Childhood Depression

Adults are not the only people who suffer from depression. Children, teenagers, and elderly may also become depressed. This article discusses how major depression, bipolar, and dysthymic disorder effects children, and childhood depression stats, symptoms, and treatment.


For those who associate depression with teenage angst or the pains and struggles of a difficult old age, or who think of childhood as a carefree, happy time, it may be unexpected to learn that depression can occur in children. There was a time when even doctors didn’t believe in childhood depression. This article gives an overview of childhood depression.

Overview of Childhood Depression

Children and adolescents are often diagnosed with three of the mood disorders, all of which include depression in one way or another: major depressive disorder, bipolar disorder, and dysthymic disorder. 

  • Major Depressive Disorder, also known as clinical depression or unipolar depression, is a mood disorder often characterized by episodes or periods of sadness, loss of interest in life, changes in sleep and eating patterns, and increased risk of suicide.
  • Bipolar Disorder, formerly known as manic depression, is a mood disorder characterized by episodes of depression, but also mania, a mood at the opposite end of the spectrum from depression and characterized by an extreme amount of energy, an elated mood, and irritability, or hypomania, a less intense form of mania. Bipolar disorder often begins in adolescence.
  • Dysthymic Disorder, or dysthymia, is usually characterized as a chronic depression with milder symptoms than major depression. It frequently begins during childhood or adolescence and is accompanied by notable changes in personality.

But the single most common type of depression in children and adolescents is according to the Surgeon General’s report, a non-pathological depression: short-term depressed feelings that occur in response to a negative or problematic experience, such as being rejected or slighted, or experiencing a loss. (Unfortunately, the Surgeon General’s report, chapter 3 refers to this by the wrong name, calling it “reactive depression, also known as adjustment disorder with depressed mood.” In this series of articles, you will find it referred to as non-pathological depression, a term used by Dr. Scott Patten in his article “Sensitization: The Sine qua non of the depressive disorders?”

This type of depression is a normal response to life’s usual range of adverse events, with symptoms usually lasting a maximum of several weeks and going away without any type of medical intervention, although, of course, being kind and understanding to someone who is depressed for any reason can be helpful. If a child experiences an extremely shocking or traumatic, that is a different situation.

Some Facts and Statistics About Childhood Depression

According to the Surgeon General’s report, 10 to 15 percent of children and adolescents show some symptom of depression at any given time, but a diagnosis of major depression is appropriate for only about 5 percent of 9 to 17 year olds. For children and adolescents who have an episode of major depression, it often lasts 7-9 months.  Children and adolescents who have dysthymic disorder are generally affected for a period of about 4 years.

For children and adolescents with major depression, it is often not the only disorder. About two-thirds of children and adolescents who have major depressive disorder will also have another mental disorder. The disorders most commonly seen along with major depression include dysthymia, anxiety disorders, disruptive or antisocial disorders, or a substance abuse disorder.

An initial occurrence of childhood depression is followed by a recurrence in 20 to 40 percent of cases within 2 years. Seventy percent of children who experience depression, have a subsequent experience of depression by the time they are adults.

Symptoms

The symptoms of major depressive disorder are sadness, loss of interest in activities that were once found interesting, and feelings of being inadequate and unloved. Children may exhibit pessimism and hopelessness about the future and feel that life isn’t of value, or even that it would be better ended. Depressed children may also be irritable and have difficulty concentrating. They may exhibit indecision and lack of motivation, have changes in their normal patterns of eating and sleeping, and fail to take care of their appearance and personal hygiene. Unlike adults, children rarely exhibit psychotic features, while they are more likely than adults to exhibit anxiety.

The symptoms of dysthymic disorder are lower key depression that exhibits on most days and during most of the day. Children may become so used to being depressed, that they come to a point at which they no longer realize that they are “not themselves.”

Bipolar disorder includes periods of depression on the one hand and periods of mania on the other. During mania, the child may have so much energy s/he doesn’t want to sleep and has difficulty sleeping when s/he tries. A child may become louder, quicker, less discriminating, and more creative. On the other hand, a child with mania may become delusional about his or her talents and abilities, and this combined with lowered inhibition and increased preoccupation with sexuality can lead to risky choices that the child would not otherwise make.

Treatment

Treatment options for childhood depression include psychotherapy and antidepressant medicine. Studies of the most effective treatment are ongoing, but the research to date suggests that cognitive behavioral therapy may be particularly effective in helping children develop a measure of control and an outlook that can help counteract their symptoms.

Sources

surgeongeneral.gov

mayoclinic.com

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