Post-Covid Depression Is Hitting Teens and Children Hard: Can You Spot the Signs?

Across the country, thousands of students are carrying something heavier than the books in their backpacks. Study after study has confirmed what school psychologists, teachers, and caregivers see firsthand: A growing number of young people have depression that began or worsened during the COVID-19 pandemic.  

When researchers looked at pooled estimates, they found roughly 1 in 4 young people across the globe experienced “clinically elevated depression symptoms” during the first year of the pandemic (Racine et al., 2021). That’s double pre-pandemic rates. And depression is still hitting harder than usual. One meta-analysis compared the prevalence of depression before and after the majority of pandemic restrictions were lifted. Depression levels were “significantly higher” afterward (Wang et al., 2022). 

In response, the U.S. Preventive Services Task Force has called for depression screening in all students ages 12 to 18.  If you’re considering universal depression screening or you’re working with individual students at risk, here’s what to know about post-covid depression in young people.  

Signs of Post-Covid Depression in Teens and Children 

Depression looks different from person to person, and some signs are easier to spot than others. For example, some people have more physical symptoms, such as body aches. Others have more emotional or motivational symptoms.   

The Diagnostic and Statistical Manual of Mental Disorders (5th ed., text revision; DSM-5-TR) describes these symptoms of major depressive disorder (MDD): 

• feeling sad, empty, hopeless, depressed, or irritable most of the time 
• losing pleasure in activities they once enjoyed 
• changing weight or appetite that is unrelated to dieting 
• sleeping too much or too little 
• feeling restless or sluggish most of the time 
• having very little energy most of the time 
• feeling worthless or feeling guilty most of the time 
• having trouble concentrating or making decisions 
• thinking about, planning, or attempting suicide 

To diagnose depression, five or more of these symptoms must be present during a 2-week period and must disrupt the person’s ability to function. The symptoms shouldn’t be related to some other cause, such as the recent loss of a loved one or a medication side effect.  

Causes of Post-Covid Depression 

Researchers are still unpacking all the reasons for the surge in depression. Many think the post-pandemic increase could be the result of 

• avoiding social situations because of the risk of illness, 
• staying at home for long periods, 
• spending less time in physical activity, 
• fearing that family members might become ill, 
• facing the economic fallout of the pandemic, 
• living with parents whose mental health was affected by the pandemic, or 
• experiencing child abuse (Wang et al., 2022). 

Environmental stressors like these can lead to inflammation in the brain and body. Inflammation has been linked to depression—and depression can make people more vulnerable to infections. Depression and inflammation are believed to travel on a two-way street (Beurel et al., 2020).  

In addition, scientists have found that the COVID-19 virus itself causes inflammation, changes in brain structures, and depression. Symptoms can last for months after the body clears the virus (Benedetti et al., 2021). By some estimates, around 35% of those who had COVID-19 also had depression symptoms up to 4 months later (Mazza et al., 2022).  

Risk Factors for Post-Covid Depression in Teens and Children 

It’s important to understand which teens and children may have a higher depression risk. In a 2022 review of survey studies, Theberath et al. described several basic risk factors associated with mental health difficulties during the pandemic. Depression risk was found to be higher for people who  

• were assigned female at birth 
• were in upper grade levels at school 
• needed more social and physical activity 
• used the Internet in an excessive way 
• experienced emotional reactivity 
• avoided new experiences 
• relied on unhealthy coping strategies such as denial or substance use 
• experienced financial loss or instability  

Depression can run in families: People with a family history of depression are more likely to experience depression early in life (van Sprang et al., 2022). Other studies found that attention-deficit/hyperactivity disorder (ADHD), a prior history of mental health difficulties, and emotional abuse all increased the risk for depression in children and teens during and after the pandemic (Bai et al., 2022; Lewis et al., 2022; Sciberras et al., 2022). 

Key Messages

The pandemic raised the risk of depression in teens and children. Changes to routines, isolation, family stress—or even COVID-19 itself—led to symptoms that, for many, still linger.  

When you know the signs and have a sense of who may be vulnerable to the condition, you can better assess depression in children and teens. No one can turn back the clock to pre-pandemic stress levels. But those with access to tools and training can help young people cope and recover today.   

For information about trusted measures of depression in young people, reach out to a WPS Assessment Consultant or explore the Children’s Depression Inventory, Second Edition™ (CDI 2®) online.  

To find out more about how WPS can help you make a difference for teens and children, check out the 2023 School Resource Guide. 

