Mood Disorders in Children

Mood disorders affect everyone, from children to older adults. Learn about treatment options as well as how to identify if your child is struggling with a mood disorder.

A mood disorder is defined by the National Institute of Mental Health as any disorder that regularly affects an individual’s emotional well-being. Mood disorders can affect everyone, ranging from young children to the elderly. Mood disorders in childhood and adolescence are especially troubling, as they often overlap with a child’s important formative years. 

When it comes to mood disorders and children, young people are affected in different ways compared to adults and the elderly. It is important to be aware of the signs and symptoms of a mood disorder in children and adolescents. Depending on the specific disorder and its severity, treatment options vary. 

What Are Mood Disorders?

What exactly are mood disorders? It can be difficult to tell if a child shows signs of a mood disorder without professional help. Some mood disorders, such as major depressive disorder, are relatively common. Other conditions, such as premenstrual dysphoric disorder (PMDD), are much less common and only affect a small percentage of females. 

Though mood disorders have probably been around for years, it was not until the 1980s that mental health professionals began studying and classifying symptoms of mood disorders in children and adolescents. 

Types of Mood Disorders in Children and Adolescents

There are numerous types of mood disorders in children, and each one has its own unique set of symptoms and treatment options. In many cases, females are more susceptible to developing mood disorders than males. This would indicate that there are hormonal and genetic factors at play. In addition, a child with a parent or relative that is diagnosed with a mood disorder is more likely to develop one themselves.

It may be hard to diagnose a child with a mood disorder since symptoms closely overlap with other mental health conditions. Because of this, mood disorders are likely underdiagnosed in youth populations. As there is a growing emphasis on mental health in the United States, particularly in children and teenagers, it is likely that even more individuals will be diagnosed with these disorders in the future. 

• Major Depressive Disorder: Major depressive disorder in children is also known as clinical depression. In this case, major depression is usually characterized by persistent sadness or irritability that can negatively impact a child’s daily life. Being diagnosed with childhood depression can predict whether a child has depressive episodes in the future. Typically, cognitive behavioral therapy, interpersonal therapy, family therapy, and medication are recommended. 
• Dysthymia: The National Institute of Mental Health classifies dysthymia in children as a persistent depressive disorder. Dysthymia, also known as dysthymic disorder, affects girls more than boys. In order to be diagnosed with dysthymia, children must exhibit depressive symptoms for at least two years. Many of the same therapies that help treat major depression can also be used to treat dysthymia in children. 
• Bipolar Disorder: Bipolar disorder in children can be slightly different from bipolar disorder in adults or teens. Regardless, bipolar disorder is characterized by intense and sometimes sudden mood swings. Individuals may go from highs (feeling elated, supercharged) to lows (feeling depressed). Signs of bipolar disorder include having a short temper, taking risks, inability to stay focused, not sleeping well or fixating on sexuality. During a depressive episode, children may feel sad, complain about their health frequently, feel hopeless and worthless or contemplate death. Bipolar disorder in teens is similar to the disorder in children, but symptoms can be more drastic and intense. Teens may struggle to maintain friendships or interact with family members. Typically, bipolar disorder in children or teens is treated with both individual therapy and various medications. 
• Premenstrual Dysphoric Disorder: Premenstrual dysphoric disorder (PMDD) is a condition that only affects females who have gone through puberty. While premenstrual syndrome (PMS) is a common occurrence for teenagers and women, PMDD is a more severe and debilitating form of PMS. Generally, symptoms of PMDD start before the menstrual cycle and can lead teenage girls to experience extreme moodiness, changes in appetite, sensitivity to rejection and overwhelming feelings. On top of the psychological symptoms, the painful physical symptoms of PMS like bloating, cramping, headaches, and breast tenderness are also present. For some women, PMDD can be managed well with exercise and diet changes. Other women benefit from the use of antidepressants or selective serotonin reuptake inhibitors (SSRIs) in the latter half of their cycle. 
• Disruptive Mood Dysregulation Disorder: Disruptive mood dysregulation disorder (DMDD) is seen in children who are angry and irritable on a regular basis and have emotional outbursts that ultimately impact their ability to function. For most children with DMDD, treatment is highly recommended because the condition can be tough to manage otherwise. For the diagnosis of disruptive mood dysregulation disorder in children, a child must exhibit symptoms for at least 12 months. Typical treatments for DMDD include a combination of psychotherapy, medication if necessary, parent training and computer-based training. 
• Mood Disorder Related to Another Health Condition: A child may exhibit symptoms of a mood disorder as a result of a co-occurring health condition. Some health conditions like traumatic physical injuries, severe infections, a diagnosis of cancer or other long-term diseases may trigger a mood disorder. In these cases, it is likely that treatment will depend on the specific mood disorder and co-occurring health condition. 
• Substance-Induced Mood Disorder: In some cases, children or adolescents may trigger a mood disorder through the use of substances. A substance-induced mood disorder can occur after an individual takes medication, is exposed to toxic substances or uses certain drugs. Treatment options will vary based on the mood disorder and the type of drug or substance that induced the disorder. 

