Symptoms of Childhood Depression

The symptoms of depression in children can be very different than in adults. Learn about depression in children and how parents can help.

It was long believed that the tumultuous moods of the teenage years were "normal", but we now understand that excessive irritability, moodiness, sleep and appetite change may signal vulnerability to depression. (Pine et al. 1999) Common symptoms of adolescent depression are irritability, hopelessness, an inability to experience pleasure from normally pleasurable life events, changes in sleep and appetite, academic decline, reduced energy, reduced social interactions, somatic symptoms, and suicidal ideation.

And unlike adults, most children deny rather than admit depression. Symptoms of depression vary with the developmental stage of the child.

Sadness and depression in children may be expressed through temper tantrums, boredom, low self-esteem, lack of motivation, and deterioration in school work. Sleep and eating problems may be expressed either way, too much or too little sleep and poor appetite or overeating.

Depressive symptoms may be acute (major depressive disorder), chronic (dysthymic disorder), or in response to a triggering life event (adjustment disorder with depressed mood). Also, normal grief symptoms that continue past two months and lead to impairment at school or home require intervention.

Treatment of Childhood Depression

• Don't ignore the symptoms of childhood depression. It's very important to seek professional treatment (a child psychologist, child psychiatrist) if you think your child is depressed. The earlier, the better to prevent deterioration in the child's functioning and recurring depressive episodes.
• For mild depression, psychological therapy alone should do. More serious depression may require antidepressant medication in combination with psychological therapy. While antidepressants have proven effective in children, the FDA has warned parents to be aware of suicidal thoughts and behaviors during antidepressant treatment; especially during the start of antidepressant medication. Parents should work with the mental health professional to observe symptoms and behavior when the child is taking antidepressant medication.

Suggestions for Helping Your Depressed Child

• Keep a resource folder to organize your child's assessment and treatment records. Include practical information such as appointments, names and numbers, and insurance records. Be proactive in your child's treatment by utilizing simple behavior, mood, and symptom logs (mood charts) to record your child's progress. When you see a helpful article or handout related to your child's disorder, print or cut it out and keep it in your folder.
• Look for environmental factors that may be related to the child's depression. Address issues of grief and loss, marital discord, alcohol or drug abuse in your family, or your own mental health problems. Other environmental conditions that are related to childhood depression are physical or sexual abuse, changes in primary caregiver, ongoing problems with learning or peer interaction, and disruption of family housing or employment. Seek counseling for yourself and your child when these environmental issues are present in your family life.
• Build social support systems for your child and your family. Find ways to spend more time with your child; she/he needs your steady presence and support. Encourage their participation in group activities that are led by a caring adult. Some examples might be church groups, child support groups, Scouts, after-school sports and recreation groups. Talk to your child's teacher or school counselor about their condition, and enlist their support to encourage and motivate your child.
• Help your child understand that depression is not forever. Talk about her/his feelings, and counteract hopeless thoughts and negative beliefs with encouragement and reality-testing. Find ways to build self-esteem and sense of competence to lead the way out of a depressive episode or chronic dysthymic disorder.

Parents should keep in mind though that relapses are common and almost one-half of the children diagnosed with depression are likely to suffer a relapse over a five-year follow-up period. Young people who suffer from depression are also likely to suffer from depression during their adult lives. Therefore, depression could continue or reappear between childhood and adulthood.

Sources:

• University of Michigan, "Facts about Depression in Children and Adolescents", Oct. 2007.
• NIMH
• About.com Parenting of K-6 Children