Internalizing Behaviors and Depression in Children

Internalizing behaviors are common among depressed children. These behaviors are quiet and often invisible because they are internalized and are generally not disruptive to others, unlike externalizing behaviors.

Examples of internalizing behaviors are:

• Being withdrawn
• Feeling sad
• Feeling lonely
• Being nervous or irritable
• Not talking 
• Headaches, stomachaches and other physical symptoms that are not related to any physical illness
• Having concentration problems
• Feeling afraid
• Feeling unloved or unwanted
• Sleeping more or less than usual
• Eating more or less than usual

These behaviors are similar to those of depressed children but do not necessarily mean your child is depressed.

A child with internalizing symptoms keeps her feelings inside, which may manifest itself in such symptoms as:

• Unexplained physical symptoms
• Social withdrawal
• Suicidal thoughts or behaviors

Due to the quiet nature of internalizing symptoms, children may not receive treatment as quickly as those with more disruptive or externalizing symptoms. In fact, because they are often disruptive and noticeable to others around them, externalizing symptoms in children have received quite a bit more attention and research than those of internalizing symptoms, but that is starting to change.

In general, girls display more internalizing symptoms than boys do.

Not all children with internalizing symptoms are depressed. In fact, internalizing symptoms are often associated with anxiety disorders and somatization disorder as well.

However, it is generally thought that a child who displays internalizing symptoms but does not yet meet the criteria for depression is at a much higher risk of developing it in the future.

If your child is showing internalizing symptoms, especially if the symptoms seem severe, talk to a mental health professional, as they may be a sign of depression or an indication of future mental illness.

Depression in children is usually treated with either medication, psychotherapy, or a combination of both. Your mental health professional or pediatrician will work with you and your child to come up with the best-individualized treatment plan for her.

Often, figuring out the best treatment for your child can take some trial and error, so try to be patient as you collaborate with your mental health professional to decide what works best for your child.

Like depression, anxiety is also treated with either medication, psychotherapy, or some combination of both. Some kids have both depression and an anxiety disorder, but your mental health professional can determine if this is the case with your child. 

No one knows exactly what causes depression or anxiety, though there seem to be multiple potential causes. Studies have shown that genetics may play a part, so if you have a close relative with an anxiety disorder or depression, your chances are higher of developing it too.

There also seem to be differences in the way people with anxiety and depression process certain brain chemicals that lead to mood stabilization. The environment can also trigger anxiety or depression in someone who has the genetic predisposition already.