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Depression in Adolescents and Children

by Kathy A. Wright, Psy.D.

Depression occurs not only in adults, but in adolescents and children as well.  Approximately five percent of adolescents and children experience depression at any given point in time.  Depressed adolescents and children are at an increased risk for committing suicide.  Depressed adolescents may turn to abusing alcohol or other drugs as a way to feel better.  The good news is that depression is a treatable illness.  It is highly responsive to treatment when recognized early and diagnosed accurately.

Depression may manifest differently in adolescents and children than it does in adults.   For example, younger children may experience symptoms of depression by having a poor appetite and/or weight loss, clinging behaviors, nightmares, not enjoying playing as much as usual, feeling sad or hopeless, frequent crying, and/or worrying more than usual.  While older children and adolescents may experience symptoms of depression as feeling anxious or having difficulty focusing on tasks, changes in appetite (eating more or less than usual), complaining of feeling sick often, preoccupation with nihilistic song lyrics, changes in sleep habits, talking of or attempting to run away from home, being angry and acting out or losing their temper more than usual, being irritable, low energy, not wanting to go to school or other social activities, feelings of guilt, thoughts of or expressions of suicide or self-destructive behavior, and/or seeming less confident or feeling like they can’t do anything right. 

While some of these behaviors are common in adolescents and children who are not depressed, in non-depressed adolescents and children, they usually do not last long, maybe four to six weeks and do not occur most of the day, nearly every day.  Parents should become concerned when the symptoms appear to impact more than one area of the adolescent’s or child’s life rather than just one part of his or her life and do not become lessened or go away with practical parental interventions.  To be given a diagnosis of depression, these symptoms would occur most of the day, nearly every day for over a two-week period, represent a change in previous functioning, and at least one of the symptoms would be depressed or irritable mood or markedly diminished interest or pleasure in most activities nearly every day for the majority of the day. 

Adolescents and children who are experiencing symptoms of depression should seek treatment when the feelings persist and interfere or cause significant distress with an adolescent’s or child’s ability to function.  Young people may be depressed for many reasons, such as stress, health conditions, changes in family life or friendships, life transitions, parental conflict, maternal depression, difficulties in school, poor social skills, trauma, or loss.  Additionally, depression tends to have a biological basis, tending to run in families.  Our genes may predispose us to depression, but this predisposition is most often impacted by life events that may lead to depression.  Adolescents and children who have attentional, learning, conduct, substance abuse, or anxiety disorders are at a higher risk for depression.

If you are concerned that your adolescent or child may be depressed, you should seek out a professional such as a psychologist, therapist, or counselor who will do an intake evaluation with you and your adolescent or child to determine if treatment is needed.  Treatments for depression are well-defined and effective for the majority of those suffering from the illness.  Two specific forms of psychotherapy have been validated as being effective in treating depression in youth:  cognitive behavioral therapy and interpersonal therapy.  Some treatment regimens will combine psychotherapy with antidepressant medications which target chemical imbalances in the brain that are associated with depression.  A consultation with your child’s pediatrician or a child psychiatrist would be needed if it is determined that medication is warranted.