Depression: Real-life strategies for helping children and teens

This series starts with Understanding depression; you might want to read that first.

Some of you are reading this at midnight, spiraling, searching, and scrolling about your child’s mental health, trying to figure out what to do. I’ve been there, as a parent, working with families, and as a person who has lived inside depression myself. I'm not a mental health professional. If you can access one, please do. But I also know that waitlists are long, insurance is a mess, and sometimes, you need ideas for tomorrow morning.

*note: The end of this article discusses self-harm and suicidal thinking. If you're not in a place to read that today, skip the last section. If you’re worried your child is going to try to hurt themselves or if they already have, please skip this article and go straight to one of the list of resources at the end.*

The problem with “talk to someone.”

The biggest piece of advice I see out there is, "Get them to talk to someone." Yes, social connection matters. Yes, a supportive listening ear is a huge asset in any mental health crisis. Yes, we all wish we could make our children feel better with our words. 

But I talked in Understanding depression about the voice depression creates in your head, telling you terrible things about yourself and the world. Conversations are hard when that voice is there. It might be telling them they should be able to handle this, that nobody wants to hear it, that their friends probably have a group chat about them being whiny, that they are breaking the family, the house, and your heart.

I used to ride the subway so full of misery that I felt guilty: I was positive my misery was emanating off me so strongly that I was actually depressing everyone around me. Imagine what terror I’d drop on a friend if I tried to talk to them about it. It's ludicrous, now. I believed it fully, then.

So yes, talking to someone is ideal, but it’s not always accessible, and as a parent, you want to approach carefully.

What actually helps

Talk about mental health in general

Make sure your kid knows that mental health challenges are real, not shameful, and not a sign of weakness. Talk about your own, as much as is appropriate, with language they can handle. Show them that big feelings are normal, and they aren’t going to break you if they share them. Be careful about how you use mental health terms as insults. Use a celebrity if you need to (“She’s taking time off to take care of her mental health? Good for her. Wow, depression can make even a professional athlete feel not successful or strong”).

Give them words for what they might feel, now or someday, without forcing them to talk about their own feelings. Naming things is often the first step toward managing them. It’s extra hard to help kids who don’t even realize they are depressed, who believe the voice in their head is their real intuition. So tell them, “Sometimes people have an awful voice in their head that says things like XYZ, but that is depression talking, not reality.” Helping them understand in general increases their chances of recognizing it if/when it happens to them. Talking generally can also be a way of letting them know you see them without pressure for them to share.

Call out depression’s mean internal voice. Separate the voice of depression from your kid's real thoughts. Help them begin to recognize, “Oh, that's not real. That's depression talking.” If they can call depression cognition out, they take away some of its power, and it's also a signal to themselves that they need support.

We call ours "Stan." We decided he's an internet troll, sending mean comments from his dark basement. So when they get a thought like “Nobody likes me,” I have sanctioned my children to say "Shut up, Stan." If you hear those thoughts voiced aloud, you can just say, “That sounds like depression talking.”

More on depression’s mean voice in Understanding depression.

Offer them presence without pressure. 

Show them you are there for them without making connection a demand. Pushing for talk or eye contact or engagement when a depressed kid has shut down often increases shame and withdrawal. 

Side-by-side activities

Popcorn and a movie on the sofa. Playing the video game together, if they’ll let you. Eating lunch and reading at the same table. A conversation about something light and totally unrelated that you both like (or can rant about). Even doing nothing together in the same room while your child’s on their phone (as long as you aren’t staring).

Brief, low-stakes check-ins 

These are better than sustained emotional conversations. "I'm here" is easier than "let’s talk about how you're feeeeeling." Maybe they can do a mental health “weather report.” Experts are pretty consistent that long emotional processing conversations with a depressed kid who isn't ready often backfire and increase avoidance. That doesn’t mean never checking in or never having hard conversations. It means following your child’s capacity instead of forcing emotional intensity. Don’t try for every day, don’t make them required. 

Indirect communication 

Try notes, texts, delivering something yummy for them when you know they haven’t eaten. Indirect communication can still be super effective, especially for teens. Some kids can take in or say in a text what they absolutely cannot handle face-to-face.

You’re not trying to bong or to use any of these as teachable moments. They stop feeling helpful the minute your child senses you need them to be okay or you are sitting there, holding your breath and thinking “We are CONNECTING!”

