By Alicke Grobler
There are many stereotypes and misconceptions about clinical depression perpetuated by media and pop culture. Although there are some common signs and symptoms of depression that occur in most cases, depression can look very different in everyone. The presentation of depression can also vary significantly across different ages and genders.
Depression is not an uncommon occurrence in adults. Recent research indicates that about 16% of adults experience depression in their lifetime. Depression is significantly more common among women and the elderly. Additionally, approximately 65-75% of people with depression are initially diagnosed in adolescence. This indicates that depression is a chronic disorder and most often develops in the teenage years. Because of this, it is essential to know and be able to identify the signs of depression as early as possible, in order to ensure that your child has access to resources and support and develops coping skills early on in the course of the disorder.
Although rare, it is possible for children younger than adolescence to be diagnosed with depression; according to the National Institute of Health (NIH), approximately 2.5% of young children in the US suffer from depression. Under the age of 12, depression is slightly more common in young boys than young girls. However, once children hit adolescence, the rate of depression jumps up to 11%. This rate is the average for all adolescents between 12-18, but the risk of depression increases substantially for older adolescents. Adolescent girls are 2-3 times more likely to develop depression than boys.
This article is not meant to scare parents, but rather to provide them with information and resources to best help their children who may be struggling. However, because depression can manifest differently in everyone, it can be hard to identify it in teens and children, and to distinguish it from the typical and developmentally normative angst of the teen years. As such, the following information will include ways to recognize depression in children and teens, risk factors to look out for, ways to help your child cope with depression, and resources available to parents and children.
Depression most often presents, across ages, as persistently low mood, hopelessness, fatigue, and lack of enjoyment. However, in children, other symptoms may be more obvious including:
- Irritability or anger
- Social withdrawal
- Changes in appetite – eating too much or too little
- Changes in sleep pattern – sleeping too much, not sleeping enough or at all
- Difficulty concentrating or thinking
- Difficulty functioning and completing day to day tasks at school, with friends, or at home.
- Physical complaints such as stomach or headache that do not respond to treatment
- Increased sensitivity to rejection or failure
- Lack of motivation
- Vocal outbursts or crying
- Feelings of guilt or worthlessness
In children under 12 years old, irritability or anger, changes in sleep pattern or appetite, vocal outbursts, and physical complaints may be the easiest to identify and the most strongly expressed symptoms. In adolescents, depression looks more like adults, with major changes in mood and functionality. However, all of the symptoms listed above could apply to a child or adolescent suffering from depression, so it is important to be aware of your child’s mood and behaviors. Children will likely display different symptoms in different settings, and most with significant depression will display a noticeable change in academic performance, social activities, and even appearance.
Some children may be at greater risk for depression than others. This is especially true for children who have a parent with depression. Depression has been linked to a genetic predisposition, and tends to run in families. Children whose parents have depression are also more likely to develop depression earlier than children whose parents do not. Other risk factors include substance use. Depression may also lead to substance abuse in older children and adolescents, which is likely to worsen the symptoms. Children may also develop depression based on major life events, loss of loved ones, or biochemical disturbances.
If you notice some of these behaviors in your child, especially if they are persistent for more than two weeks, do not be afraid to consult a mental health professional.
Depression is a cyclic disorder. This means that those who have depression typically go through periods of feeling healthy and functioning well, and periods or episodes of depression. Major Depressive Disorder is diagnosed if an individual has a depressive episode lasting two weeks or more that significantly interferes with their daily functioning. However, depressive episodes often end on their own after a period of time. The end of a depressive episode does not mean that depression has been cured and is no longer a cause for concern; rather, it is highly likely that a depressive episode will recur in the future. Therefore, even if your child is not currently exhibiting the symptoms or signs described, or if the symptoms stop or improve naturally, it is still essential to seek resources and support for your child.
There are a variety of effective treatment options for depression, including psychopharmacology and psychotherapy. Mindfulness and cognitive behavioral therapy have both been shown to be effective in reducing depressive symptoms, and Mindfulness Based Cognitive Therapy has been shown to be effective in reducing the risk of relapse of a depressive episode. If you are concerned that your child is depressed, you have a number of options to seek support.
Your pediatrician may be able to help you find suitable antidepressants for your child, and can likely refer you to a psychiatrist and/or therapist.
Your child’s school counselor can connect you to resources both in and out of school.
The Youth and Family Services Social Worker, Kristie Demirev, at the Community Center can work with families on an individual basis to assess their needs and connect them to supports they need. She can be reached at 781 698 4843 and is free to all residents.
The following articles are also helpful for educating yourself about depression in children and adolescents. If you are concerned about your child, please reach out and find support for yourself and your family:
Hankin, B. L., Young, J. F., Abela, J. R., Smolen, A., Jenness, J. L., Gulley, L. D., … & Oppenheimer, C. W. (2015). Depression from childhood into late adolescence: Influence of gender, development, genetic susceptibility, and peer stress. Journal of abnormal psychology, 124(4), 803.
Avenevoli, S., Swendsen, J., He, J. P., Burstein, M., & Merikangas, K. R. (2015). Major depression in the National Comorbidity Survey–Adolescent Supplement: prevalence, correlates, and treatment. Journal of the American Academy of Child & Adolescent Psychiatry, 54(1), 37-44.
Alicke Grobler is a Master of Social Work candidate at Boston College, studying clinical social work with a focus in mental health. She is currently an intern with the Lexington Human Services Department, and aspires to help increase access to and awareness of mental health care for low income families and military families. She can be reached by calling the Human Services Department at (781) 698-4840.
Parenting Matters columns are presented to the Lexington community through a collaboration with the Lexington Human Services Department of Youth Services. Information provided in these columns is general in nature and not intended to be a substitute for a personalized clinical evaluation. Please see a professional for any concerns you may have about this topic or any others in a Parenting Matters column. LEXINGTON COMMUNITY CENTER 39 Marrett Road, Lexington, MA 02421. Open Monday – Friday 8:30 AM to 4:30 PM