Depression or Mood Disorder in Children and Teens with Obesity

Depression is a mood disorder. It affects the way someone thinks and feels. It is a serious illness. The most common symptom is a lasting feeling of deep sadness. People who are depressed may also feel hopeless. Or they may feel that life isn’t worth living. Sometimes depression can lead to thoughts of suicide or death.

Like other illnesses, depression is not something that someone can just “snap out of.” Left untreated, it can lead to many problems. If your child is depressed, they will need treatment.

Experts have found a strong link between depression and children and teens with obesity. Young people with obesity face many social challenges. They often have a hard time fitting in with their peers. They face teasing and bullying from other kids. They can find it hard to keep friends or make new friends. They often see lots of content about ideal body weight on social media. And they may be blamed for their weight. Or made to feel ashamed of it.

Over time, this can damage a child’s self-confidence. It can lead to feelings of low self-esteem. This can even affect young children. A child or teen may feel isolated and different from other kids. They may begin to dread going to school. They may start doing poorly in school. They may withdraw from other kinds of social situations. This can lead to feelings of depression.

Here are some signs to watch out for in your child. A child or teen may not have every symptom listed here. But talk with your child’s healthcare provider if they have symptoms that get in the way of their daily life.

Younger children may not know how to talk about how they feel. Instead they may show it by:

• Eating or sleeping more or less than normal

• Worrying a lot

• Often feeling afraid or anxious

• Behaving badly or aggressively

• Having hyperactive behavior

• Complaining of stomachaches or other pains that can’t be explained

• Thinking or talking about death or suicide

It can be harder to spot depression in teens. That’s because kids this age often have mood swings due to changing hormones. But if your teen is always depressed, you should be concerned. Signs of depression can include:

• Isolating from family and friends

• Eating or sleeping more or less than normal

• Talking about feeling hopeless or worthless

• Increase in reckless or risk-taking behavior

• Having problems in school and at home

• Not wanting to do things they once enjoyed

• Using drugs or alcohol

• Hostile behavior or rage

• Thoughts or talk of death or suicide

• Self-harm (cutting, burning, or bruising themselves on purpose)

Treatment can help depressed children and teens. Talk with your child's healthcare provider or school counselor or psychologist. Or check with your local mental health center, social service agency, or hospital. Let your child or teen know that their pain can be eased.

Pay close attention to your child's social media postings. Be vigilant about signs of cyber and in-person bullying. Children may be ashamed to tell you about being bullied. Have open-ended conversations about what is going on at school and online and, if bullying is happening, take steps with online platforms, teachers, and administrators to manage the situation. Let your child know that you are there to help them.

Watch for any comments about self-harm, harming others, weapons, or alcohol or drug use. Watch for behavior changes that concern you. Offer your child love and support. If they talk about death or suicide, get help right away.

NOTE: If your child is suicidal and you have guns in your home or car, consider temporarily removing them to a safe location. If that is not possible, secure them locked, unloaded, and disassembled with essential pieces locked and stored separately. Store and lock ammunition in a separate location. Make certain your child does not know the codes of the locks, the combination, or the location of the keys. Ask about gun storage in all homes your child visits. These actions can save a child's life.

If your child is diagnosed with depression, treatment will depend on how severe the depression is. Treatment will likely include:

• Being supportive of your child, and watching them to make sure symptoms don’t get worse

• Talk therapy with a counselor or other trained professional. This may be done one-on-one. It can also be done in a group with other young people with similar issues, or with family members.

• Medicines for depression, called antidepressants

The provider may also work with your child to create a personalized safety plan. This is a set of coping strategies and emergency resources your child can use to help them through a crisis. A safety plan can help reduce the possible risk of suicide. It will include your child's:

• Specific warning signs or triggers for suicidal thoughts
• Effective coping strategies that can be used at all times of day or night when these triggers or thoughts occur
• Names and contact numbers for social contacts/supports
• Emergency contacts including 988, trusted therapists, and family members

Safety plans can be developed via a smartphone app or on a paper template. If your child is given a paper template, consider asking them to take a picture of the plan so it will be on their phone and quickly available. As additional support, a commonly used virtual safety planning tool is the Virtual Hope Box.

Call or text 988 if your child has suicidal thoughts, a plan to harm themselves or others, and the means to carry out the plan. If you think your child is suicidal, never leave them alone, not even for a minute.

When you call or text 988, you will be connected to trained crisis counselors at the 988 Suicide & Crisis Lifeline. An online chat option is also available at www.988lifeline.org Lifeline is free and available 24/7.

• 988lifeline.org or 800-273-TALK (800-273-8255)

• National Alliance on Mental Illness at www.nami.org or 800-950-6264

• National Institute of Mental Health at www.nimh.nih.gov or 866-615-6464

• Mental Health America at www.mentalhealthamerica.net or 800-969-6642