Offer them empathy, not pity, or reasons they shouldn’t be depressed

Empathy is saying I am here with you, and I understand. It’s not “poor baby” or staring at you like you are a fragile system of bombs that might go off at any minute. Other people's pity can be horrifying and uncomfortable and infantilizing. Your child may be thinking, “I am basically fine, but I am depressed, so please don't pat me on the shoulder because it is so cringy, but it might make me crack, and I simply cannot crack in front of you.”

Similarly, nobody ever felt less depressed because someone else told them how lucky they are. Trust me: they probably know and then they feel bad about that too.

Don’t make your child manage your feelings

I know you are spiraling and terrified, full of grief, anxiety, anger that they won’t confide in you. Those are real feelings, and I have been there. But they are not the main problem (depression is), and they are not good for your child to take on in addition to everything else.

Kids, especially perceptive ones, read parental anxiety acutely, and it adds to their burden. It can make them feel like it’s important to seem like they feel better, like they need to hide things from you, so you don’t stress out. It is also harder for you to be truly empathetic or to see what’s really going on if your own feelings are overwhelming you.

Please figure out how to process your own feelings away from your child (you deserve someone to talk to also!). Crisis lines are there for parents too.

Get them moving

I hate saying this because it's so cliché. And also it's cliché because it works. It is, in fact, one of the only scientifically supported strategies for depression. Get them walking, outside if you can, in some daylight. (some older teens like to wander late at night when nobody else is around, which is nerve-wracking, but at least they're moving.).

I also hate this one because it’s hard. It’s nearly impossible to make a teen do something. It’s extra hard if what they’re doing is on a screen. I just want to acknowledge that.

Instead of begging or needling, try sneaky bribery, like, “I’m craving something sweet. Do you want to go get us Insomnia Cookies?” or “I’m headed to [place they like]. Wanna come get a [thing they like]?”

Use the dog. Borrow a dog. Borrow a little kid who wants to play catch. They’ll get both movement and caring for another creature. 

Don’t bring them the thing. Ignore the “can you bring me my water bottle?” text.

Sometimes you cannot get them off the sofa and that is also okay for a while. The goal isn't to fix the depression with a walk. The goal is to interrupt the stillness. Even a five-minute walk to the mailbox counts. Please don’t turn this into a battle in yourself or with them.

Maintain routines and expectations, flexibly

Structure and routine can be helpful. Being super strict/punitive about the rules isn’t. Cancelling everything and rearranging the whole household confirms to your child that they’re broken and the whole family knows it. 

Again, the goal is to offer accommodations and ease some requirements if needed, without handling them with kid gloves. Think of the sprained ankle (from Understanding depression). You’d maybe drive them places you’d usually make them walk, let them off laundry duty, or deliver them some ice wordlessly. You wouldn’t cancel work to follow them around projecting, “ARE YOU OKAY YOU POOR THING HOW IS YOUR ANKLE TALK TO ME ABOUT THE PAIN!” 

When they say they’re “fine,” hear them without arguing or believing them

Sometimes they simply won’t talk about it. Lots of times. When they say “I'm fine, mom” try validating without accepting it at face value. Say, “Okay, I hear you” instead of “No, you're not” or “That’s great!” You’re not arguing, but you’re also not pretending to believe them. “I’ll be here (or in the kitchen or somewhere else close) if you need me.” Just stay nearby, showing that they aren’t alone even if they aren’t ready to talk. 

Protect the relationship over the agenda. If pushing for connection is damaging the relationship, stop pushing. The relationship is the long game.

Trust someone else

A hard but true thing: sometimes the most helpful thing a parent can do is get out of the way and let someone else in. A coach, an aunt, a friend's parent: someone who doesn't carry the full weight of being a parent. Kids can sometimes share with a low-stakes adult what they absolutely cannot say to a person they love, need, and want to protect. It’s not that you don’t have a good relationship or they don’t need you. It’s because those things are true, because they want you to think they are amazing, that sometimes it’s easier with someone else.

Get help, even though the system is hard

Therapy can be great, group or individual, intensive or weekly, online or in person. Talk to your pediatrician, your neighbourhood parents, local hotlines; there are lots of therapists out there, so finding the right one might be a process.

There are many therapeutic approaches and different kids respond to different kinds. If your child is deep in it and has no framework yet for understanding that this is depression and not reality, they may first need support that helps them understand what they are experiencing, and realize that they deserve to feel better, before they’re given more structured strategies for climbing out. They definitely need to feel deeply seen and safe, not just behaviour-managed. 

