Depression Across Development

How the same vulnerability takes new shapes from childhood to adolescence.

When we picture childhood depression, it’s easy to imagine a miniature version of adult sadness: tears, isolation, and despair. But depression in children doesn’t just scale down; it transforms. What it looks like before puberty can be very different from how it shows up after.

This shift tells us something profound about how emotional disorders develop: they grow and change with the child. Understanding these changes is key to identifying early signs that might otherwise be missed, and to supporting kids before patterns become deeply rooted.

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Key Concepts

Depression: A mood disorder involving persistent sadness, loss of interest, or irritability, along with physical or cognitive changes (e.g., sleep, appetite, or concentration problems).

Puberty: The developmental period marked by hormonal, physical, and brain changes that prepare the body for reproduction and reshape emotional processing.

Heterotypic Continuity: When the same underlying vulnerability (like a tendency toward depression) shows up in different ways across development. The form changes, but the function (the core emotional dysregulation) remains.

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Research Spotlight

Developmental psychopathology reminds us that no disorder exists outside of development. As Sroufe and Rutter (1984) explained, only by understanding the developmental process (with its constant reorganization and adaptation) can we understand how early experiences shape later disorder.

• Before puberty, depression tends to appear as behavioral symptoms (e.g., acting out, losing interest in play, clinginess, or being unusually tired or tearful) rather than overt sadness.

  • Classic work by Kovacs and Devlin (1998) and later reviews by Angold, Costello, & Erkanli (1999) highlight that prepubertal depression often blends with anxiety and oppositional behavior, making it harder to detect and blurring diagnostic lines.

• After puberty, the picture shifts.

  • Depression begins to look more like the internalized, cognitive pattern familiar in adults (e.g., feelings of worthlessness, hopelessness, and guilt).

    • Rates tend to rise dramatically, particularly for girls (Hankin et al., 1998; Hyde et al., 2008). The hormonal shifts of puberty interact with changes in brain regions like the amygdala (emotional center) and prefrontal cortex (regulatory center).

    • These biological changes, paired with growing self-consciousness and social comparison, mean teens experience and interpret their feelings in more self-referential ways (Forbes & Dahl, 2012; Natsuaki et al., 2009).

  • Basically, what’s happening is a reorganization of symptoms, not discontinuity.

• Depression not some fixed entity, but is a process that unfolds through interactions among biology, emotion, and environment (Cicchetti & Toth, 1998; Cicchetti, 2016).

  As children mature, so do the ways their vulnerabilities are expressed.

• A recent review of continuity patterns in psychopathology found that heterotypic continuity best captures the course of depressive symptoms: the same underlying risk taking on new forms as children age (Speranza et al., 2023).

So, while a moody 8-year-old and a withdrawn 15-year-old might not seem to share the same struggle, research suggests they might share the same underlying risk profile just showing up differently with age.

Together, these findings paint a developmental arc: the child’s body, brain, and social world change, so the depression does too.

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Why This Matters

Recognizing how depression evolves over time isn’t just theoretical. It’s transformative for how we notice and respond to distress in kids.

When adults expect depression to always look like sadness, they risk missing it in children who show frustration, clinginess, or somatic symptoms instead. Teachers might label a child as defiant when they’re actually distressed. Parents might assume a teen’s withdrawal is just “typical adolescence” when it’s something deeper.

Understanding developmental expression also guides treatment and prevention.

• For younger children, approaches that strengthen parent–child connection and emotional language can be most effective.

• For adolescents, therapy that targets cognitive patterns and social meaning-making becomes critical.

When we understand that depression develops with the child, we stop chasing symptoms and start supporting growth.

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Long Story Short

Depression doesn’t stay static — it grows up with the child. Before puberty, it’s often hidden behind irritability, somatic complaints, or behavior changes. After puberty, it takes on a more recognizable emotional and cognitive form. Recognizing these shifts helps us identify and support struggling children earlier and more effectively.

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Quick Takeaways

• Depression changes form across development. In kids, it may look like irritability or physical complaints; in teens, it’s more internalized sadness or self-criticism.

• Puberty is a turning point. Hormonal, cognitive, and social changes reshape how emotions are experienced and expressed.

• Early signs are often missed. Many “behavior problems” in children are actually early signs of mood disturbance.

• Heterotypic continuity matters. The same underlying vulnerability can take different forms over time, but it’s still depression.

• Understanding development means understanding hope. If depression develops, it can also redevelop toward resilience, connection, and healing.

Have you noticed a shift in how your child (or a student you work with) expresses sadness or frustration as they’ve grown? What changed in how they showed it or how you saw it?

Development Decoded is built on a simple belief: science should be clear, practical, and accessible to anyone who cares about kids. I write, research, and create resources outside of my day job and family life to make that happen. If you’d like to help fuel the work, you can now do so with one coffee at a time.

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References

Angold, A., Costello, E. J., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40(1), 57–87.

Cicchetti, D. (2016). Socioemotional, personality, and biological development: Illustrations from a multilevel developmental psychopathology perspective on child maltreatment. Annual Review of Psychology, 67, 187–211.

Cicchetti, D., & Toth, S. L. (1998). The development of depression in children and adolescents. American Psychologist, 53(2), 221–241.

Forbes, E. E., & Dahl, R. E. (2012). Research Review: Altered reward function in adolescent depression. Journal of Child Psychology and Psychiatry, 53(1), 12–24.

Hankin, B. L., Abramson, L. Y., Moffitt, T. E., Silva, P. A., McGee, R., & Angell, K. E. (1998). Development of depression from preadolescence to young adulthood: Emerging gender differences in a 10-year longitudinal study. Journal of Abnormal Psychology, 107(1), 128–140.

Hyde, J. S., Mezulis, A. H., & Abramson, L. Y. (2008). The ABCs of depression: Integrating affective, biological, and cognitive models to explain the emergence of the gender difference in depression. Psychological Review, 115(2), 291–313.

Kovacs, M., & Devlin, B. (1998). Internalizing disorders in childhood. Journal of Child Psychology and Psychiatry, 39(1), 47–63.

Natsuaki, M. N., Biehl, M. C., & Ge, X. (2009). Trajectories of depressed mood from early adolescence to young adulthood: The effects of pubertal timing and adolescent dating. Journal of Research on Adolescence, 19(1), 47–74.

Speranza, A. M., Liotti, M., Spoletini, I., & Fortunato, A. (2023). Heterotypic and homotypic continuity in psychopathology: A narrative review. Frontiers in Psychology, 14:1194249. doi: 10.3389/fpsyg.2023.1194249.

Sroufe, L. A., & Rutter, M. (1984). The domain of developmental psychopathology. Child Development, 55(1), 17–29.