What is depression?
Clinical depression goes beyond sadness. It's more than having a bad day or coping with a major loss such as the death of a parent, grandparent, or even a favorite pet. It's also not a personal weakness or a character flaw. Youth suffering from clinical depression cannot simply "snap out of it."
Depression is a brain disorder (mental illness) that affects the whole person-it affects the way one feels, thinks, and acts. Early-onset depression can lead to school failure, alcohol or other drug use, and even suicide. However, it is highly treatable.
What are the signs of early-onset depression?
- Persistent sadness and hopelessness
- Withdrawal from friends and from activities once enjoyed
- Increased irritability or agitation
- Missed school or poor school performance
- Changes in eating and sleeping habits
- Indecision, lack of concentration, or forgetfulness
- Poor self-esteem or guilt
- Frequent physical complaints, such as headaches and stomachaches
- Lack of enthusiasm, low energy, or low motivation
- Drug and/or alcohol abuse
- Thoughts of death or suicide
Do other disorders or behaviors commonly coexist with early-onset depression?
- Youth under stress who experience a loss or who have attention, learning, or conduct disorders are at a higher risk for depression. (American Academy of Child & Adolescent Psychiatry [AACAP], 1995)
- Almost one-third of six- to twelve-year-old children diagnosed with major depression will develop bipolar disorder within a few years. (AACAP, 1995)
- Four out of every five runaway youths suffer from depression. (U.S. Select Committee on Children, Youth & Families)
- Clinical depression can contribute to eating disorders. On the other hand, an eating disorder can lead to a state of clinical depression. (Stellefson, Medical University of South Carolina, 1998)
What can parents or caregivers do?
If parents or another adult in a young person's life suspect a problem with depression, they should:
- be aware of the behaviors that concern them and note how long the behaviors have been going on, how often they occur, and how severe they seem;
- see a mental health professional or the child's doctor for evaluation and diagnosis;
- get accurate information from libraries, helplines and other sources;
- ask questions about treatments and services;
- talk to other families with similar problems in the community; and
- find a family support group such as NAMI.
If we as caregivers are not satisfied with the answers we get from a mental healthcare provider, what next?
If you have questions about, or are not satisfied with, the mental health care your child is receiving, it is important to discuss these issues with the provider. Ask for more information and seek help from other sources. You can also call the NAMI HelpLine at the toll free number, (800) 950-6264.
Where should family members or other caregivers seek help?
Early diagnosis and treatment are essential for youth with depression. Youth who exhibit symptoms of depression should be referred to, and further evaluated by, a mental health professional who specializes in treating children and teenagers.
The diagnostic evaluation may include psychological testing, laboratory tests, and consultation with other medical specialists such as a child and adolescent psychiatrist. A comprehensive treatment plan may include psychotherapy, ongoing evaluations and monitoring, or psychiatric medication. Optimally, the treatment plan is developed with the caregiver/family; and, whenever possible, the youth should be involved in the decisions.
Know the facts:
- As many as one in every 33 children and one in eight adolescents may have depression. (U.S. Center for Mental Health Services [CMHS], 1996)
- Once a young person has experienced a major depression, he or she is at risk of developing another depression within the next five years. (CMHS, 1996)
- Two-thirds of children with mental health problems do not get the help they need. (CMHS, 1996)
- A recent study led by Dr. Graham Emslie of the University of Texas, Southwestern Medical Center, concludes that treatment of major depression is as effective for children as it is for adults. (American Medical Association, Archives of General Psychiatry, November 15, 1997)
- Suicide is the third leading cause of death for 15 to 24 year olds (approximately 5,000 young people) and the sixth leading cause of death for five to 15 year olds. The rate of suicide for five to 24 year olds has nearly tripled since 1960. (American Academy of Child & Adolescent Psychiatry [AACAP], 1995.)
Reviewed by David G. Fassler, M.D., child and adolescent psychiatrist, Otter Creek Associates, Burlington, VT and author (with Lynn Dumas) of Help Me, I'm Sad.