Understanding Mood Disorders in Children and Teens

With kids and teens typically described as “moody,” the warning signs of a mood disorder are often overlooked. It’s true that big feelings are a natural part of childhood development. So how do you know if your child has a mood disorder? What does a mood disorder look like? And what can you do as a parent to get them the help they need?

What is a mood disorder?

First, let’s clarify what a mood disorder is.

“Mood disorders are what we talk about when we think about depression or bipolar disorder,” explains Howard Weeks, MD, MBA, DFAPA, DFAACAP (he/him), chief medical officer at Pathlight Mood & Anxiety Center. “Sadness is a common human emotion. Depression is not. Depression is constant, severe sadness. It kind of takes sadness from a level of one or two and moves it up to a hundred” ^[1].

The difference between a mood disorder and feeling “moody” largely depends on duration. When depression, irritability, or swings from sadness to euphoria persist for an extended period of time without relief, inhibiting someone’s ability to function, then there is a very real possibility of a mood disorder.

The most common mood disorders include:

• Major depressive disorder — extremely low moods
• Bipolar disorder — extremely high (manic, euphoric or hyperactive) and low moods
• Persistent depressive disorder — depression that lasts more than two years
• Cyclothymia — less severe form of bipolar disorder that may include hypomania and episodes of moderate depression
• Seasonal affective disorder — depression that starts and stops around the same time each year (typically during fall and winter months)

How these mood disorders present in your child or teen may vary.

Signs and symptoms of a mood disorder in children

It is common for children to not yet have the language to label and explain their feelings. That is why, while it’s important to listen to your child, it’s not all about what they say; it’s often what they do.

If you feel your child is living with a mood disorder, here are some signs and symptoms to be aware of:

• Lack of motivation
• Loss of interest in activities
• Low self-esteem
• Increased irritability
• Change in appetite
• Feelings of hopelessness or helplessness
• Feelings of inadequacy or not being up to the task
• Excessive guilt, disproportionate to any event

Keep in mind that it’s not the occurrence of these signs on a given day that make the difference between a mood disorder and your child going through a rough spot. It is when you notice these signs consistently, when they are starting to impair your child’s ability to function or when your child is having suicidal thoughts that professional support is recommended.

“This is different than the natural emotions that we all feel when something bad happens,” notes Dr. Weeks. “If I have a loved one die, I'm going to be sad and go through bereavement and that is a normal response. Depression often happens for no particular reason” ^[1].

It’s also important to note that there is overlap between some of these signs and other mental health disorders. That’s why if you see these signs, you can reach out for a free assessment so our expert team will help you connect the dots and get your loved one matched with the exact support they need.

Signs and symptoms of a mood disorder in teens

While teens share many of the same signs and symptoms listed above, here are some that are more specific to what older kids might experience:

• Frequent physical complaints such as stomach aches or headaches
• Trouble with relationships
• Difficulty focusing or making decisions
• Feelings of wanting to die
• Problems sleeping or insomnia
• Lack of appetite
• Hostility or perpetual anger
• Low motivation

Keep in mind that this is not an exhaustive list and while societal norms may make light of teens experiencing many of these symptoms as just “teen angst,” you need to pay attention to how they play out over an extended period of time and their intensity.

In general, because of the growth and brain development of teens, they tend to sleep longer and have a bigger appetite, so insomnia and lack of appetite are red flags. Trust your intuition, as you know your child best.

Causes of mood disorders

Mood disorders arise from a complex interplay of genetic, biological, environmental and psychological factors. Chronic stress, family history of mental illness, trauma and neurochemical imbalances can all contribute to the development of mood disorders in children and teens. It’s never just one cause.

In a systematic review, researchers looked at the influence of environmental factors (such as unexpected life events or long-term stress and trauma exposure) only to conclude that while the environment has some influence, it isn’t the only factor ^[2]. Genetics actually play a significant part in determining whether a child or teen is likely to develop a mood disorder.

Importantly, mood disorders are biological illnesses.

“Depression, for example, doesn't have to be triggered by some bad event,” shares Dr. Weeks. “It often happens for no particular reason, but then we tend to link that to ‘things going on in my life’ and kind of anchor on them. But it wasn't that those things necessarily caused the depression. It's a biological illness that then affects the lens through which one experiences the entire world” ^[1].

Genetics and mood disorders

Genetics can predispose individuals to mood disorders but they don't guarantee their onset. Children and teens with a family history of mood disorders may be at a higher risk but, as mentioned, environmental factors also play a role. Understanding genetic predispositions can help one tailor treatment approaches effectively.

“There's not one single chromosome that leads to depression or bipolar disorder. It seems to be multifactorial,” explains Dr. Weeks. “But what we can clearly see is severe mood disorders can run in families. So we know there's a genetic component” ^[1].

While there is a genetic component to most mood disorders, there is evidence that the genetic tie is strongest for bipolar disorder, which has a heritability rate of 60-93% ^[3]. But the reasons are still unclear, and our experts hope that future research can give us more insight.

How to get help

You know your child best and you know when something feels off. When that happens, you can reach out for a free assessment and a compassionate mental health professional will match your child with the exact support they need.

At Pathlight Mood & Anxiety Center, your child will:

• Gain helpful, practical skills to work through hard things
• Work with a psychiatrist-led team that cares
• Connect with peers who can relate to what they are going through

“A mood disorder is a very treatable illness,” offers Dr. Weeks. “The problem is, some estimate, that up to 70% of people with depression, for example, don't seek care” ^[1].

We know this is hard. That’s why we’re here for your family every step of the way.

Medications for mood disorders

Medication can play an important role in the treatment of mood disorders, in combination with other evidence-based modalities. We know this is a difficult decision for families to make. Kris Ramos, MSW, LCSW, CEDS, clinical director at Pathlight Mood & Anxiety Center, shares how families can reframe this conversation:

"Psychotropic medications do help alleviate the emotional pain associated with mood disorders. It is important to remember that while all medications have side effects, we wouldn't stop children from taking cold medication just because it makes them drowsy because, in the end, it provides essential relief from the most pressing and painful symptoms. The same can be applied in this situation.”

So, what can families do?

“It can be especially helpful for caregivers to ask questions and seek support for any fears they have regarding medications, as they are certainly not alone,” notes Ramos.

Support for parents and caregivers

We know this can feel overwhelming, but keep in mind that you're not alone. It’s important for you to have a safe space to share what you’re going through, which is why we offer free caregiver support groups.

Dr. Weeks shares these words of encouragement:

“What I really hope is that families recognize that mood disorders are treatable, medical, biological illnesses. And I hope they recognize that there is help out there” [1].