Recognizing Depression in Children
As I said in an earlier blog entry, most of my childhood was blighted by clinical depression. After I was diagnosed at age 27, my parents told me that they knew something was wrong, but didn’t know what. Not surprising, since I grew up in the 1960s and 70s, and depression in children wasn’t even considered a possibility until the 1980s. But even today, years after the medical community acknowledged that children could be clinically depressed, it is not easy to recognize.
There are a couple of reasons why this is the case. Although more and more people are becoming aware that clinical depression is not a mood but a disease, there are still plenty of people who don’t realize that. So while they might be able to find reasons why an adult might be depressed (trouble with the person’s job or marriage, financial difficulties, etc.) there are generally few reasons that a child might be displaying a sad demeanor, barring major loss of some kind or a dysfunctional home life.
It wouldn’t occur to someone who is looking at depression strictly as a mood change caused by external troubles to think that a child might have clinical depression. After all, most people look back fondly on their childhood as a time when they didn’t have much to worry about beyond getting homework done and making up their Christmas list. So if you’re looking at depression simply as a mood in reaction to difficult circumstances, you’re unlikely to think of depression in connection to children.
Secondly, children actually manifest depression differently than adults do. While they share some depression symptoms with adults, there are some symptoms that are unique to children. So even if you’re savvy about what the typical symptoms of clinical depression are, you might miss seeing depression in a child.
A third reason that depression is often overlooked in children is that they are not skilled at articulating or identifying their feelings. Even adults have trouble describing their clinical depression. Children have not yet developed either their vocabulary or general articulation to the point that they can really effectively tell you when they’re in a depressed mood. Instead of communicating, they may act out, which for them really is a form of communication.
Finally, the constantly evolving development of children makes it hard to say for certain whether a change is here to stay or is just a phase. With adults, it’s often safe to say that a radical change in appetite or weight is a sign of depression (along with other depression symptoms, of course). But my son’s appetite can change radically from week to week. One week he’s eating normally, the next he’s leaving half the food on the plate, and the next he’s eating twice his normal amounts (which usually coincides with growth spurts). So changes in children are often nothing to be concerned about.
So how do you spot depression in a child? I think that parents need to follow their instincts. As I said, my parents knew that something was wrong when I was a child; they just didn’t have the right information available for a correct diagnosis. Fortunately, these days parents and other adults do have a lot of good information about depression in children.
The depression symptoms that are common to all age groups, children to adults, are:
- Persistent sadness and/or irritability
- Feelings of hopelessness and helplessness
- Loss of interest in activities once enjoyed
- Change in appetite and/or sleep patterns
- Feelings of worthlessness or guilt
- Thoughts of death or suicide
Symptoms that might indicate depression in a child:
- Physical complaints that seem to have no cause
- Being isolated socially
- Extreme sensitivity to rejection or failure
- School avoidance
- Reckless behavior
- Repeated emotional outbursts
- Being fearful or anxious
Please note that as with an adult, a child should display these symptoms for more than two weeks before depression is a consideration.
Deborah Gray wrote about depression as a Patient Expert for HealthCentral. She lived with undiagnosed clinical depression, both major episodes and dysthymia, from childhood through young adulthood. She was finally diagnosed at age 27, and since that time, her depression has been successfully managed with medication and psychotherapy.