Depression

Depression is not a character weakness. And it’s not just a passing phase. It’s a real illness that can be diagnosed and treated effectively. 

What is Depression? 

Depression is a common and serious form of childhood mental disorder. It is more severe than normal sadness. It can interfere with a child's energy, concentration, sleep, and appetite. And it can go on for weeks, months, or even longer.

Clinical depression in children includes several disorders:

Major depressive disorder, where children have feelings of overwhelming sadness or irritability, worthlessness, and guilt. They lose interest in activities that once gave them pleasure. They are frequently bored. They may complain of physical problems, such as stomachaches or headaches.

Disruptive mood dysregulation disorder, where children are mostly irritable for a long time. Often their behavior is out of control. They may also have other disorders, such as Oppositional Defiant Disorder (ODD), Attention-Deficit/Hyperactivity Disorder (ADHD) or an anxiety disorder.

Persistent depressive disorder (dysthymia), which resembles major depressive disorder, but the symptoms are not usually as intense. However, they may last a year or longer.

Up to three percent of children and up to eight percent of adolescents suffer from depression. Fewer than half of those afflicted receive the treatment they need.

Depression is not a character weakness. And it’s not just a passing phase. It’s a real illness that can be diagnosed and treated effectively. 

What Symptoms Should Parents Look for?

The symptoms of depression in children can be subtle at first. They may occur suddenly. Or they may happen slowly over time. It can be hard to recognize that your child might have depression.

Signs and symptoms of depression in children include:

  • Sadness.

  • Irritability.

  • A marked change in appetite.

  • Sleeping too little at night or too much during the day.

  • Loss of interest in activities, friends or family.

  • Fatigue.

  • Feeling slowed down or "burned out."

  • Excessive feelings of guilt and low self-esteem.

  • Inability to concentrate.

  • Indecisiveness.

  • Decline in school performance.

  • Feelings of hopelessness and helplessness.

  • Inappropriate sexual activity.

  • Physical complaints (stomachaches, headaches).

  • No longer wanting to be with family and friends.

  • Recurring thoughts of death and suicide.

Any of these signs can be found on occasion in children who are not depressed. When seen together, nearly every day, they are red flags for depression.

Family members and friends should take all suicide threats or attempts seriously.

Adolescents and teens who are thinking about suicide might:

  • Talk about suicide or death in general.

  • Give hints that they might not be around anymore.

  • Talk about feeling hopeless or feeling guilty.

  • Pull away from friends or family.

  • Write songs, poems, or letters about death, separation, and loss.

  • Start giving away treasured possessions to siblings or friends.

  • Lose the desire to take part in favorite things or activities.

  • Have trouble concentrating or thinking clearly.

  • Experience changes in eating or sleeping habits.

  • Engage in risk-taking behaviors.

  • Lose interest in school or sports.

Suicide among teens often happens after a stressful life event. It could be triggered by problems at school, or a breakup with a boyfriend or girlfriend. Or by the death of a loved one, a divorce, or even a major family conflict.

What Causes Depression in Children?

Doctors do not know exactly what causes depression. Physical disorders, life experiences, and heredity can contribute.

There is evidence that children whose parents have depression are at a greater risk of being depressed.

A child’s risk for becoming depressed may increase with stress or having gone through an experience of devastating loss or trauma. Behavioral problems and other mental disorders – for example, conduct, attention-deficit, learning, anxiety, and substance abuse disorders — frequently occur with depression and may help explain its onset. A family history of bipolar disorder is another significant risk factor.

How is Depression Diagnosed?

To diagnose depression, doctors rely on several sources of information, including an interview with the child and information from parents and teachers. Sometimes doctors use structured questionnaires to help distinguish depression from a normal reaction to an unhappy situation.

A diagnostic evaluation for depression will normally include:

  • A complete history of symptoms to determine how long and how often they have been present
  • Questions about any thoughts of death or suicide
  • Inquiries about any family history of depression and other mental illnesses
Doctors try to find out whether family or social stresses may have precipitated the depression. They may do tests to determine whether a physical disorder is the cause.

How is Depression Treated?

Treatment for depression usually centers around professional counseling and medication. It also may include education about depression for your child and your family.

For adolescents, a combination of psychotherapy and antidepressants is usually most effective. For younger children, psychotherapy alone is usually tried first.

When Should you Seek Help for Children with Depression?

Depression can get better. But without the right attention and care, it can continue. Or get worse.

If you think that your child may have symptoms of depression, seek professional help soon. The best time to start is now. Early intervention is critical. And if the signs of depression are there, waiting for your child to grow out of these behaviors is probably wishful thinking.

If you’re not sure where to start, start with your family physician or your child’s pediatrician. The doctor will probably do a complete physical exam to make sure there isn’t another heath condition that is causing depression-like symptoms.

If the doctor thinks your child has depression, he or she should be able to refer you to a mental health specialist for evaluation and treatment.