Child and Adolescent Depression: Different from Adult
If your child has seemed persistently sad, is uninterested in previously enjoyed activities, and seems at the same time to be doing worse in school, it may be more than "just a phase." About 14% of adolescents and 6% of prepubescent children suffer from significant depression.
Depression in children and adolescents manifests itself differently from that in adults. In addition to the symptoms above, children may complain of headaches, stomach aches, or persistent boredom. If you have noticed that your child's school performance is deteriorating, this may be another sign of depression.
Rather than wait and hope that your child is merely passing through a phase, it is probably best to see a mental health professional. Untreated depression can cause unnecessary suffering or in some cases even suicide. Correct Diagnosis:
The first step is to obtain a diagnosis. The same symptoms can be caused by other medical and psychological problems. A mental health professional first must rule out such conditions as sleep disorders, substance abuse, attention deficit disorder, and so forth. If the symptoms do indicate depression, there are varying degrees of severity and duration. Your child may suffer from an adjustment disorder with a depressed mood from dysthymia or from major depression. Bipolar disorder (manic-depressive illness) is rare but also possible in children and adolescents. Both major depression and bipolar disorders have significant genetic components. If there is a family history of depression or bipolar disorders, they are like to surface in childhood or adolescence.
Treatments:
Pharmacologic treatment of adult depression has improved dramatically in the past two decades, and antidepressant drugs have been successful for adults. Unfortunately, antidepressant medication seems to be less successful for depressed children and adolescents.
This may be because neural pathways are still immature, or because chemical balances are different during adolescence. Currently, physicians prescribe antidepressant medications on a case-by-case basis, and some youth do seem to benefit from them.
Active and focused talk therapy seems to be most successful with depressed children and adolescents. A therapist can address your child's distorted thinking and self-impressions, such as feelings of hopelessness, helplessness, worthlessness, or a combination of perfectionism and low self-esteem.
Because children and adolescents are so dependent on adults for caretaking, the therapist may wish to assess your child's home environment. This could mean that the therapist may look for abuse, neglect, family conflict, and school difficulties. As a result, the therapist will more than likely want to discuss your child or adolescent with each parent.
Severe depression in childhood or adolescence is frequently a chronic and recurrent disorder. As many as 70% of school-aged children treated for major depression will have a recurrence of depressive symptoms within five years.
However, most depressed children and adolescents respond to various combinations of psychotherapy, family therapy, pharmacological treatment, and environmental improvement. As with most psychiatric disorders, earlier diagnosis and treatment is associated with faster and more complete recovery.