Even kids get depressed
June 7, 1999
Web posted at: 8:58 AM EDT (1258 GMT)
By Pat Carolan
(WebMD) -- Depression is a psychiatric disorder characterized by a profound and long-lasting sadness or despair. It affects approximately 18 million people in the United States every year -- and not all of them are old enough to vote.
"First-graders can and do get depressed," says Dr. James C. MacIntyre, associate professor of psychiatry at Albany Medical College in New York. "It's not a common thing, but kids in the early grades experience significant depression." And on even rarer occasions, preschoolers show signs of depression. A child who stops playing with friends, frequently complains of stomachaches or headaches or is considered a "troublemaker" may actually be depressed.
How prevalent is childhood depression?
At any time, approximately 5 percent of children and adolescents are experiencing a depression, with the percentage increasing with age. During childhood the number of boys and girls is the same. But in adolescence girls outnumber boys 2-to-1, a ratio that continues into adulthood.
However, not all children and teens have the same risk of developing a depressive disorder. Children with a family history of depression have a greater chance. So do children who are stressed, who have experienced loss, such as of a parent or someone with whom they were close, or who have attention, learning, conduct or anxiety disorders.
What should parents look for?
Childhood depression resembles adult depression, but there are some differences. "Children before puberty typically complain about physical aches and pains, not feeling well, being tired," says MacIntyre. "They rarely say 'I feel depressed.' Many of them might not even say they're sad. They just know they don't feel well."
Depressed adolescents look more like depressed adults. They are frequently irritable, sullen, withdrawn. "It becomes harder for people to see what's going on with adolescents," continues MacIntyre. "They think it's just normal adolescent behavior, whereas it's something more significant."
Additional warning signs may include:
changes in eating and/or sleeping patterns
loss of interest in activities that were formerly enjoyed
loss of energy
low self-esteem, feelings of guilt
inability to concentrate, indecisiveness
difficulty with relationships, social isolation
frequent absences from school, poor school performance
feelings of hopelessness and helplessness
recurring thoughts of death and suicide, harming oneself
How serious is it?
Depression is not just a phase that a child or teen is going through; it's a real psychiatric disorder and is as serious as adult depression.
Young people who experience self-injurious or suicidal thoughts are more vulnerable to acting on those thoughts because they don't fully comprehend the consequences of their actions. And depressed adolescents may abuse drugs or alcohol in an attempt at feeling better.
Adolescents also may start engaging in anti-social or delinquent behavior. They're depressed, angry, unhappy about things, and they act out. "Whenever a kid who hasn't done these things before starts engaging in anti-social behavior, parents should check to be sure he isn't depressed and his behavior is one manifestation of it," says MacIntyre.
What about treatment?
Treatment often includes both individual and family psychotherapy. Individual counseling and therapy helps kids understand what they are feeling bad about. "Many of these kids, because they're depressed, may develop poor self-esteem -- feeling bad about themselves, their abilities to be successful in school, have friends," continues MacIntyre. "Always walking around with doom and gloom feeds on itself and it's self-defeating. Therapy trains them not to think depressing thoughts and scenarios."
Families also need help understanding what's going on. They need support and they need guidance about how to interact with their children.
Treatment may also include the use of antidepressant medication. However, according to MacIntyre, some of the medications that are successful in treating adolescents and adults are not especially effective in younger children.
There's a high success rate in the treatment of depression in children and adolescents, particularly if diagnosed early. If a child exhibits behaviors that are symptomatic of depression, parents should contact a mental-health practitioner. However, young children with physical complaints should first be seen by their primary-care provider to rule out another physical basis for the complaints. The important thing is not to wait for whatever it is to go away spontaneously.
Copyright 1999 by WebMD, Inc. All rights reserved.
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