Depression in Children and Adolescents

Editor Review by : Alex Sam

Depression is a widespread illness among children (less than 18 years). Approximately 5% of children at any one time may experience from serious depression. Depression grow up with age, especially after the onset of teens. There is no gender related distinction in the prevalence of depression among pre-adolescent children. However, onset of puberty is connected with a marked increase in the rate of depression among females, with a female to male ratio of 2:1. The prevalence of depression may be higher in children with other psychiatric disorders (ADHD, conduct disorder, eating disorders, anxiety disorders) and in those with general medical conditions (diabetes, asthma, cancers and other chronic illnesses). The prevalence may also be higher among children with developmental disorders and mental retardation.

It is often during adolescence that depression first demonstrates itself in girls, and for the first time girls outnumber boys 2:1 in prevalence of the illness. It is expected that 4.7% of the teenage population suffers from depression. It was long believed that the disruptive moods of the teenage years were “normal”, but we now recognize that unnecessary irritability, moodiness, sleep and appetite change may signal a vulnerability to depression. Common symptoms of adolescent depression are irritability, hopelessness, anhedonia, modifications in sleep and appetite, academic declination, reduced energy, reduced social interactions, somatic symptoms, and suicidal ideation. We also know that more minor symptoms which might not meet full criteria for Major Depressive Disorder (subsyndromal illness) may influence girls to full blown episodes later in life. Numerous factors may predispose adolescent girls to depression. These include the increase in hormones associated with puberty, changes in body shape and rising sexual identity, family stressors such as divorce and peer pressure. Disconnection connected with leaving for college is another stressor which may predispose to depression. Adolescents who develop depression often have recurrences in adulthood and a more severe course. Early detection is essential to minimize recurrences and morbidity from the illness.

Symptoms of depression in children

Contrasting to adults, a good number of children reject rather than admit depression. Symptoms of depression diverge with the developmental stage of the child. Denial of symptoms, aggression, excessive crying, and physical symptoms may be more common among preadolescent children. Common symptoms of depression among adolescents and older pre-adolescent children include irritability, withdrawal, isolative behavior, loss of interest and/or pleasure in previously enjoyed activities, sleep disturbance (reduced or increased sleep), changes in appetite (reduced or increased appetite), and reduced energy. Physical symptoms such as chronic headaches or stomach aches which cannot be attributed to a physical illness, are common among children with depression. A large sum young people with depression go through from academic decay. Some youngsters may use street drugs and alcohol in an effort to lessen their depression. Variance with authority may result from irritability. Atypical symptoms such as excessive sleep, increased appetite, an extreme sensitivity to rejection, and irritability are more common among children than among adults. In the most severe forms of depression, distortions of reality such as and may be noted.

Suicide and depression in children

Depression in children is connected with a pregnant personal loss and a negative impact on the society. One of the most serious outcomes of depression is suicide. Majority of the children who endeavor or reflect suicide are likely to suffer from depression. Prompt classification and treatment of depression is important. Untreated depression may lead to failure to achieve full academic potential, disruption of key relationships within and outside the family, loss of self esteem, and self-harmful behaviors which may include drug use, risk taking behaviors, and suicide.

Treatment choices for children with depression

Depression in children can be effectively treated with a combination of psychotherapy and antidepressants. Mild depression may be treated with psychotherapy alone. More serious depression requires an antidepressant medication. Many safe and effective antidepressants are currently available. For the treatment to be fully effective, it is critical that the treatment should continue for several months, or longer. However, 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, continuity of illness between childhood and adult forms of depression is noteworthy.

Comprehensive treatment of a depressive episode is likely to prevent short-term sequelae (self-harm, academic failure) and prevent long-term negative outcomes (disruption of key relationships, impairment of problem-solving skills, a heightened vulnerability to loss). However, patients and their families should be aware that relapses are common and require prompt professional attention.