Updated 13 February 2015

Are your kids stressed or depressed?

Being a kid is great fun – for the most part. But kids can also experience stress and depression. Here’s what to look out for.


Adults usually view the lives of kids as stress-free since they have no jobs to go to, meetings to attend, or bills to pay. However, psychologists know that kids, just like adults, can experience varying degrees of stress which, if not managed, can lead to serious mental and physical health problems.

Whether it’s doing well at school, making and sustaining friendships, or managing perceived expectations from their parents, teachers or coaches, the stress that children experience can arise from different sources, according to the American Psychological Association (APA).

While some stress can be positive in that it provides the energy needed to tackle a big test or sports event, too much stress can create unnecessary hardship and challenges, says the APA.

Experts at New York University’s (NYU) Child Study Center also note that, when short-lived and manageable, stress offers the opportunity for a child to stretch his or her potential and adapt to new conditions. However, when stress becomes drawn-out and unmanageable, adult intervention is needed to help the child cope.

Read: Schooling: when one size doesn't fit all

The NYU experts advise parents to be particularly mindful of two conditions: chronic stress and post-traumatic stress disorder (PTSD).

With chronic stress, the child feels overwhelmed by tasks ahead – expectations at school, divorce in the family and conflict with peers, for example.

Dr Raul Silva, a former associate professor of child psychiatry at the NYU School of Medicine, says: “In chronic stress, a person feels trapped in a lasting, difficult situation, such as bleak poverty, an unhappy home, or unrealistic expectations from parents.

PTSD differs from chronic stress in that it occurs as the result of a traumatic experience – such as serious injury or threat, violence, sexual abuse – which is then relived it with the same emotional intensity months and even years later.  

So, when does stress become unhealthy?

Dr Silva notes that a response to stress becomes unhealthy when it interferes with everyday, normal functioning: “For example, when the child stops doing their homework or when they revert to earlier behaviours that are no longer age-appropriate, such as thumb-sucking or bed-wetting.”

Some of the common ways in which stress can manifest in children may include the following, according to the APA:

•    Acting irritable or moody
•    Withdrawing from activities that used to give them pleasure
•    Routinely expressing worries
•    Complaining more than usual about school
•    Crying
•    Displaying surprising fearful reactions
•    Clinging to a parent or teacher
•    Sleeping too much or too little
•    Eating too much or too little
•    PTSD can manifest through intrusive memories or nightmares. Symptoms may also include avoidance of people or things associated with the initial traumatic event, and being easily startled.

How to reduce stress and anxiety

The APA offers the following pointers for parents who are dealing with a stressed or anxious child:

•    Stay calm – Children look to their parents to determine how to react in situations.
•    Encourage bravery – If a child faces their fears, the anxiety reduces naturally on its own over time.
•    Reward bravery – A hug or kiss will do and will encourage more acts of bravery.
•    Promote positivity – Affected children often get lost in negative thoughts and self-criticism.
•    Create relaxation time – Children need time to relax and be kids.
•    Listen and understand – If your child says they’re worried or scared, believe them.

The link between stress and depression

Dr Silva cautions that the long-term negative consequences of stress on health can be insidious and may include a weakened immune system and higher risk of depression.

Sustained or chronic stress, in particular, leads to elevated hormones such as cortisol, the “stress hormone” and reduced serotonin and other neurotransmitters in the brain, including dopamine, which has been linked to depression, according to Dr. Esther Sternberg, a leading stress researcher and Chief of Neuroendocrine Immunology and Behaviour at the National Institute of Mental Health, in the USA.

Read: Kids who walk or bike to school eat less junk food

“When these chemical systems are working normally, they regulate biological processes like sleep, appetite, energy and sex drive, and permit expression of normal moods and emotions. However, when the stress response fails to shut off and reset after a difficult situation has passed, it can lead to depression in susceptible people,” says Dr. Sternberg.

Depression has a strong genetic component, meaning that if a family member has suffered from the disorder (whether on the father's or mother’s side), the child will have the predisposition for developing it. But there are life events or stressors that can trigger this predisposition, according to Port Elizabeth-based counselling psychologist, Frances Collett, who points out that depression can occur in children as young as three years of age.

Identifying and tackling depression

“With depression in childhood, we often only think to look out for low mood and sadness, but one of the key features in childhood depression is irritability. You can also look out for a symptom known as anhedonia – a lack of or decrease in taking pleasure in tasks and activities that your child usually enjoys,” says Collett.

She says the primary symptoms of depression in children, much like stress, revolve around sadness, a feeling of hopelessness, and mood changes, and may include:

-    Irritability
-    Anger
-    Social withdrawal
-    Sensitivity to rejection
-    Changes in appetite
-    Changes in sleep pattern
-    Vocal outbursts or crying
-    Difficulty concentrating
-    Low energy
-    Physical complaints that don’t respond to treatment
-    Reduced ability to function during daily events
-    Thoughts of death and suicide.

“As a parent or caregiver, you know your child best and will sense when something is wrong. Explore whether the symptoms you are seeing at home are evident in other settings, get as much collateral information as possible and act,” advises Collett, adding that parents, children and teens do not need to tackle severe stress on their own.

Read: Is your child depressed?

Psychologists have special training to help people identify problems and develop effective strategies to resolve overwhelming feelings of stress.

“Take your child to the doctor for a full examination in order to rule out any possible medical conditions (such as anaemia, low blood pressure, blood sugar dysregulation, thyroid problems). Once this is done, and if there is nothing medical that can account for your child’s symptoms, consult with a psychologist. Psychologists can assess whether the symptoms are in fact primarily related to a depression, or if there is another concern at play,” says Collett.


- American Psychological Association
- New York University Child Study Center
- Dr. Esther Sternberg (The Stress-depression Connection)
- Frances Collett (Registered Counselling Psychologist)

Also read:

Institutional neglect changes kids' brain structure
Why Soweto school children want to give up on life
Need for earlier recognition and treatment of ADHD


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Michael Simpson has been a senior psychiatric academic, researcher, and Professor in several countries, having worked at London University in the UK; McMaster University in Canada; Temple University in Philadelphia, USA.; and the University of Natal in South Africa.

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