Related Topic: Disruptive mood dysregulation disorder treatment plan

Symptoms of Mood Disorders in Children

There are many mood disorder symptoms. Symptoms of mood disorder in a child may not be easily recognized, or they may be attributed to an entirely separate condition. Children and adolescents may have trouble expressing or vocalizing how they feel, which can make diagnosis difficult. Signs of mood disorders can be different between children and teenagers, particularly with the added element of puberty. 

Some signs of mood disorder in children include:

• Frequently feeling sad, helpless or lonely 
• Feeling inadequate or having low self-esteem
• Feeling guilty 
• Feeling like they would be better off dead
• No longer enjoying activities or hobbies
• Problems sleeping
• Changes in appetite
• Problems with relationships
• Lethargy
• Attempting suicide or suicidal ideation 
• Frequently complaining of physical problems like headaches or being tired
• Running away or threatening to run away
• Being hypersensitive to rejection
• Being aggressive or irritable 

While most of the signs between children and teenagers will overlap, a few are more common in teenagers. Some signs of mood disorders in teenagers include:

• Similar, but more intense symptoms as children
• Longer duration of symptoms
• Not performing well in school
• Always being angry
• Exhibiting rebellious behaviors 
• Becoming problematic with family members
• Problems with friends and acquaintances

Causes of Mood Disorders

There are many potential causes of mood disorders. However, the exact causes of mood disorders are generally unknown. It is likely that what causes mood disorders in children and adolescents comes down to a combination of biological, psychological, social and environmental factors. 

For instance, it has been speculated that mood disorders result from chemical imbalances in the brain. In addition, experiencing traumatic events, having high-stress levels or having a genetic predisposition are all associated with developing a mood disorder. 

Diagnosing Childhood Mood Disorders

In order for a child or adolescent to receive a mood disorder diagnosis, they must be seen by a clinical psychologist, psychiatrist or other qualified mental health professionals for a comprehensive psychiatric evaluation. Mental health professionals will often defer to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for a mood disorder and mental health diagnoses. The DSM-5 is a diagnostic tool that contains information about how to recognize and treat patients with mood disorders or other mental health conditions. 

According to the Children’s Hospital of Philadelphia, a typical psychiatric evaluation includes: 

• Determining the child’s health and general medical history
• Recording specific symptoms the child experiences
• Noting how the child acts at home and with others in social settings
• Identifying stresses in the child’s life, both big and small
• Receiving information from teachers and other people who regularly interact with the child
• The child’s history of mental health conditions, other conditions and medications used
• How the parent would like to proceed with treatment, as well as a discussion of all treatment options

Treating Mood Disorders in Children

How are mood disorders treated in children? After a psychiatric evaluation, a medical professional will tailor treatment options that are unique to the mood disorder and the child or adolescent. Most mood disorders are treated with a combination of individual and family therapy, psychotherapy and medication. Treatment also encourages positive interaction and reinforcement at school. 

Medications for children with mood disorders include: 

• Mood stabilizers
• Antidepressants
• SSRIs

If managed with proper treatment, children and adolescents with mood disorders can function normally in society. The National Institute of Mental Health estimates that the lifetime prevalence of any mood disorder in children aged 13 to 18 is 14%. The lifetime prevalence of a severe mood disorder in this age group is 4.7%. 

These estimates show the outlook for children and adolescents with mood disorders is positive. As more research continues to be conducted on each mood disorder, it is likely that treatment options will continue to improve. 

What Parents Should Know

There are a few things that parents should remember about mood disorders in children:

• Treatment involves the whole family, not just the child diagnosed with a mood disorder
• There is nothing parents could have done to prevent their child’s mood disorder
• Parents should educate themselves about the differences between mood disorders in children, teens, and adults

If you or a loved one is struggling with a mood disorder and a co-occurring addiction, The Recovery Village can help. Contact us today to discuss how a mood disorder and addiction can be treated together.

Editor – Jonathan Strum

Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more

Medically Reviewed By – Dr. Bonnie Bullock, PHD

Bonnie is a medical communications specialist at Boston Strategic Partners, a global health industry consulting firm. Her recent work in mental health includes developing conference materials for clinical studies in mood disorders and copy-editing clinical manuscripts. Read more