Research and Resources: 

Bai, Y., Fu, M., Wang, X., Liu, D., Zhang, Y., Liu, C., Zhang, B., & Guo, J. (2022). Relationship among child maltreatment, parental conflict, and mental health of children during the COVID-19 lockdown in China. Journal of Child & Adolescent Trauma, 1–10. Advance online publication. https://doi.org/10.1007/s40653-022-00478-x 

Benedetti, F., Palladini, M., Paolini, M., Melloni, E., Vai, B., De Lorenzo, R., Furlan, R., Rovere-Querini, P., Falini, A., & Mazza, M. G. (2021). Brain correlates of depression, post-traumatic distress, and inflammatory biomarkers in COVID-19 survivors: A multimodal magnetic resonance imaging study. Brain, Behavior, & Immunity - Health, 18, 100387. https://doi.org/10.1016/j.bbih.2021.100387 

Beurel, E., Toups, M., & Nemeroff, C. B. (2020). The bidirectional relationship of depression and inflammation: Double trouble. Neuron, 107(2), 234–256. https://doi.org/10.1016/j.neuron.2020.06.002 

Lewis, K. J. S., Lewis, C., Roberts, A., Richards, N. A., Evison, C., Pearce, H. A., Lloyd, K., Meudell, A., Edwards, B. M., Robinson, C. A., Poole, R., John, A., Bisson, J. I., & Jones, I. (2022). The effect of the COVID-19 pandemic on mental health in individuals with pre-existing mental illness. British Journal of Psychiatry Open, 8(2), e59. https://doi.org/10.1192/bjo.2022.25 

Mazza, M. G., Palladini, M., Poletti, S., & Benedetti, F. (2022). Post-COVID-19 depressive symptoms: Epidemiology, pathophysiology, and pharmacological treatment. CNS Drugs, 36(7), 681–702. https://doi.org/10.1007/s40263-022-00931-3 

Racine, N., McArthur, B. A., Cooke, J. E., Eirich, R., Zhu, J., & Madigan, S. (2021). Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID-19: A meta-analysis. JAMA Pediatrics, 175(11), 1142–1150. https://doi.org/10.1001/jamapediatrics.2021.2482 

Schlensog-Schuster, F., Keil, J., Von Klitzing, K., Gniewosz, G., Schulz, C. C., Schlesier-Michel, A., Mayer, S., Stadelmann, S., Döhnert, M., Klein, A. M., Sierau, S., Manly, J. T., Sheridan, M. A., & White, L. O. (2022). From maltreatment to psychiatric disorders in childhood and adolescence: The relevance of emotional maltreatment. Child Maltreatment, 10775595221134248. Advance online publication. https://doi.org/10.1177/10775595221134248 

Sciberras, E., Patel, P., Stokes, M. A., Coghill, D., Middeldorp, C. M., Bellgrove, M. A., Becker, S. P., Efron, D., Stringaris, A., Faraone, S. V., Bellows, S. T., Quach, J., Banaschewski, T., McGillivray, J., Hutchinson, D., Silk, T. J., Melvin, G., Wood, A. G., Jackson, A., Loram, G., … Westrupp, E. (2022). Physical health, media use, and mental health in children and adolescents with ADHD during the COVID-19 pandemic in Australia. Journal of Attention Disorders, 26(4), 549–562. https://doi.org/10.1177/1087054720978549 

Theberath, M., Bauer, D., Chen, W., Salinas, M., Mohabbat, A. B., Yang, J., Chon, T. Y., Bauer, B. A., & Wahner-Roedler, D. L. (2022). Effects of COVID-19 pandemic on mental health of children and adolescents: A systematic review of survey studies. SAGE Open Medicine, 10, 20503121221086712. https://doi.org/10.1177/20503121221086712 

U.S. Preventive Services Task Force. (2022 October 11). Depression and suicide risk in children and adolescents: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-depression-suicide-risk-children-adolescents 

van Sprang, E. D., Maciejewski, D. F., Milaneschi, Y., Elzinga, B. M., Beekman, A. T. F., Hartman, C. A., van Hemert, A. M., & Penninx, B. W. J. H. (2022). Familial risk for depressive and anxiety disorders: Associations with genetic, clinical, and psychosocial vulnerabilities. Psychological Medicine, 52(4), 696–706. https://doi.org/10.1017/S0033291720002299 

Wang, S., Chen, L., Ran, H., Che, Y., Fang, D., Sun, H., Peng, J., Liang, X., & Xiao, Y. (2022). Depression and anxiety among children and adolescents pre and post COVID-19: A comparative meta-analysis. Frontiers in Psychiatry, 13, 917552. https://doi.org/10.3389/fpsyt.2022.917552