Depression in Children & Teens Is Treatable
According to the National Institute of Mental Health (NIMH), about 11 percent of children and adolescents in the United States develop a depressive disorder before the age of 18. In young children, depression incidence is similar in girls and boys, but after puberty, the condition occurs twice as often in women.
It's important to take childhood depression seriously. If you notice a change in your child's personality or behavior, or a teacher or other caregiver indicates that the child "doesn't seem to be him- or herself," contact your pediatrician. If you suspect your child may be depressed, the first step is to get an accurate diagnosis.
"Typical" behaviors varyfrom child to child and from one childhood stage to the nextand depression symptoms often change as the child's brain develops; therefore, it can be difficult to determine whether a child is going through a temporary "phase," or he/she has a depressive disorder. In general, symptoms that last more than 2 weeks and interfere with your child's daily life may indicate a depressive disorder.
Childhood depression can be classified as major depressive disorder or dysthymia. Major depression may occur throughout your child’s lifetime, with each episode lasting at least 2 weeks. Dysthymia is less severe but chroniclasting 2 years or longer.
Childhood Depression Symptoms
Children who are depressed may pretend to be sick and refuse to go to school. They may develop intense, unreasonable fears, and become unusually clingy. Older children and adolescents may develop problems at school and exhibit changes in personality and behaviorbecoming extremely anxious, sensitive, irritable, angry, or withdrawn; feeling hopeless, misunderstood, worthless or inadequate, for example.
Unusual behavior and other signs to look for include the following:
- Appetite changes (loss of appetite or eating more than usual)
- Changes in sleep patterns (staying up late, sleeping in, inability to sleep, sleeping too much)
- Fatigue, lack of energy
- Frequent crying, sadness
- Headaches, stomachaches, or other symptoms that occur without a physical cause
- Loss of interest in activities and hobbies
- Problems concentrating or focusing
- Social withdrawal or isolation
- Thoughts about death or suicide
Childhood Depression Diagnosis & Treatment
After ruling out a physical cause for symptoms of depression, your child’s doctor may suggest a psychological evaluation by a mental health provider who specializes in the treatment of children. If your child is diagnosed with a depressive disorder, the next step is to work with his/her health care team to develop a course of treatment.
Early diagnosis and treatment improves the prognosis (expected outcome) for children with depression. Without proper treatment, the condition often relapses. Treatment often takes 6 months or longer. In children and teens, the consequences of a lengthy recovery may be significantkids may be required to repeat a grade in school, or may find they no longer "belong" in their social group of friends.
In many cases, a combination of psychotherapy and medication is most effective. Mental health care providers assess the severity of the conditionin children, adolescents, and adults with depressionbefore prescribing medication(s). Successful treatment can make a significant improvement in the child's quality of life.
Fluoxetine (Prozac) is approved for use in children 8 years of age and older, and escitalopram (Lexapro) is approved for adolescents 12 years of age and older. According to the U.S. Food and Drug Administration (FDA), these medications are approved to treat depressionand not just to treat behavioral problems associated with the condition. Please note that several antidepressants used to treat depressive disorders in adults have not been approved for children and teens.
Antidepressants carry a boxed warning due to the risk for suicidal thinking and behavior in children and adults 24 years of age and younger. Children and teens who take antidepressants should be monitored closely for suicidality.
Young people with depression not diagnosed as a chronic condition may be able to discontinue taking antidepressant medication after a period of stability. Antidepressants must be tapered slowlygradually reducing the dosageto prevent serious effects like agitation, irritability, and severe mood disturbances.
Childhood depression should not go undiagnosed and untreated. With proper treatment, your child can recover sooner and more completelyhelping to ensure his or her good mental health for a lifetime.
Sources: U.S. Food and Drug Administration; National Institute of Mental Health (NIMH)