes in appetite, meaning they're eating a lot more, they're eating a lot less. If they're having problems sleeping, right? They're having trouble falling asleep, they're they're much, much more difficult to wake up in the morning, meaning they're sleeping a lot more. If they're having chronic feelings of fatigue, meaning they're just tired all the time, they want to sleep all the time. That may just be they're sleepy, it may be that they're staying up too late on their device, or it may be depression. It may be that they um say things that point to low self-esteem. They may make comments about hating themselves or hating how they look or hating their life or wishing that wishing that they weren't here anymore. All of these things are devastating to hear as parents and maybe something we need to respond to right away, right? It may be that we need to make sure that we are, you know, making a call to the pediatrician or trying to find a resource for them that will um help kind of get them out of that mood. So I think that um anytime our kids are talking about wanting to hurt themselves or wishing they were dead, anything in that realm, we should be kind of immediately responding in some way, meaning having a conversation about it or thinking with them or spending more intentional time just being near them. The thing about depression in kids, and and frankly, even in adults, is that it feels very isolating. Depression feels like I am on an island all by myself and it's dark and cloudy and scary all the time. And I feel like no one's here and no one knows I'm here. And so the more we can be physically and emotionally present and available for our kids when they're experiencing any kind of depression, even if they don't open up and be like, Well, I'm really depressed. Because frankly, they may not ever do that. But they may say, I just don't feel good. I don't feel, I don't feel right, I don't feel okay, I'm really struggling, I'm having trouble with friends, right? That's our opportunity to say, okay, what can I do to help? What do you think you need? Right? Asking questions like that. Other things that we'll see in kids who are depressed, um, sometimes we will see uh suicidal thoughts. So asking them, do you have thoughts of wanting to hurt yourself? Have you ever had thoughts of wanting to hurt yourself? If they say yes, don't freak out, just say, okay, tell me more about that. How often has that happened? Do you really want to die or do you want to just stop hurting? Those questions may feel very scary, but they are scarier for your child to experience alone. So the the fear you have about asking is exponentially more scary for your child to experience. And though you may um do a great job of supporting your child if you haven't had kind of explicit conversations about suicide or thoughts of her um hurting themselves or depression, they may feel very alone in it. Most people don't talk about suicide. Most people have a fear that if we bring it up, they will um our our kids will think more about suicide. And that is a myth. Uh, that's not actually what we see in the data in terms of suicidal attempts or completions. So my experience has been that if we open the door for a child to feel like we are there with them, they're more likely to feel supported by us. They're more likely to feel like we don't think they're crazy because many folks who um have thoughts of wanting to hurt themselves, they may feel like, gosh, no one could possibly understand how sad or bad or or deeply wounded I feel. So by opening that door and saying, I'm coming in the door with you, I'm gonna be in the darkness with you, I'm not afraid, I will be here with you, right? Those are the messages we're sending when we bring this up and talk to them about it in a fully empathetic kind of way. And of course, if your child is saying they're having thoughts of hurting themselves, then it would be important for you to talk with your pediatrician or get them into a therapist who can help them get out of that rut. So those are some common things to think about when your child may be experiencing some depressed mood. Um, we would be looking for changes in other areas of their life as well. So just like in adults, you know, kids might experience a depressed day or two here or there. If it's starting to impact their relationships with friends, their grades, their ability to do regular life things, then we start to become more worried. If their grades are pretty good, they're still hanging out with friends, but they're kind of like just angry at you at home. We're a little less worried, though we may still want to get them in to talk to somebody before things get too bad. One other mode of getting help may include talking to your school counselor. So if you're having a hard time finding a great therapist in the community, one place to start may be to ask your school if they have a social worker, a school psychologist, any um a counselor, anybody who is there who can maybe talk to your child a little bit while they're at school. Um, it may be good just to have continued support in every area of your child's life if they're struggling. So again, hopefully this was helpful. I'm gonna try to do a series of a variety of different topics. This one was about depression, but we'll also cover other topics. So if you're having any topics you want me to talk about in terms of what do we expect to see in these kind of common, um commonly thought of disorders or problems in childhood or adolescence, please feel free to reach out. I would love to hear from you. And until then, make words matter for good, y'all.