Take into account anything important about your child’s identity or development (are they neurodivergent, LGBTQ+, adopted, a visible minority, communication delayed…). Ideally find someone with experience with kids or teens like them. This is partly so the therapist can better connect with your child and partly so they don’t interpret your child’s needs incorrectly because they don’t understand (some autistic kids, for example, end up with personality disorder diagnoses when assessed by folks who don’t understand neurodivergence).

Yes, I know what happens next for a lot of families. You finally make the call, and they take your information and give you six other places to call, all of whom have waitlists, referral requirements, insurance issues, assessments, and paperwork. Then, on the day of the appointment, your kid is like, “Nope, not doing that.” 

It is still worth calling. It is still worth talking to your child’s doctor, to the hotline, to other parents who might have resources. You’re not bothering anyone. Plus, every call you make, every waitlist you get on, everything you try, it all reminds your child that you’re with them, and they don’t have to handle this alone.

Remember

Depression is awful partly because it feels permanent. It tells you this is who you are now. But that’s a lie too. Many children who seem completely unreachable during a bad episode do reconnect, recover, and feel like themselves again, sometimes slowly, and unevenly, and with support. Don’t let depression convince you that things can’t ever get better, for you or your child.

About suicide and self-harm

If what you’re seeing feels like more serious self-harm or potential self-harm, if your child is talking about not wanting to be here or other horrifying things, this is not something you and your child should try to handle alone. There are some strategies below, but this requires more than strategies from me. Please see the resource list at the end of the article.

Self-harm can be a way for kids to regulate their feelings, to create a situation where they can care for themselves in ways that are accessible to them, to drown out other feelings with physical pain, which may be easier to deal with than the awfulness in their head. It doesn't necessarily mean kids are looking to hurt themselves, or have suicidal thoughts, although sometimes they do.

Finding out your child is self-harming is terrifying. You don’t have to understand it to help. You don't have to have the right words. Your most important job (and this is hard) is to stay in the room physically and emotionally. Don't gasp, don't frantically ask why, don't let your own panic take over the moment, even though your soul is exploding. They are watching to see if you can handle this, so try hard to show them you can.

Some ideas for when kids self-harm

Start small: "Do you need some polysporin?" Caring for a physical wound — gently, practically, without escalating to crisis — can be easier for both of you than talking. It sends the message “I care about you, and I can handle whatever you need me to” without requiring anyone to talk.

Say, "I'm really glad you shared this with me." Even if glad isn't at all what you're feeling. What you mean is, “I know it was hard to share. You did the right thing and I am not going anywhere.”

Later, you can say, "Is there anything you need from me right now?" which lets you offer care while leaving them in charge. Or, you can ask, with genuine curiosity (not anxiety or sarcasm), “Did it help?” to open the door to more conversation, but don’t push.

If you’re scared it’s more than self-harm

Sometimes, the depression voice tells you you'll never get out of the pit, so why go on? Sometimes it tells you the people you love would be happier, less stressed, if you weren't around, that the kind thing to do is set them free from the burden of your existence. 

That thought, any thought or indication from your child that sounds like “They’d be better off without me” or “I can’t keep going” is your signal to act. Don’t panic, but that is depression talking, and depression has said enough. It’s time to get your child some help. 

If you’re seeing things that worry you (there’s a list, in Understanding depression), you are allowed to seek help for yourself, as a worried parent, before your child is ready to make use of it. A crisis line will talk to you, too.

In the meantime, your job is to stay connected. Don't leave, don't panic visibly, don't make them feel like they've broken you. If they’ve confided in you, you can simply say, “I’m so glad you told me.” Show them however you can that they are in charge, but they don’t have to handle this alone. 

I want you to know that asking for help (even if your child doesn't want it) is not a betrayal. You are not going to ruin the relationship or break them. You are showing them their safety is the most important thing to you. You are keeping them safe when they can’t do it themselves, just like you did when they were very young.

Resources

For the US, 988 is the Suicide and Crisis Lifeline. Call or text. 

The Trevor Project offers 24/7 crisis services for LGBTQ+ youth in the US. Text START to 678-678 or call 866-488-7386

For Canada, Kids Help Phone (1-800-668-6868, or text CONNECT to 686868) is the main national resource for youth and is available in both English and French.

The Crisis Text Line (text HOME to 741741) works in the US and Canada. It’s especially relevant for teens who won't make a phone call. 

For more local options, search for [your location] + suicide hotline or crisis text line. Many cities (not enough) have police or non-police mobile mental health crisis units that can come to your home in an emergency.