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Depression in Youth Associated with Poor Outcomes in Adulthood, Study Finds

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Key Takeaways

  • Depression in childhood and adolescence is linked to higher levels of anxiety, substance use, worse health and social functioning, fewer financial and educational accomplishments, and increased criminality in adulthood.
  • This association was strongest for children who reported high levels of depressive issues multiple times across their childhood, as opposed to those with a single incidence of depression.
  • Participants who first reported depressive symptoms in childhood had better outcomes in adulthood than those who first reported depressive issues in adolescence.

There is a lot that most people don't know about the reality of childhood depression, and it needs to be better understood. A recently published study in the Journal of the American Academy of Child & Adolescent Psychiatry found that depression in childhood and adolescence was associated with higher levels of anxiety in adulthood.

According to the CDC, 3.2% of children aged 3-17 years have been diagnosed with depression, with age and poverty levels impacting the odds of treatment. Some of the possible causes of childhood depression include brain chemistry, environmental factors, family history, trauma, etc.

Despite effective treatments, inequitable access means that children may never receive support for their mental health, which may contribute to children with depression having such poor outcomes in adulthood.

Understanding the Research

This longitudinal study assessed the health of 1,420 participants from 11 primarily rural counties of North Carolina and found that depression in childhood was associated with anxiety, depression, financial and educational challenges, and criminality in adulthood.

Children who received specialty mental health treatment for their depression had fewer subsequent anxiety concerns but continued to demonstrate issues with substance use, and other social outcomes.

While this study is representative of a rural community in the southeastern U.S., a limitation is that findings are not generalizable to the entire U.S.

Social Structures Impact Mental Health

Founder and psychotherapist of Nokdu Therapy, Gonji Lee, LCSW, says, "Copeland's study demonstrates how mental health services can potentially transform the course of depression throughout a person's lifetime."

The general mental health field often fails to consider how social structures impact emotional suffering and well-being, but Lee highlights how depression inextricably interacts with the social conditions of a person, such as class, race, gender, sexual orientation, ability, among others.

To elucidate this, Lee asks, "If a person continues to be uncertain whether they will be able to maintain their housing from month to month, or if a person has to fear for their life because they identify as a gender that they were not assigned at birth, then what more can the mental health field pour resources into to address prevalent root causes of emotional distress?"

Gonji Lee, LCSW

If a person has to fear for their life because they identify as a gender that they were not assigned at birth, then what more can the mental health field pour resources into?

— Gonji Lee, LCSW

This is why Lee states that mental health services must work in conjunction with efforts to address underlying social marginalization. "Without doing so, the mental health field runs the risk of gaslighting marginalized communities for having very normal responses to oppressive conditions," they say.

Lee says, "People who are marginalized are not necessarily always depressed or suffering emotionally. While these elements may be strongly linked, people are wildly resilient and have fostered the ability to locate joy and abundance in spite of the many barriers that continue to exist today."

Assessment Needed from Young Ages

Psychotherapist at Providence Saint John’s Child & Family Development Center, Sharon Greene, LCSW, says, "The important piece is knowing the signs of depression in children and adolescents. It’s about caregivers asking their children and adolescents how they’re feeling and being discerning of the response. In addition, systemic screening for depression needs to be instituted in schools and healthcare systems like pediatrician offices."

Sharon Greene, LCSW

It’s about caregivers asking their children and adolescents how they’re feeling and being discerning of the response. In addition, systemic screening for depression needs to be instituted in schools and healthcare systems like pediatrician offices.

— Sharon Greene, LCSW

Caregivers and parents need to grow their awareness of what depression looks like in children and adolescents, as Greene explains that it does present somewhat differently than in adults.

"Some symptoms are similar to adult depression, such as continuous feelings of sadness, difficulty concentrating, loss of interest in extracurricular activities, abandonment of hobbies, social withdrawal, changes in appetite, and altered sleep patterns. There are some major differences such as sudden outbursts, difficulty concentrating, stomachaches, headaches, difficulties at school, problems with friends, general irritability, disruptive behaviors," she says. 

"From my two decades in clinical practice where I provide mental health services to children, adolescents, and adults, I know that treatment significantly helps reduce and can even eliminate depression," Greene says.

"The use of evidence-based practices like Cognitive Behavioral Therapy and Interpersonal Psychotherapy helps my clients build a set of coping skills to deal with depression. Children and adolescents integrate coping skills so they can utilize them at future points when they experience struggle."

What This Means For You

As this research demonstrates, it is crucial to have discussions with children and adolescents about mental health in addition to their physical health to make sure they are feeling supported in all areas. On a larger level, greater efforts need to be made to challenge oppression in society given the impact that can have on the individual mental health of children, adolescents, and adults when marginalized.

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Article Sources
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  1. Copeland WE, Alaie I, Jonsson U, Shanahan L. Associations of childhood and adolescent depression with adult psychiatric and functional outcomesJ Am Acad Child Adolesc Psychiatry. 2021;60(5):604-611. doi:10.1016/j.jaac.2020.07.895

  2. Centers for Disease Control and Prevention. Data and statistics on children's mental health. Updated March 22, 2021.