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 favourite 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 Neuropsychological disorder that affects the whole person – it affects the way one feels, thinks, and acts. Early-onset depression can lead to school failure, conflicting relationships, drinking or 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.

More information about the Signs of Depression in Children and Adolescents.

Do other disorders or behaviours 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.
Almost one-third of six to twelve-year-old children diagnosed with clinical depression will develop bipolar disorder (known as manic depressive illness) within a few years (American Department of Health & Human Services).
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.

What can parents or caregivers do?

If parents or a guardian suspect a problem with depression, they should:

Be aware of the behaviours that concern them and note how long the behaviours 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 assessment, treatment/management and services.
Talk to other families with similar problems in the community.

If we as caregivers are not satisfied with the answers we get, what next?

If you have questions about, or are not satisfied with the child/adolescent’s progress, it is important to discuss these issues with your provider. You and the provider may want to consider the following:

The home experience for the child needs changes or adjustments.
The current treatment plan needs to be re-evaluated.
Discuss with your provider the possibility of a second opinion.

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 youth with neuropsychological disorders.

The comprehensive diagnostic evaluation may include psychological testing, laboratory tests, and consultation with other medical specialists such as a a neurologist or a developmental paediatrician. A comprehensive treatment/management plan may include child/adolescent psychotherapy, parental/family counselling, ongoing evaluations and monitoring, or psychiatric medication. Optimally, the treatment/management plan is developed with the clinical team/family; and, whenever possible, the youth should be involved in the decisions.

Know the facts:

As many as 3% of children and 12% of adolescents may have depression.
Once a young person has experienced a major depression, he or she is at risk of developing another depression within the next five years.
More than 60% of children with mental health problems do not get the help they need.
At least one recent study concludes that treatment of clinical depression is as effective for children as it is for adults.
Depression leads to attempted and completed suicide. Suicide is the third leading cause of death for 15 to 24 year olds 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.

Reviewed by M. Kodsi, M.D., Child and Family Psychiatrist.

* Adapted from NAMI ‘Facts About Childhood Depression’