Depression

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Depression is a serious mood disorder that can interfere with a child or adolescent's ability to function. It is normal for a child to feel moody or sad from time to time; however, if these feelings last for weeks or months, they may be a sign of depression.

2% of young children and 8% of adolescents have serious depression. Children under stress, who experience a loss, or who have attention, learning, conduct or anxiety disorders are at a higher risk for depression. Depression also tends to run in families.

Depression may not look the same in a child as in an adult. If one or more of these signs of depression are present for 2 weeks or more, parents should seek help:

• Frequent sadness, tearfulness, crying
• Not as interested in activities; or not able to enjoy previously favorite activities
• Hopelessness
• Persistent boredom; low energy
• Social isolation, poor communication
• Low self-esteem and guilt
• Extreme sensitivity to rejection or failure
• Increased irritability, anger, or hostility
• Difficulty getting along or connecting with others
• Frequent complaints of physical illnesses such as headaches and stomachaches
• Frequent absences from school or poor performance in school
• Poor concentration
• Too much or too little eating and/or sleeping
• Talk of or effort to run away from home
• Thoughts or expressions of suicide or self-destructive behavior

The symptoms may be different depending on how old the child is.

Both very young children and grade school children may lack energy and become withdrawn. They may show little emotion, seem to feel hopeless, and have trouble sleeping. Often they will lose interest in friends and activities they liked before. They may complain of headaches or stomachaches. A child may be more anxious or clingy with caregivers. Teens may sleep a lot or move or speak more slowly than usual. Some teens and children with severe depression may see or hear things that aren't there (hallucinate) or have false beliefs (delusions). Children and adolescents who cause trouble at home or at school may also be suffering from depression. Because the child may not always seem sad, parents and teachers may not realize that troublesome behavior is a sign of depression. When asked directly, these children can sometimes state they are unhappy or sad.

Why is depression a concern?

Depression can range from mild to severe. In its most severe form, depression can cause a child to lose hope and want to die. Depressed children and adolescents are at increased risk for committing suicide. Depressed adolescents may abuse drugs or alcohol as a way of trying to feel better.

Diagnosis/evaluation

To diagnose depression, a doctor may do a physical exam and ask questions about your child's past health. You and your child may be asked to fill out a form about your child's symptoms. The doctor may ask your child questions to learn more about how he or she thinks, acts, and feels.

Some diseases can cause symptoms that look like depression. The child may have tests to help rule out physical problems, such as a low thyroid level or anemia. It is common for children with depression to have other problems too, such as anxiety, attention deficit hyperactivity disorder (ADHD) or an eating disorder. The doctor may ask questions about these problems to help your child get the right diagnosis and treatment.

Treatment offers hope

Individual and/or family therapy has been shown to be effective in treating depression. Treatment may also include the use of antidepressant medication.

When to seek help

If one or more symptoms of depression are present for 2 weeks or longer, parents should seek help.

Long-term outlook for depression

Depression is a treatable illness. However, depression may affect a young person's performance at school or work and their interactions with family and friends. If depression goes undiagnosed, it is associated with increased risk of suicide and depression in adulthood.

How to live with depression

• Encourage your child to get regular exercise, spend time with supportive friends, eat healthy foods, and get enough sleep
• See that your child takes medicine as prescribed and goes to all follow-up appointments
• Make time to talk and listen to your child. Ask how he or she is feeling. Express your love and support.
• Maintain contact with others, both friends and adults
• Remind your child that things will get better in time. Depression causes the false belief that they will never get better

Treatment length

Your child may start to feel better after 1 to 3 weeks of taking antidepressant medicine. But it can take as many as 6 to 8 weeks to see more improvement. Make sure your child takes antidepressants as prescribed and keeps taking them so they have time to work.

Additional References:

The American Academy of Child and Adolescent Psychiatry. (2013, July). Facts for Families; Depression in Children and Teens. Retrieved from www.aacap.org.

Depression in Children and Teens – Topic Overview. (2014, November 14). Retrieved from www.webmd.com.