Lori Carraway, Ph.D.
- WSU Cooperative Extension, Snohomish County
The scientific literature on diagnosis and treatment of
children/adolescents with depression is much more limited than that concerning adult
depression. It is also very new, only 4-5 years old. Signs of depression in young people
are often viewed as normal mood swings, typical of the child’s developmental stage.
Among both children and adolescents, depressive disorders indicate an increased risk for
illness and psychosocial troubles.
- a number of recent studies indicate that up to 2.5% of children and 8.3% of adolescents
in the US suffer from depression.
- research indicates that the onset of depressive disorders is occurring earlier in life
than in past decades and that depression in youth may persist into adulthood and/or
reoccur more severely in adulthood
- depression is associated with suicide.
- in 1997, suicide was the third leading cause of death in 10- to 24-year olds.
- when depression is suspected, the person should be referred to a physician or mental
health specialist for assessment and treatment.
- depression may co-exist with other difficulties such as ADHD, ADD, conduct disorder,
learning disorders, etc.
Symptoms of Major Depressive Disorder
Common to Adults, Children and Adolescents
Five or more of the following symptoms must be present for 2 weeks or
more for a diagnosis of major depression can be made:
- persistent sad or irritable mood
- loss of interest in activities once enjoyed
- significant change in appetite or body weight
- difficulty sleeping or over-sleeping
- psychomotor agitation or retardation
- loss of energy
- feelings of worthlessness or inappropriate guilt
- difficulty concentrating
- recurrent thoughts of death or suicide
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The ways in which symptoms are expressed depend on the child’s developmental
stage. Young people, especially young children, have trouble identifying and describing
their internal emotional states or mood states. Instead, they may act out in ways that are
simply interpreted as misbehavior – e.g., irritability toward others; refusal to eat;
slow movement, stalling, being distracted when an adult wants a task completed, consistent
crying/whining, excessive thumb-sucking.
Behaviors Associated with Childhood and Adolescent Depression
- frequent vague physical complaints such as headaches, muscle aches, stomach aches,
tiredness
- frequent school absences or poor performance in school
- talk of or efforts to run away from home
- outbursts of shouting, complaining, unexplained irritability or crying excessively
- being bored
- lack of interest in playing with friends
- giving away prized possessions
- fear of death
- social isolation, poor communication
- alcohol or substance abuse
- extreme sensitivity to rejection or failure
- increased irritability, anger or hostility
- reckless behavior
- difficulty with relationships
Risk Factors Associated with Childhood and Adolescent Depression
- boys and girls are at equal risk in childhood, but in adolescence, girls are twice as
likely to develop depression
- there appears to be a stronger familial link with childhood depression – one is
more likely to become depressed if there is a family history of the disorder (e.g., a
parent was depressed at an early age) -- than in adolescent depression
- stress
- cigarette smoking
- loss of a parent or loved one
- break-up of a romantic relationship
- attentional, conduct or learning disorders
- chronic illness, such as diabetes or hemophilia
- abuse or neglect
- other trauma, including natural disasters
- there is some initial evidence that erratic cortisol levels, as per salivary testing,
may be indicative of depression – especially among unattached infants and/or young
children who have been exposed to extreme and unpredictable stress.
